The perfect family: decision making in biparental care.

PubMed

Akçay, Erol; Roughgarden, Joan

2009-10-13

Previous theoretical work on parental decisions in biparental care has emphasized the role of the conflict between evolutionary interests of parents in these decisions. A prominent prediction from this work is that parents should compensate for decreases in each other's effort, but only partially so. However, experimental tests that manipulate parents and measure their responses fail to confirm this prediction. At the same time, the process of parental decision making has remained unexplored theoretically. We develop a model to address the discrepancy between experiments and the theoretical prediction, and explore how assuming different decision making processes changes the prediction from the theory. We assume that parents make decisions in behavioral time. They have a fixed time budget, and allocate it between two parental tasks: provisioning the offspring and defending the nest. The proximate determinant of the allocation decisions are parents' behavioral objectives. We assume both parents aim to maximize the offspring production from the nest. Experimental manipulations change the shape of the nest production function. We consider two different scenarios for how parents make decisions: one where parents communicate with each other and act together (the perfect family), and one where they do not communicate, and act independently (the almost perfect family). The perfect family model is able to generate all the types of responses seen in experimental studies. The kind of response predicted depends on the nest production function, i.e. how parents' allocations affect offspring production, and the type of experimental manipulation. In particular, we find that complementarity of parents' allocations promotes matching responses. In contrast, the relative responses do not depend on the type of manipulation in the almost perfect family model. These results highlight the importance of the interaction between nest production function and how parents make decisions, factors that have largely been overlooked in previous models.

Toward a Multilevel Perspective on the Allocation of Educational Resources.

ERIC Educational Resources Information Center

Monk, David H.

1981-01-01

The importance of the following is demonstrated: (1) striking a balance between the attention given to resource allocation practices at macro compared to microlevels of decision making; and (2) learning more about how resource allocation decisions made at one level affect practices at other levels of the educational system. (Author/GK)

S4HARA: System for HIV/AIDS resource allocation.

PubMed

Lasry, Arielle; Carter, Michael W; Zaric, Gregory S

2008-03-26

HIV/AIDS resource allocation decisions are influenced by political, social, ethical and other factors that are difficult to quantify. Consequently, quantitative models of HIV/AIDS resource allocation have had limited impact on actual spending decisions. We propose a decision-support System for HIV/AIDS Resource Allocation (S4HARA) that takes into consideration both principles of efficient resource allocation and the role of non-quantifiable influences on the decision-making process for resource allocation. S4HARA is a four-step spreadsheet-based model. The first step serves to identify the factors currently influencing HIV/AIDS allocation decisions. The second step consists of prioritizing HIV/AIDS interventions. The third step involves allocating the budget to the HIV/AIDS interventions using a rational approach. Decision-makers can select from several rational models of resource allocation depending on availability of data and level of complexity. The last step combines the results of the first and third steps to highlight the influencing factors that act as barriers or facilitators to the results suggested by the rational resource allocation approach. Actionable recommendations are then made to improve the allocation. We illustrate S4HARA in the context of a primary healthcare clinic in South Africa. The clinic offers six types of HIV/AIDS interventions and spends US$750,000 annually on these programs. Current allocation decisions are influenced by donors, NGOs and the government as well as by ethical and religious factors. Without additional funding, an optimal allocation of the total budget suggests that the portion allotted to condom distribution be increased from 1% to 15% and the portion allotted to prevention and treatment of opportunistic infections be increased from 43% to 71%, while allocation to other interventions should decrease. Condom uptake at the clinic should be increased by changing the condom distribution policy from a pull system to a push system. NGOs and donors promoting antiretroviral programs at the clinic should be sensitized to the results of the model and urged to invest in wellness programs aimed at the prevention and treatment of opportunistic infections. S4HARA differentiates itself from other decision support tools by providing rational HIV/AIDS resource allocation capabilities as well as consideration of the realities facing authorities in their decision-making process.

Decision-making in crisis: Applying a healthcare triage methodology to business continuity management.

PubMed

Moore, Bethany; Bone, Eric A

2017-01-01

The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.

Satisficing in Split-Second Decision Making Is Characterized by Strategic Cue Discounting

ERIC Educational Resources Information Center

Oh, Hanna; Beck, Jeffrey M.; Zhu, Pingping; Sommer, Marc A.; Ferrari, Silvia; Egner, Tobias

2016-01-01

Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through "satisficing," fast but "good-enough" heuristic decision making that prioritizes some sources of…

What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?

PubMed Central

Lane, Haylee; Sturgess, Tamica; Philip, Kathleen; Markham, Donna; Martin, Jennifer; Walsh, Jill; Hubbard, Wendy; Haines, Terry

2018-01-01

Background: Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Methods: Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Results: Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Conclusion: Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers face. PMID:29764105

TESTING MULTI-CRITERIA DECISION ANALYSIS FOR MORE TRANSPARENT RESOURCE-ALLOCATION DECISION MAKING IN COLOMBIA.

PubMed

Castro Jaramillo, Hector Eduardo; Goetghebeur, Mireille; Moreno-Mattar, Ornella

2016-01-01

In 2012, Colombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute (IETS), the disbandment of the Regulatory Commission for Health and the reassignment of reimbursement decision-making powers to the Ministry of Health and Social Protection (MoHSP). These dynamic changes provided the opportunity to test Multi-Criteria Decision Analysis (MCDA) for systematic and more transparent resource-allocation decision-making. During 2012 and 2013, the MCDA framework Evidence and Value: Impact on Decision Making (EVIDEM) was tested in Colombia. This consisted of a preparatory stage in which the investigators conducted literature searches and produced HTA reports for four interventions of interest, followed by a panel session with decision makers. This method was contrasted with a current approach used in Colombia for updating the publicly financed benefits package (POS), where narrative health technology assessment (HTA) reports are presented alongside comprehensive budget impact analyses (BIAs). Disease severity, size of population, and efficacy ranked at the top among fifteen preselected relevant criteria. MCDA estimates of technologies of interest ranged between 71 to 90 percent of maximum value. The ranking of technologies was sensitive to the methods used. Participants considered that a two-step approach including an MCDA template, complemented by a detailed BIA would be the best approach to assist decision-making in this context. Participants agreed that systematic priority setting should take place in Colombia. This work may serve as the basis to the MoHSP on its interest of setting up a systematic and more transparent process for resource-allocation decision-making.

Task allocation among multiple intelligent robots

NASA Technical Reports Server (NTRS)

Gasser, L.; Bekey, G.

1987-01-01

Researchers describe the design of a decentralized mechanism for allocating assembly tasks in a multiple robot assembly workstation. Currently, the approach focuses on distributed allocation to explore its feasibility and its potential for adaptability to changing circumstances, rather than for optimizing throughput. Individual greedy robots make their own local allocation decisions using both dynamic allocation policies which propagate through a network of allocation goals, and local static and dynamic constraints describing which robots are elibible for which assembly tasks. Global coherence is achieved by proper weighting of allocation pressures propagating through the assembly plan. Deadlock avoidance and synchronization is achieved using periodic reassessments of local allocation decisions, ageing of allocation goals, and short-term allocation locks on goals.

A model of human decision making in multiple process monitoring situations

NASA Technical Reports Server (NTRS)

Greenstein, J. S.; Rouse, W. B.

1982-01-01

Human decision making in multiple process monitoring situations is considered. It is proposed that human decision making in many multiple process monitoring situations can be modeled in terms of the human's detection of process related events and his allocation of attention among processes once he feels event have occurred. A mathematical model of human event detection and attention allocation performance in multiple process monitoring situations is developed. An assumption made in developing the model is that, in attempting to detect events, the human generates estimates of the probabilities that events have occurred. An elementary pattern recognition technique, discriminant analysis, is used to model the human's generation of these probability estimates. The performance of the model is compared to that of four subjects in a multiple process monitoring situation requiring allocation of attention among processes.

Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2018-04-13

Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

Tailoring Software for Multiple Processor Systems

DTIC Science & Technology

1982-10-01

resource management decisions . Despite the lack of programming support, the use of multiple processor systems has grown sub- -stantially. Software has...making resource management decisions . Specifically, program- 1 mers need not allocate specific hardware resources to individual program components...Instead, such allocation decisions are automatically made based on high-level resource directives stated by ap- plication programmers, where each directive

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.

Decentralisation and health services delivery in Tanzania: Analysis of decision space in planning, allocation, and use of financial resources.

PubMed

Kigume, Ramadhani; Maluka, Stephen; Kamuzora, Peter

2018-04-01

While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space. In the areas of priority setting and planning, district health authorities had moderate decision space. However, in the financial resource allocation and expenditure of funds from the central government, the districts had narrow decision-making space. The districts, nevertheless, had wider decision-making space in mobilising and using locally generated financial resources. However, the ability of the districts to allocate and use locally generated resources was constrained by bureaucratic procedures of the central government. The study concludes that decentralisation by devolution which is being promoted in the policy documents in Tanzania is yet to be realised at the district and local levels. The study recommends that the central government should provide more space to the decentralised district health systems to incorporate locally defined priorities in the district health plans. Copyright © 2018 John Wiley & Sons, Ltd.

Funding Based on Needs? A Study on the Use of Needs Assessment Data by a Major Humanitarian Health Assistance Donor in its Decisions to Allocate Funds

PubMed Central

Olin, Emma; von Schreeb, Johan

2014-01-01

Background: International humanitarian assistance is essential for disaster-affected populations, particularly in resource scarce settings. To target such assistance, needs assessments are required. According to internationally endorsed principles, donor governments should provide funding for humanitarian assistance based on need. Aim: The aim of this study is to explore a major donor’s use of needs assessment data in decision-making for allocations of funds for health-related humanitarian assistance contributions. Setting: This is a case study of the Swedish International Development Cooperation Agency (Sida), a major and respected international donor of humanitarian assistance. Methods: To explore Sida’s use of needs assessment data in practice for needs-based allocations, we reviewed all decision documents and assessment memoranda for humanitarian assistance contributions for 2012 using content analysis; this was followed by interviews with key personnel at Sida. Results: Our document analysis found that needs assessment data was not systematically included in Sida’s assessment memoranda and decision documents. In the interviews, we observed various descriptions of the concept of needs assessments, the importance of contextual influences as well as previous collaborations with implementing humanitarian assistance organizations. Our findings indicate that policies guiding funding decisions on humanitarian assistance need to be matched with available needs assessment data and that terminologies and concepts have to be clearly defined. Conclusion: Based on the document analysis and the interviews, it is unclear how well Sida used needs assessment data for decisions to allocate funds. However, although our observations show that needs assessments are seldom used in decision making, Sida’s use of needs assessments has improved compared to a previous study. To improve project funds allocations based on needs assessment data, it will be critical to develop distinct frameworks for allocation distributions based on needs assessment and clear definitions, measurements and interpretations of needs. Key words: Needs assessment, humanitarian assistance, disasters, donor decision-making PMID:24894417

Administrative Decision Making and Resource Allocation.

ERIC Educational Resources Information Center

Sardy, Susan; Sardy, Hyman

This paper considers selected aspects of the systems analysis of administrative decisionmaking regarding resource allocations in an educational system. A model of the instructional materials purchase system is presented. The major components of this model are: environment, input, decision process, conversion structure, conversion process, output,…

Influence of biases in numerical magnitude allocation on human prosocial decision making.

PubMed

Arshad, Qadeer; Nigmatullina, Yuliya; Siddiqui, Shuaib; Franka, Mustafa; Mediratta, Saniya; Ramachandaran, Sanjeev; Lobo, Rhannon; Malhotra, Paresh A; Roberts, R E; Bronstein, Adolfo M

2017-12-01

Over the past decade neuroscientific research has attempted to probe the neurobiological underpinnings of human prosocial decision making. Such research has almost ubiquitously employed tasks such as the dictator game or similar variations (i.e., ultimatum game). Considering the explicit numerical nature of such tasks, it is surprising that the influence of numerical cognition on decision making during task performance remains unknown. While performing these tasks, participants typically tend to anchor on a 50:50 split that necessitates an explicit numerical judgement (i.e., number-pair bisection). Accordingly, we hypothesize that the decision-making process during the dictator game recruits overlapping cognitive processes to those known to be engaged during number-pair bisection. We observed that biases in numerical magnitude allocation correlated with the formulation of decisions during the dictator game. That is, intrinsic biases toward smaller numerical magnitudes were associated with the formulation of less favorable decisions, whereas biases toward larger magnitudes were associated with more favorable choices. We proceeded to corroborate this relationship by subliminally and systematically inducing biases in numerical magnitude toward either higher or lower numbers using a visuo-vestibular stimulation paradigm. Such subliminal alterations in numerical magnitude allocation led to proportional and corresponding changes to an individual's decision making during the dictator game. Critically, no relationship was observed between neither intrinsic nor induced biases in numerical magnitude on decision making when assessed using a nonnumerical-based prosocial questionnaire. Our findings demonstrate numerical influences on decisions formulated during the dictator game and highlight the necessity to control for confounds associated with numerical cognition in human decision-making paradigms. NEW & NOTEWORTHY We demonstrate that intrinsic biases in numerical magnitude can directly predict the amount of money donated by an individual to an anonymous stranger during the dictator game. Furthermore, subliminally inducing perceptual biases in numerical-magnitude allocation can actively drive prosocial choices in the corresponding direction. Our findings provide evidence for numerical influences on decision making during performance of the dictator game. Accordingly, without the implementation of an adequate control for numerical influences, the dictator game and other tasks with an inherent numerical component (i.e., ultimatum game) should be employed with caution in the assessment of human behavior. Copyright © 2017 the American Physiological Society.

Direct Allocation Costing: Informed Management Decisions in a Changing Environment.

ERIC Educational Resources Information Center

Mancini, Cesidio G.; Goeres, Ernest R.

1995-01-01

It is argued that colleges and universities can use direct allocation costing to provide quantitative information needed for decision making. This method of analysis requires institutions to modify traditional ideas of costing, looking to the private sector for examples of accurate costing techniques. (MSE)

Effect of social influence on effort-allocation for monetary rewards.

PubMed

Gilman, Jodi M; Treadway, Michael T; Curran, Max T; Calderon, Vanessa; Evins, A Eden

2015-01-01

Though decades of research have shown that people are highly influenced by peers, few studies have directly assessed how the value of social conformity is weighed against other types of costs and benefits. Using an effort-based decision-making paradigm with a novel social influence manipulation, we measured how social influence affected individuals' decisions to allocate effort for monetary rewards during trials with either high or low probability of receiving a reward. We found that information about the effort-allocation of peers modulated participant choices, specifically during conditions of low probability of obtaining a reward. This suggests that peer influence affects effort-based choices to obtain rewards especially under conditions of risk. This study provides evidence that people value social conformity in addition to other costs and benefits when allocating effort, and suggests that neuroeconomic studies that assess trade-offs between effort and reward should consider social environment as a factor that can influence decision-making.

Husband and Wife Perspectives on Farm Household Decision-making Authority and Evidence on Intra-household Accord in Rural Tanzania.

PubMed

Anderson, C Leigh; Reynolds, Travis W; Gugerty, Mary Kay

2017-02-01

We use OLS and logistic regression to investigate variation in husband and wife perspectives on the division of authority over agriculture-related decisions within households in rural Tanzania. Using original data from husbands and wives (interviewed separately) in 1,851 Tanzanian households, the analysis examines differences in the wife's authority over 13 household and farming decisions. The study finds that the level of decision-making authority allocated to wives by their husbands, and the authority allocated by wives to themselves, both vary significantly across households. In addition to commonly considered assets such as women's age and education, in rural agricultural households women's health and labor activities also appear to matter for perceptions of authority. We also find husbands and wives interviewed separately frequently disagree with each other over who holds authority over key farming, family, and livelihood decisions. Further, the results of OLS and logistic regression suggest that even after controlling for various individual, household, and regional characteristics, husband and wife claims to decision-making authority continue to vary systematically by decision-suggesting that decision characteristics themselves also matter. The absence of spousal agreement over the allocation of authority (i.e., a lack of "intra-household accord") over different farm and household decisions is problematic for interventions seeking to use survey data to develop and inform strategies for reducing gender inequalities or empowering women in rural agricultural households. Findings provide policy and program insights into when studies interviewing only a single spouse or considering only a single decision may inaccurately characterize intra-household decision-making dynamics.

Tactical decision making for selective expansion of operating room resources incorporating financial criteria and uncertainty in subspecialties' future workloads.

PubMed

Dexter, Franklin; Ledolter, Johannes; Wachtel, Ruth E

2005-05-01

We considered the allocation of operating room (OR) time at facilities where the strategic decision had been made to increase the number of ORs. Allocation occurs in two stages: a long-term tactical stage followed by short-term operational stage. Tactical decisions, approximately 1 yr in advance, determine what specialized equipment and expertise will be needed. Tactical decisions are based on estimates of future OR workload for each subspecialty or surgeon. We show that groups of surgeons can be excluded from consideration at this tactical stage (e.g., surgeons who need intensive care beds or those with below average contribution margins per OR hour). Lower and upper limits are estimated for the future demand of OR time by the remaining surgeons. Thus, initial OR allocations can be accomplished with only partial information on future OR workload. Once the new ORs open, operational decision-making based on OR efficiency is used to fill the OR time and adjust staffing. Surgeons who were not allocated additional time at the tactical stage are provided increased OR time through operational adjustments based on their actual workload. In a case study from a tertiary hospital, future demand estimates were needed for only 15% of surgeons, illustrating the practicality of these methods for use in tactical OR allocation decisions.

Modelling decision-making by pilots

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.

1993-01-01

Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).

Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

PubMed Central

Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

2013-01-01

ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

Reciprocal Cost Allocation and Decision Making for Universities.

ERIC Educational Resources Information Center

Metzger, Lawrence M.

1994-01-01

Examines the use of the reciprocal method as an alternative to more conventional methods of university service department cost allocation. This method can be used with software that is readily available and with already known data. Reciprocal cost allocation will provide appropriate allocation values for financial reporting and data for university…

Resource allocation in public health practice: a national survey of local public health officials.

PubMed

Baum, Nancy M; DesRoches, Catherine; Campbell, Eric G; Goold, Susan Dorr

2011-01-01

The purpose of this study was to gain an empirical understanding of the types of allocation decisions local health officials (LHOs) make and the factors that influence those allocation decisions. We conducted a national survey of LHOs in the United States in 2008 to 2009. The sample was stratified by the size of the population served by the department. We merged our data with data from the 2008 National Association of County and City Health Officials Profile survey. Descriptive statistics were generated using weighted data. Our final sample size was 608 respondents, with an average of 10 years experience. The LHOs reported little shifting of resources among population groups but greater capacity to redirect staffing time. Less than half of LHOs reported using economic analyses or conducting needs assessments when setting priorities. Having sole provider status in a community strongly influenced LHOs' allocation decisions. In addition, the effectiveness of activities, previous budget allocations, and input from boards of health were influential factors in allocation decisions. Public expectations were moderately to very influential, but direct public input had a low impact on allocation decisions. Survey findings provide a clearer understanding of how LHOs fulfill their obligations as stewards of public health resources and ensure effective activities and access to needed services. It may be useful to assess the value of more structured allocation methods (eg, decision frameworks) in the allocation process. Expanding opportunities for public engagement in priority setting may also be valuable for difficult allocation decisions.

Understanding Resource Allocation in High Schools.

ERIC Educational Resources Information Center

Hartman, William T.

Despite commonly held views concerning educators' rational decision-making behavior, there are competing interpretations of school personnels' objective, actions, and decision-making processes. Alternative explanations emphasize bureaucratic routine, administrative convenience, educator self-interest, and political motivations, rather than…

Towards Rational Decision-Making in Secondary Education.

ERIC Educational Resources Information Center

Cohn, Elchanan

Without a conscious effort to achieve optimum resource allocation, there is a real danger that educational resources may be wasted. This document uses input-output analysis to develop a model for rational decision-making in secondary education. (LLR)

Many-objective robust decision making for water allocation under climate change.

PubMed

Yan, Dan; Ludwig, Fulco; Huang, He Qing; Werners, Saskia E

2017-12-31

Water allocation is facing profound challenges due to climate change uncertainties. To identify adaptive water allocation strategies that are robust to climate change uncertainties, a model framework combining many-objective robust decision making and biophysical modeling is developed for large rivers. The framework was applied to the Pearl River basin (PRB), China where sufficient flow to the delta is required to reduce saltwater intrusion in the dry season. Before identifying and assessing robust water allocation plans for the future, the performance of ten state-of-the-art MOEAs (multi-objective evolutionary algorithms) is evaluated for the water allocation problem in the PRB. The Borg multi-objective evolutionary algorithm (Borg MOEA), which is a self-adaptive optimization algorithm, has the best performance during the historical periods. Therefore it is selected to generate new water allocation plans for the future (2079-2099). This study shows that robust decision making using carefully selected MOEAs can help limit saltwater intrusion in the Pearl River Delta. However, the framework could perform poorly due to larger than expected climate change impacts on water availability. Results also show that subjective design choices from the researchers and/or water managers could potentially affect the ability of the model framework, and cause the most robust water allocation plans to fail under future climate change. Developing robust allocation plans in a river basin suffering from increasing water shortage requires the researchers and water managers to well characterize future climate change of the study regions and vulnerabilities of their tools. Copyright © 2017 Elsevier B.V. All rights reserved.

Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions.

PubMed

Husain, Sara; Kadir, Masood; Fatmi, Zafar

2007-01-23

Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make financial allocations based on real, rather than perceived needs. With a large part of HIV program funding dedicated to public-private partnerships, it becomes imperative to develop public sector capacity to administer contracts, coordinate and monitor activities of the non-governmental sector.

Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions

PubMed Central

Husain, Sara; Kadir, Masood; Fatmi, Zafar

2007-01-01

Background Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. Methods A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. Results HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Conclusion Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective decision making is required to make financial allocations based on real, rather than perceived needs. With a large part of HIV program funding dedicated to public-private partnerships, it becomes imperative to develop public sector capacity to administer contracts, coordinate and monitor activities of the non-governmental sector. PMID:17244371

Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

PubMed

Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

2016-09-01

To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

Adaptive sampling of information in perceptual decision-making.

PubMed

Cassey, Thomas C; Evens, David R; Bogacz, Rafal; Marshall, James A R; Ludwig, Casimir J H

2013-01-01

In many perceptual and cognitive decision-making problems, humans sample multiple noisy information sources serially, and integrate the sampled information to make an overall decision. We derive the optimal decision procedure for two-alternative choice tasks in which the different options are sampled one at a time, sources vary in the quality of the information they provide, and the available time is fixed. To maximize accuracy, the optimal observer allocates time to sampling different information sources in proportion to their noise levels. We tested human observers in a corresponding perceptual decision-making task. Observers compared the direction of two random dot motion patterns that were triggered only when fixated. Observers allocated more time to the noisier pattern, in a manner that correlated with their sensory uncertainty about the direction of the patterns. There were several differences between the optimal observer predictions and human behaviour. These differences point to a number of other factors, beyond the quality of the currently available sources of information, that influences the sampling strategy.

Conceptual Problems.

ERIC Educational Resources Information Center

Foley, Walter J.

A systems theory approach to information requirements in education and in evaluation strategies is applied to decision making. Educational decision making itself involves long range planning, system structuring to implement goals, system allocation (cost), and system monitoring which provides the feedback. Each level requires differential…

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game.

PubMed

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders' hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders' rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders' rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five.

Societal values in the allocation of healthcare resources: is it all about the health gain?

PubMed

Stafinski, Tania; Menon, Devidas; Marshall, Deborah; Caulfield, Timothy

2011-01-01

Over the past decade, public distrust in unavoidable value-laden decisions on the allocation of resources to new health technologies has grown. In response, healthcare organizations have made considerable efforts to improve their acceptability by increasing transparency in decision-making processes. However, the social value judgments (distributive preferences of the public) embedded in them have yet to be defined. While the need to explicate such judgments has become widely recognized, the most appropriate approach to accomplishing this remains unclear. The aims of this review were to identify factors around which distributive preferences of the public have been sought, create a list of social values proposed or used in current resource allocation decision-making processes for new health technologies, and review approaches to eliciting such values from the general public. Social values proposed or used in making resource allocation decisions for new health technologies were identified through three approaches: (i) a comprehensive review of published, peer-reviewed, empirical studies of public preferences for the distribution of healthcare; (ii) an analysis of non-technical factors or social value statements considered by technology funding decision-making processes in Canada and abroad; and (iii) a review of appeals to funding decisions on grounds in part related to social value judgments. A total of 34 empirical studies, 10 technology funding decision-making processes, and 12 appeals to decisions were identified and reviewed. The key factors/patient characteristics addressed through policy statements and around which distributive preferences of the public have been sought included severity of illness, immediate need, age (and its relationship to lifetime health), health gain (amount and final outcome/health state), personal responsibility for illness, caregiving responsibilities, and number of patients who could benefit (rarity). Empirical studies typically examined the importance of these factors in isolation. Therefore, the extent to which preferences around one factor may be modified in the presence of others is still unclear. Research that seeks to clarify interactions among factors by asking the public to weigh several of them at once is needed to ensure the relevance of elicited preferences to real-world technology funding decisions.

Pilot interaction with automated airborne decision making systems

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Chu, Y. Y.; Greenstein, J. S.; Walden, R. S.

1976-01-01

An investigation was made of interaction between a human pilot and automated on-board decision making systems. Research was initiated on the topic of pilot problem solving in automated and semi-automated flight management systems and attempts were made to develop a model of human decision making in a multi-task situation. A study was made of allocation of responsibility between human and computer, and discussed were various pilot performance parameters with varying degrees of automation. Optimal allocation of responsibility between human and computer was considered and some theoretical results found in the literature were presented. The pilot as a problem solver was discussed. Finally the design of displays, controls, procedures, and computer aids for problem solving tasks in automated and semi-automated systems was considered.

Exploring Data-Driven Decision-Making in the Field: How Faculty Use Data and Other Forms of Information to Guide Instructional Decision-Making. WCER Working Paper No. 2014-3

ERIC Educational Resources Information Center

Hora, Matthew T.; Bouwma-Gearhart, Jana; Park, Hyoung Joon

2014-01-01

A defining characteristic of current U.S. educational policy is the use of data to inform decisions about resource allocation, teacher hiring, and curriculum and instruction. Perhaps the biggest challenge to data-driven decision making (DDDM) is that data use alone does not automatically result in improved teaching and learning. Research indicates…

The California Law Enforcement Community’s Intelligence-Led Policing Capacity

DTIC Science & Technology

2010-12-01

intelligence product used for sound decision making , strategic targeting, and more efficient resource allocation, whereas lack of clarity and the...providing law enforcement executives with actionable intelligence products for sound decision making , strategic targeting, and efficient resource

Decision making in the Navy Budget Office.

DTIC Science & Technology

1986-06-01

The primary objective of this thesis is to familiarize the reader with the budget decision making pocesses and considerations which influence the ...formulation of the Department of the navy’s (DON) budget from perspective of the Office of Budget and Reports (OBR), the impact of resource allocation...budgetary) decisions upon the overall framwork within which DON budgetary decisions are made, the organizational

An Analysis and Allocation System for Library Collections Budgets: The Comprehensive Allocation Process (CAP)

ERIC Educational Resources Information Center

Lyons, Lucy Eleonore; Blosser, John

2012-01-01

The "Comprehensive Allocation Process" (CAP) is a reproducible decision-making structure for the allocation of new collections funds, for the reallocation of funds within stagnant budgets, and for budget cuts in the face of reduced funding levels. This system was designed to overcome common shortcomings of current methods. Its philosophical…

The past, present and future of HIV, AIDS and resource allocation

PubMed Central

2009-01-01

Background How should HIV and AIDS resources be allocated to achieve the greatest possible impact? This paper begins with a theoretical discussion of this issue, describing the key elements of an "evidence-based allocation strategy". While it is noted that the quality of epidemiological and economic data remains inadequate to define such an optimal strategy, there do exist tools and research which can lead countries in a way that they can make allocation decisions. Furthermore, there are clear indications that most countries are not allocating their HIV and AIDS resources in a way which is likely to achieve the greatest possible impact. For example, it is noted that neighboring countries, even when they have a similar prevalence of HIV, nonetheless often allocate their resources in radically different ways. These differing allocation patterns appear to be attributable to a number of different issues, including a lack of data, contradictory results in existing data, a need for overemphasizing a multisectoral response, a lack of political will, a general inefficiency in the use of resources when they do get allocated, poor planning and a lack of control over the way resources get allocated. Methods There are a number of tools currently available which can improve the resource-allocation process. Tools such as the Resource Needs Model (RNM) can provide policymakers with a clearer idea of resource requirements, whereas other tools such as Goals and the Allocation by Cost-Effectiveness (ABCE) models can provide countries with a clearer vision of how they might reallocate funds. Results Examples from nine different countries provide information about how policymakers are trying to make their resource-allocation strategies more "evidence based". By identifying the challenges and successes of these nine countries in making more informed allocation decisions, it is hoped that future resource-allocation decisions for all countries can be improved. Conclusion We discuss the future of resource allocation, noting the types of additional data which will be required and the improvements in existing tools which could be made. PMID:19922688

76 FR 24548 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... committee uses third-party analyst research and a proprietary fundamental process to make allocation... investment process: Step 1: The Sub-Adviser's use of third-party research consists of analyzing the consensus... analyst research and a proprietary fundamental process to make allocation decisions. Changes to the Fund's...

What Does it Really Cost? Allocating Indirect Costs.

ERIC Educational Resources Information Center

Snyder, Herbert; Davenport, Elisabeth

1997-01-01

Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

Utilization of health technologies-Do not look where there is a light; shine your light where there is a need to look! Relating national health goals with resource allocation decision-making; illustration through examining the Israeli healthcare system.

PubMed

Shavit, Oren

2009-10-01

Innovative health technologies are often the focus of attention. However, in the allocation of public resources for improving health, the focus should be on the health needs of the population. It is the need that should be analyzed first, and decision makers should then evaluate the full range of interventions available, whether new or old, to meet this need. This is in contrast to analyzing the technology first and then characterizing the need it meets, which is the current practice in reimbursement decision-making in several countries. The identified health need should define national health goals, and these goals should be proactively assimilated into the reimbursement decision-making process. Differential reimbursement rates could reflect the relative contribution of the technology to the unmet health need.

Decision space for health workforce management in decentralized settings: a case study in Uganda.

PubMed

Alonso-Garbayo, Alvaro; Raven, Joanna; Theobald, Sally; Ssengooba, Freddie; Nattimba, Milly; Martineau, Tim

2017-11-01

The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that managers have in six areas of HRM (e.g. policy, planning, remuneration and incentives, performance management, education and information) the study compares the roles allocated by Uganda's policy and regulatory frameworks with the actual room for decision-making that district health managers perceive that they have. Results show that in some areas District Health Management Team (DHMT) members make decisions beyond their conferred authority while in others they do not use all the space allocated by policy. DHMT members operate close to the boundaries defined by public policy in planning, remuneration and incentives, policy and performance management. However, they make decisions beyond their conferred authority in the area of information and do not use all the space allocated by policy in the area of education. DHMTs' decision-making capacity to manage their workforce is influenced by their own perceived authority and sometimes it is constrained by decisions made at higher levels. We can conclude that decentralization, to improve workforce performance, needs to devolve power further down from district authorities onto district health managers. DHMTs need not only more power and authority to make decisions about their workforce but also more control over resources to be able to implement these decisions. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Healthcare resource allocation decisions affecting uninsured services

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services. PMID:27934550

Information support for decision making on dispatching control of water distribution in irrigation

NASA Astrophysics Data System (ADS)

Yurchenko, I. F.

2018-05-01

The research has been carried out on developing the technique of supporting decision making for on-line control, operational management of water allocation for the interfarm irrigation projects basing on the analytical patterns of dispatcher control. This technique provides an increase of labour productivity as well as higher management quality due to the improved level of automation, as well as decision making optimization taking into account diagnostics of the issues, solutions classification, information being required to the decision makers.

What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?

PubMed

Lane, Haylee; Sturgess, Tamica; Philip, Kathleen; Markham, Donna; Martin, Jennifer; Walsh, Jill; Hubbard, Wendy; Haines, Terry

2017-09-12

Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers face. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game

PubMed Central

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C.; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders’ hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders’ rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders’ rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five. PMID:29184518

76 FR 50449 - Fisheries off West Coast States; Pacific Coast Groundfish Fishery Management Plan; Trawl...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... decision making did not clearly state that Amendment 21 allocations supersede the previous limited entry... 21 supersedes the limited entry/open access allocations for groundfish species allocated through... the limited entry trawl fishery. DATES: Comments on Amendment 21-1 must be received no later than 5 p...

Training Decisions Technology Analysis

DTIC Science & Technology

1992-06-01

4.5.1 Relational Data Base Management 69 4.5.2 TASCS Data Content 69 4.5.3 Relationships with TDS 69 4.6 Other Air Force Modeling R&D 70 4.6.1 Time ...executive decision making were first developed by M. S. Scott Morton in the early 1970’s who, at that time , termed them " management decision systems" (Scott...Allocations to Training Settings o Managers ’ Preferences for Task Allocations to Training Settings o Times Required to Training Tasks in Various

A robust optimisation approach to the problem of supplier selection and allocation in outsourcing

NASA Astrophysics Data System (ADS)

Fu, Yelin; Keung Lai, Kin; Liang, Liang

2016-03-01

We formulate the supplier selection and allocation problem in outsourcing under an uncertain environment as a stochastic programming problem. Both the decision-maker's attitude towards risk and the penalty parameters for demand deviation are considered in the objective function. A service level agreement, upper bound for each selected supplier's allocation and the number of selected suppliers are considered as constraints. A novel robust optimisation approach is employed to solve this problem under different economic situations. Illustrative examples are presented with managerial implications highlighted to support decision-making.

Health care priority setting: principles, practice and challenges

PubMed Central

Mitton, Craig; Donaldson, Cam

2004-01-01

Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA). Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated. PMID:15104792

Making Decisions about Workforce Development in Registered Training Organisations

ERIC Educational Resources Information Center

Hawke, Geof

2008-01-01

The purpose of this research activity is to understand further how large and small registered training organisations (RTOs) make decisions about the allocation of resources for developing their workforces. Six registered training organisations--four technical and further education (TAFE) institutes and two private providers--were selected for…

Gender Discrimination in the Allocation of Migrant Household Resources.

PubMed

Antman, Francisca M

2015-07-01

This paper considers the relationship between international migration and gender discrimination through the lens of decision-making power over intrahousehold resource allocation. The endogeneity of migration is addressed with a difference-in-differences style identification strategy and a model with household fixed effects. The results suggest that while a migrant household head is away, a greater share of resources is spent on girls relative to boys and his spouse commands greater decision-making power. Once the head returns home, however, a greater share of resources goes to boys and there is suggestive evidence of greater authority for the head of household.

Function allocation for humans and automation in the context of team dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeffrey C. Joe; John O'Hara; Jacques Hugo

Within Human Factors Engineering, a decision-making process called function allocation (FA) is used during the design life cycle of complex systems to distribute the system functions, often identified through a functional requirements analysis, to all human and automated machine agents (or teammates) involved in controlling the system. Most FA methods make allocation decisions primarily by comparing the capabilities of humans and automation, but then also by considering secondary factors such as cost, regulations, and the health and safety of workers. The primary analysis of the strengths and weaknesses of humans and machines, however, is almost always considered in terms ofmore » individual human or machine capabilities. Yet, FA is fundamentally about teamwork in that the goal of the FA decision-making process is to determine what are the optimal allocations of functions among agents. Given this framing of FA, and the increasing use of and sophistication of automation, there are two related social psychological issues that current FA methods need to address more thoroughly. First, many principles for effective human teamwork are not considered as central decision points or in the iterative hypothesis and testing phase in most FA methods, when it is clear that social factors have numerous positive and negative effects on individual and team capabilities. Second, social psychological factors affecting team performance and can be difficult to translate to automated agents, and most FA methods currently do not account for this effect. The implications for these issues are discussed.« less

Sharing intelligence: Decision-making interactions between users and software in MAESTRO

NASA Technical Reports Server (NTRS)

Geoffroy, Amy L.; Gohring, John R.; Britt, Daniel L.

1991-01-01

By combining the best of automated and human decision-making in scheduling many advantages can accrue. The joint performance of the user and system is potentially much better than either alone. Features of the MAESTRO scheduling system serve to illustrate concepts of user/software cooperation. MAESTRO may be operated at a user-determinable and dynamic level of autonomy. Because the system allows so much flexibility in the allocation of decision-making responsibilities, and provides users with a wealth of information and other support for their own decision-making, better overall schedules may result.

Working against Ourselves: Decision Making in a Small Rural School District

ERIC Educational Resources Information Center

Patterson, Jean A.; Koenigs, Andrew; Mohn, Gordon; Rasmussen, Cheryl

2006-01-01

Purpose: The purpose of this paper is to examine decision making and resource allocation in a small, rural district in a Midwestern state of the USA during a time of economic retrenchment. Design/methodology/approach: Qualitative case study methods were used, including focus groups and personal interviews with current and former district…

Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

PubMed

Goeree, Ron; Diaby, Vakaramoko

2013-12-01

In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

The ethics of end-of-life decisions in the elderly: deliberations from the ECOPE study.

PubMed

Reiter-Theil, Stella

2003-06-01

Is age a factor underlying clinical decision-making? Should age be a criterion in the allocation of health care resources? Is it correct to criticize this approach as 'ageism'? What role does 'paternalism' play? These questions are the focus of this chapter which takes an interdisciplinary perspective of clinical ethics in order to provide an ethical evaluation of the situation of the elderly in health care. First, the text of the chapter is based on the descriptive level referring to (a) clinical ethics consultation, (b) the ECOPE study on 'Ethical Conditions of Passive Euthanasia' focusing on decision-making, and studies about age as a factor in clinical decisions, such as the American SUPPORT study. Second, at the normative level, ethical deliberations are discussed for and against age as a criterion for allocating health care resources. Finally, it is suggested that the differences in evidence to be found about the role of age as a factor in clinical decision-making may be due to the different national health policies as well as to the insufficient awareness of ethical principles violated by covert 'ageist' attitudes.

Improving Shipboard Decision Making in the CBR-D (Chemical/Biological Radiological Defense) Environment: Concepts of Use for and Functional Description of a Decision Aid/Training System (DECAID)

DTIC Science & Technology

1988-08-19

take place over the period of several days. Decisions regarding MOPP level or resource allocation made on day I may have no immediate impact, but a...present -- conditions, and manage a resource library to assist the DCA in making decisions under conditions of uncertainty. Several areas of utilization are...students work through a scenario, the device couid then display the consequences of those decisions or provide optimal decision recommendations

Economic Evaluation Enhances Public Health Decision Making

PubMed Central

Rabarison, Kristina M.; Bish, Connie L.; Massoudi, Mehran S.; Giles, Wayne H.

2015-01-01

Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking “how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?” is important when making decisions about resource allocation and scaling of interventions. PMID:26157792

Spatial attention during saccade decisions.

PubMed

Jonikaitis, Donatas; Klapetek, Anna; Deubel, Heiner

2017-07-01

Behavioral measures of decision making are usually limited to observations of decision outcomes. In the present study, we made use of the fact that oculomotor and sensory selection are closely linked to track oculomotor decision making before oculomotor responses are made. We asked participants to make a saccadic eye movement to one of two memorized target locations and observed that visual sensitivity increased at both the chosen and the nonchosen saccade target locations, with a clear bias toward the chosen target. The time course of changes in visual sensitivity was related to saccadic latency, with the competition between the chosen and nonchosen targets resolved faster before short-latency saccades. On error trials, we observed an increased competition between the chosen and nonchosen targets. Moreover, oculomotor selection and visual sensitivity were influenced by top-down and bottom-up factors as well as by selection history and predicted the direction of saccades. Our findings demonstrate that saccade decisions have direct visual consequences and show that decision making can be traced in the human oculomotor system well before choices are made. Our results also indicate a strong association between decision making, saccade target selection, and visual sensitivity. NEW & NOTEWORTHY We show that saccadic decisions can be tracked by measuring spatial attention. Spatial attention is allocated in parallel to the two competing saccade targets, and the time course of spatial attention differs for fast-slow and for correct-erroneous decisions. Saccade decisions take the form of a competition between potential saccade goals, which is associated with spatial attention allocation to those locations. Copyright © 2017 the American Physiological Society.

The games economists play: Why economics students behave more selfishly than other students

PubMed Central

Gerlach, Philipp

2017-01-01

Do economics students behave more selfishly than other students? Experiments involving monetary allocations suggest so. This article investigates the underlying motives for the economic students’ more selfish behavior by separating three potential explanatory mechanisms: economics students are less concerned with fairness when making allocation decisions; have a different notion of what is fair in allocations; or are more skeptical about other people’s allocations, which in turn makes them less willing to comply with a shared fairness norm. The three mechanisms were tested by inviting students from various disciplines to participate in a relatively novel experimental game and asking all participants to give reasons for their choices. Compared with students of other disciplines, economics students were about equally likely to mention fairness in their comments; had a similar notion of what was fair in the situation; however, they expected lower offers, made lower offers, and were less willing to enforce compliance with a fair allocation at a cost to themselves. The economics students’ lower expectations mediated their allocation decisions, suggesting that economics students behaved more selfishly because they expected others not to comply with the shared fairness norm. PMID:28873465

The games economists play: Why economics students behave more selfishly than other students.

PubMed

Gerlach, Philipp

2017-01-01

Do economics students behave more selfishly than other students? Experiments involving monetary allocations suggest so. This article investigates the underlying motives for the economic students' more selfish behavior by separating three potential explanatory mechanisms: economics students are less concerned with fairness when making allocation decisions; have a different notion of what is fair in allocations; or are more skeptical about other people's allocations, which in turn makes them less willing to comply with a shared fairness norm. The three mechanisms were tested by inviting students from various disciplines to participate in a relatively novel experimental game and asking all participants to give reasons for their choices. Compared with students of other disciplines, economics students were about equally likely to mention fairness in their comments; had a similar notion of what was fair in the situation; however, they expected lower offers, made lower offers, and were less willing to enforce compliance with a fair allocation at a cost to themselves. The economics students' lower expectations mediated their allocation decisions, suggesting that economics students behaved more selfishly because they expected others not to comply with the shared fairness norm.

Cross-cultural differences in distributive justice: a comparison of Turkey and the U.S.

PubMed

Murphy-Berman, Virginia A; Berman, John J; Cukur, Cem Safak

2012-01-01

When allocators make decisions about distributing resources, they face a dilemma if the expectations for consequences that will flow from particular choices are incongruent with each other. For example, a certain allocation choice might be expected to make an allocator appear warm and likable but unfair. Previous research has found that culture can shape these perceptions and, thus, their congruence or incongruence. The present study further investigated these ideas. Differences between Turkish and U.S. students' perceptions of allocators who distributed resources on the basis of merit vs. need were investigated. Results revealed an allocation dilemma among the U.S. but not among the Turkish students. Specifically, the U.S. students perceived greater incongruence among allocation consequences for both merit and need choices than did the students from Turkey for whom perceptions of allocator's fairness were more aligned with perceptions of allocator's warmth.

Gender Discrimination in the Allocation of Migrant Household Resources*

PubMed Central

Antman, Francisca M.

2016-01-01

This paper considers the relationship between international migration and gender discrimination through the lens of decision-making power over intrahousehold resource allocation. The endogeneity of migration is addressed with a difference-in-differences style identification strategy and a model with household fixed effects. The results suggest that while a migrant household head is away, a greater share of resources is spent on girls relative to boys and his spouse commands greater decision-making power. Once the head returns home, however, a greater share of resources goes to boys and there is suggestive evidence of greater authority for the head of household. PMID:27546986

75 FR 59206 - Ketchikan-Misty Fiords Ranger District; Tongass National Forest; Alaska; Ketchikan-Misty Fiords...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... full environmental analysis and decision-making process so interested and affected people may...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority... Ketchikan- Misty Fiords Ranger District. The decision on the EIS will allocate recreation carrying capacity...

Equity in healthcare resource allocation decision making: A systematic review.

PubMed

Lane, Haylee; Sarkies, Mitchell; Martin, Jennifer; Haines, Terry

2017-02-01

To identify elements of endorsed definitions of equity in healthcare and classify domains of these definitions so that policy makers, managers, clinicians, and politicians can form an operational definition of equity that reflects the values and preferences of the society they serve. Systematic review where verbatim text describing explicit and implicit definitions of equity were extracted and subjected to a thematic analysis. The full holdings of the AMED, CINAHL plus, OVID Medline, Scopus, PsychInfo and ProQuest (ProQuest Health & Medical Complete, ProQuest Nursing and Allied Health Source, ProQuest Social Science Journals) were individually searched in April 2015. Studies were included if they provided an original, explicit or implicit definition of equity in regards to healthcare resource allocation decision making. Papers that only cited earlier definitions of equity and provided no new information or extensions to this definition were excluded. The search strategy yielded 74 papers appropriate for this review; 60 of these provided an explicit definition of equity, with a further 14 papers discussing implicit elements of equity that the authors endorsed in regards to healthcare resource allocation decision making. FIVE KEY THEMES EMERGED: i) Equalisation across the health service supply/access/outcome chain, ii) Need or potential to benefit, iii) Groupings of equalisation, iv) Caveats to equalisation, and v) Close enough is good enough. There is great inconsistency in definitions of equity endorsed by different authors. Operational definitions of equity need to be more explicit in addressing these five thematic areas before they can be directly applied to healthcare resource allocation decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions.

PubMed

Dakin, Helen; Gray, Alastair

2018-05-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of "mutually exclusive." This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were "mutually exclusive" makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making.

Allocating health care: cost-utility analysis, informed democratic decision making, or the veil of ignorance?

PubMed

Goold, S D

1996-01-01

Assuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions

PubMed Central

Dakin, Helen; Gray, Alastair

2018-01-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of “mutually exclusive.” This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were “mutually exclusive” makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making. PMID:29683792

Linking Performance Measures to Resource Allocation: Exploring Unmapped Terrain.

ERIC Educational Resources Information Center

Ewell, Peter T.

1999-01-01

Examination of how (and whether) particular types of institutional performance measures can be beneficially used in making resource allocation decisions finds that only easily verifiable "hard" statistics should be used in classic performance funding approaches, although surveys and the use of good practices by institutions may…

Opinions of Swedish citizens, health-care politicians, administrators and doctors on rationing and health-care financing.

PubMed

Rosén, Per; Karlberg, Ingvar

2002-06-01

To compare the views of citizens and health-care decision-makers on health-care financing, the limits of public health-care, and resource allocation. A postal survey based on a randomized sample of adults taken by the national registration and stratified samples of health-care politicians, administrators, and doctors in five Swedish counties. A total number of 1194 citizens (response rate 60%) and 427 decision-makers (response rate 69%). The general public have high expectations of public health-care, expectations that do not fit with the decision-makers' views on what should be offered. To overcome the discrepancy between demand and resources, physicians prefer increased patient fees and complementary private insurance schemes to a higher degree than do the other respondents. Physicians take a more favourable view of letting politicians on a national level exert a greater influence on resource allocation within public health-care. A majority of physicians want politicians to assume a greater responsibility for the exclusion of certain therapies or diagnoses. Most politicians, on the other hand, prefer physicians to make more rigorous decisions as to which medical indications should entitle a person to public health-care. The gap between public expectations and health-care resources makes it more important to be clear about who should be accountable for resource-allocation decisions in public health-care. Significant differences between physicians' and politicians' opinions on financing and responsibility for prioritization make the question of accountability even more important.

Bayesian Decision Theory Guiding Educational Decision-Making: Theories, Models and Application

ERIC Educational Resources Information Center

Pan, Yilin

2016-01-01

Given the importance of education and the growing public demand for improving education quality under tight budget constraints, there has been an emerging movement to call for research-informed decisions in educational resource allocation. Despite the abundance of rigorous studies on the effectiveness, cost, and implementation of educational…

Forecasting resource-allocation decisions under climate uncertainty: fire suppression with assessment of net benefits of research

Treesearch

Jeffrey P. Prestemon; Geoffrey H. Donovan

2008-01-01

Making input decisions under climate uncertainty often involves two-stage methods that use expensive and opaque transfer functions. This article describes an alternative, single-stage approach to such decisions using forecasting methods. The example shown is for preseason fire suppression resource contracting decisions faced by the United States Forest Service. Two-...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROGRAMS TO HELP DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation... allocates funds in a manner that effectively supports the strategic decision-making initiatives of the... to the effective creation, expansion, or maintenance of foreign markets, FAS seeks to identify those...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROGRAMS TO HELP DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation... allocates funds in a manner that effectively supports the strategic decision-making initiatives of the... to the effective creation, expansion, or maintenance of foreign markets, FAS seeks to identify those...

Increasing Medical Student Numbers in England, 2001. Report.

ERIC Educational Resources Information Center

Higher Education Funding Council for England, Bristol.

This report provides information on the further allocation of additional medical student numbers in England from 2001-2002 and explains the decision making process underpinning these allocations. A report by the Medical Workforce Standing Advisory Committee in December 1997 concluded that a substantial increase in medical school intakes was…

[Allocation decisions of health insurance rehabilitation managers--An explorative case study concerning stroke rehabilitation].

PubMed

Hasenbein, U; Wallesch, C-W

2003-12-01

We investigated processes of and subjective reasons for resource allocation in three out of four rehabilitation specialists of a regional office of a major health insurance. Decisions of health insurance personnel include approval of and duration of rehabilitation treatment and choice of clinical provider. Insurance specialists are mainly involved in documentation and coordination, whereas decisions mainly follow expert recommendations, mainly of the medical service. Allocation is based primarily on somatic impairment and disability, psychosocial function, motivation and rehabilitation potential are regarded as secondary. Goals and expected results of rehabilitation are neither individually defined nor their achievement evaluated. Decision processes are dominated by routines and agreements. Only exceptionally, defined rules and procedures are applied. Active case management is hampered by a highly specialized internal structure of the investigated insurance fund. The optimal fulfillment of individual requirements for a limited-time rehabilitation treatment is the central criterion for decision making. However, the specialists lack detailed information concerning appropriateness, quality and efficacy of rehabilitation providers, especially when taking patient-related variables into account. Instead, they trust that only high-quality institutions are contracted. Systematic control and feedback of rehabilitation results is not available. The surveyed rehabilitation managers do not include cost aspects in their decision-making. They would regard this as alien to a member- and patient-oriented policy. Improvement potentials with respect to rehabilitation case management are being reviewed.

Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

PubMed

Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

2018-02-23

In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training outcomes may not provide sufficient information for policy-makers to make decisions on future training programmes. Based on our findings, we have developed an evidence-based framework, which incorporates but expands beyond the Kirkpatrick model, to provide conceptual and practical guidance that aids in the design of training programme evaluations better suited to meet the information needs of policy-makers and to inform policy decisions.

An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department.

PubMed

Yousefi, M; Ferreira, R P M

2017-03-30

This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section. In this simulation, unlike previous studies, all staff agents took part in the decision-making process to re-allocate the resources in the emergency department. The simulation modeled the behavior of patients, receptionists, triage nurses, emergency room nurses and doctors. Patients were able to decide whether to stay in the system or leave the department at any stage of treatment. In order to evaluate the performance of this approach, 6 different scenarios were introduced. In each scenario, various key performance indicators were investigated before and after applying the group decision-making. The outputs of each simulation were number of deaths, number of patients who leave the emergency department without being attended, length of stay, waiting time and total number of discharged patients from the emergency department. Applying the self-organizing approach in the simulation showed an average of 12.7 and 14.4% decrease in total waiting time and number of patients who left without being seen, respectively. The results showed an average increase of 11.5% in total number of discharged patients from emergency department.

An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department

PubMed Central

Yousefi, M.; Ferreira, R.P.M.

2017-01-01

This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section. In this simulation, unlike previous studies, all staff agents took part in the decision-making process to re-allocate the resources in the emergency department. The simulation modeled the behavior of patients, receptionists, triage nurses, emergency room nurses and doctors. Patients were able to decide whether to stay in the system or leave the department at any stage of treatment. In order to evaluate the performance of this approach, 6 different scenarios were introduced. In each scenario, various key performance indicators were investigated before and after applying the group decision-making. The outputs of each simulation were number of deaths, number of patients who leave the emergency department without being attended, length of stay, waiting time and total number of discharged patients from the emergency department. Applying the self-organizing approach in the simulation showed an average of 12.7 and 14.4% decrease in total waiting time and number of patients who left without being seen, respectively. The results showed an average increase of 11.5% in total number of discharged patients from emergency department. PMID:28380196

Sustainability in health care by allocating resources effectively (SHARE) 4: exploring opportunities and methods for consumer engagement in resource allocation in a local healthcare setting.

PubMed

Harris, Claire; Ko, Henry; Waller, Cara; Sloss, Pamela; Williams, Pamela

2017-05-05

This is the fourth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Healthcare decision-makers have sought to improve the effectiveness and efficiency of services through removal or restriction of practices that are unsafe or of little benefit, often referred to as 'disinvestment'. A systematic, integrated, evidence-based program for disinvestment was being established within a large Australian health service network. Consumer engagement was acknowledged as integral to this process. This paper reports the process of developing a model to integrate consumer views and preferences into an organisation-wide approach to resource allocation. A literature search was conducted and interviews and workshops were undertaken with health service consumers and staff. Findings were drafted into a model for consumer engagement in resource allocation which was workshopped and refined. Although consumer engagement is increasingly becoming a requirement of publicly-funded health services and documented in standards and policies, participation in organisational decision-making is not widespread. Several consistent messages for consumer engagement in this context emerged from the literature and consumer responses. Opportunities, settings and activities for consumer engagement through communication, consultation and participation were identified within the resource allocation process. Sources of information regarding consumer values and perspectives in publications and locally-collected data, and methods to use them in health service decision-making, were identified. A model bringing these elements together was developed. The proposed model presents potential opportunities and activities for consumer engagement in the context of resource allocation.

Are pricing and reimbursement decision-making criteria aligned with public preferences regarding allocation principles in the Polish healthcare sector?

PubMed

Kolasa, Katarzyna

2014-10-01

Given growing interest in multicriteria decision making and multiple cost-effectiveness thresholds' approach, it was decided to investigate its usefulness in Poland. The pricing and reimbursement (P&R) regulations were reviewed and a cross-sectional survey was conducted amongst nurses. The study investigated whether P&R rules are aligned with the preferences of healthcare professional towards the concept of equity. The references to aversion to inequalities in health and capacity to benefit were recognized as the most and least important principle respectively by the group of nurses. Different weightings of health gain dependent on disease severity were accepted by half of the study's population. In the review of legal acts, references to capacity to benefit were frequently found. The opposite was registered for other concepts of equity. There is room for further improvement with respect to the alignment between the Polish P&R decision making criteria and public preferences regarding allocation principles.

Ethical triage and scarce resource allocation during public health emergencies: tenets and procedures.

PubMed

Kuschner, Ware G; Pollard, John B; Ezeji-Okoye, Stephen C

2007-01-01

Public health emergencies may result in mass casualties and a surge in demand for hospital-based care. Healthcare standards may need to be altered to respond to an imbalance between demands for care and resources. Clinical decisions that involve triage and scarce resource allocation may present unique ethical challenges. To address these challenges, the authors detailed tenets and procedures to guide triage and scarce resource allocation during public health emergencies. The authors propose health care organizations deploy a Triage and Scarce Resource Allocation Team to over-see and guide ethically challenging clinical decision-making during a crisis period. The authors' goal is to help healthcare organizations and clinicians balance public health responsibilities and their duty to individual patients during emergencies in as equitable and humane a manner as possible.

Planning for deficit irrigation

USDA-ARS?s Scientific Manuscript database

Irrigators with limited water supplies that lead to deficit irrigation management need to make decisions about crop selection, water allocations to each crop, and irrigation schedules. Many of these decisions need to occur before the crop is planted and depend on yield-evapotranspiration (ET) and yi...

The Cost Structure of Higher Education: Implications for Governmental Policy in Steady State.

ERIC Educational Resources Information Center

Lyell, Edward H.

The historical pattern of resource allocation in American higher education as exemplified by public colleges in Colorado was examined. The reliance upon average cost information in making resource allocation decisions was critiqued for the special problems that arise from student enrollment decline or steady state. A model of resource allocation…

Improved ant colony optimization for optimal crop and irrigation water allocation by incorporating domain knowledge

USDA-ARS?s Scientific Manuscript database

An improved ant colony optimization (ACO) formulation for the allocation of crops and water to different irrigation areas is developed. The formulation enables dynamic adjustment of decision variable options and makes use of visibility factors (VFs, the domain knowledge that can be used to identify ...

75 FR 54530 - Food Distribution Program on Indian Reservations: Administrative Funding Allocations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... could this description be more helpful in making the rule easier to understand? II. Procedural Matters... rational basis for allocating funds to the Regional Offices. FDPIR State agencies expressed concern that... participants served by each State agency. The decision to pilot a new funding methodology in fiscal year 2008...

Mixed strategy to allocate resources with air pollution treatment in China: based on the analytic network process and large-group decision-making method.

PubMed

Chen, Xi; Zhao, Liu; Özdemir, Mujgan Sagir; Liang, Haiming

2018-04-05

The resource allocation of air pollution treatment in China is a complex problem, since many alternatives are available and many criteria influence mutually. A number of stakeholders participate in this issue holding different opinions because of the benefits they value. So a method is needed, based on the analytic network process (ANP) and large-group decision-making (LGDM), to rank the alternatives considering interdependent criteria and stakeholders' opinions. In this method, the criteria related to air pollution treatment are examined by experts. Then, the network structure of the problem is constructed based on the relationships between the criteria. Further, every participant in each group provide comparison matrices by judging the importance between criteria according to dominance, regarding a certain criteria (or goal), and the geometric average comparison matrix of each group is obtained. The decision weight of each group is derived by combining the subjective weight and the objective weight, in which the subjective weight is provided by organizers, while the objective weight is determined by considering the consensus levels of groups. The final comparison matrices are obtained by the geometric average of comparison matrices and the decision weights. Next, the resource allocation is made according to the priorities of the alternatives using the super decision software. Finally, an example is given to illustrate the use of the proposed method.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina

2017-06-21

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

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.

Rational Budgeting? The Stanford Case.

ERIC Educational Resources Information Center

Chaffee, Ellen Earle

The budget decision making process at Stanford University, California, from 1970 through 1979 was evaluated in relation to the allocation of general funds to 38 academic departments. Using Simon's theory of bounded rationality and an organizational level of analysis, the Stanford decision process was tested for its rationality through…

The Rational Approach to Budget Cuts: One University's Experience. ASHE 1987 Annual Meeting Paper.

ERIC Educational Resources Information Center

Hardy, Cynthia

The experiences of the University of Montreal in using a rational-analytic framework to allocate resources at a time of budget costs are discussed. The following characteristics for rational decision-making are identified and applied to the University of Montreal: whether goals were known, whether alternative methods of resource allocation were…

Business School Computer Usage, Fourth Annual UCLA Survey.

ERIC Educational Resources Information Center

Frand, Jason L.; And Others

The changing nature of the business school computing environment is monitored in a report whose purpose is to provide deans and other policy-makers with information to use in making allocation decisions and program plans. This survey focuses on resource allocations of 249 accredited U.S. business schools and 15 Canadian schools. A total of 128…

Allocation of Public Resources for Psychological Therapy between Types of Mental Health Condition: Towards Structural Balance

ERIC Educational Resources Information Center

Tustin, Don

2009-01-01

This paper addresses issues of allocating public resources efficiently between mental health conditions that are associated with different levels of disability, and presents an adaptation of an established framework to help decision-making in this area. The adapted framework refers to psychological interventions that are universal, indicated,…

The Role of Ethics Committees and Ethics Consultation in Allocation Decisions

PubMed Central

Strech, Daniel; Hurst, Samia; Danis, Marion

2013-01-01

Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria

PubMed Central

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2017-01-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees’ roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery. PMID:28344984

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

PubMed

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2016-11-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital.

PubMed

McIntosh, Catherine; Dexter, Franklin; Epstein, Richard H

2006-12-01

In this tutorial, we consider the impact of operating room (OR) management on anesthesia group and OR labor productivity and costs. Most of the tutorial focuses on the steps required for each facility to refine its OR allocations using its own data collected during patient care. Data from a hospital in Australia are used throughout to illustrate the methods. OR allocation is a two-stage process. During the initial tactical stage of allocating OR time, OR capacity ("block time") is adjusted. For operational decision-making on a shorter-term basis, the existing workload can be considered fixed. Staffing is matched to that workload based on maximizing the efficiency of use of OR time. Scheduling cases and making decisions on the day of surgery to increase OR efficiency are worthwhile interventions to increase anesthesia group productivity. However, by far, the most important step is the appropriate refinement of OR allocations (i.e., planning service-specific staffing) 2-3 mo before the day of surgery. Reducing surgical and/or turnover times and delays in first-case-of-the-day starts generally provides small reductions in OR labor costs. Results vary widely because they are highly sensitive both to the OR allocations (i.e., staffing) and to the appropriateness of those OR allocations.

The use of the Dutch Self-Sufficiency Matrix (SSM-D) to inform allocation decisions to public mental health care for homeless people.

PubMed

Lauriks, Steve; de Wit, Matty A S; Buster, Marcel C A; Fassaert, Thijs J L; van Wifferen, Ron; Klazinga, Niek S

2014-10-01

The current study set out to develop a decision support tool based on the Self-Sufficiency Matrix (Dutch version; SSM-D) for the clinical decision to allocate homeless people to the public mental health care system at the central access point of public mental health care in Amsterdam, The Netherlands. Logistic regression and receiver operating characteristic-curve analyses were used to model professional decisions and establish four decision categories based on SSM-D scores from half of the research population (Total n = 612). The model and decision categories were found to be accurate and reliable in predicting professional decisions in the second half of the population. Results indicate that the decision support tool based on the SSM-D is useful and feasible. The method to develop the SSM-D as a decision support tool could be applied to decision-making processes in other systems and services where the SSM-D has been implemented, to further increase the utility of the instrument.

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

Evaluation of allocation methods for calculation of carbon footprint of grass-based dairy production.

PubMed

Rice, P; O'Brien, D; Shalloo, L; Holden, N M

2017-11-01

A major methodological issue for life cycle assessment, commonly used to quantify greenhouse gas emissions from livestock systems, is allocation from multifunctional processes. When a process produces more than one output, the environmental burden has to be assigned between the outputs, such as milk and meat from a dairy cow. In the absence of an objective function for choosing an allocation method, a decision must be made considering a range of factors, one of which is the availability and quality of necessary data. The objective of this study was to evaluate allocation methods to calculate the climate change impact of the economically average (€/ha) dairy farm in Ireland considering both milk and meat outputs, focusing specifically on the pedigree of the available data for each method. The methods were: economic, energy, protein, emergy, mass of liveweight, mass of carcass weight and physical causality. The data quality for each method was expressed using a pedigree score based on reliability of the source, completeness, temporal applicability, geographical alignment and technological appropriateness. Scenario analysis was used to compare the normalised impact per functional unit (FU) from the different allocation methods, between the best and worst third of farms (in economic terms, €/ha) in the national farm survey. For the average farm, the allocation factors for milk ranged from 75% (physical causality) to 89% (mass of carcass weight), which in turn resulted in an impact per FU, from 1.04 to 1.22 kg CO 2 -eq/kg (fat and protein corrected milk). Pedigree scores ranged from 6.0 to 17.1 with protein and economic allocation having the best pedigree. It was concluded that when making the choice of allocation method, the quality of the data available (pedigree) should be given greater emphasis during the decision making process because the effect of allocation on the results. A range of allocation methods could be deployed to understand the uncertainty associated with the decision. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictive and Prognostic Models: Implications for Healthcare Decision-Making in a Modern Recession

PubMed Central

Vogenberg, F. Randy

2009-01-01

Various modeling tools have been developed to address the lack of standardized processes that incorporate the perspectives of all healthcare stakeholders. Such models can assist in the decision-making process aimed at achieving specific clinical outcomes, as well as guide the allocation of healthcare resources and reduce costs. The current efforts in Congress to change the way healthcare is financed, reimbursed, and delivered have rendered the incorporation of modeling tools into the clinical decision-making all the more important. Prognostic and predictive models are particularly relevant to healthcare, particularly in the clinical decision-making, with implications for payers, patients, and providers. The use of these models is likely to increase, as providers and patients seek to improve their clinical decision process to achieve better outcomes, while reducing overall healthcare costs. PMID:25126292

Multiple Criteria Decision-Making Techniques in Higher Education

ERIC Educational Resources Information Center

Ho, William; Dey, Prasanta K.; Higson, Helen E.

2006-01-01

Purpose: The purpose of this paper is to review the literature which focuses on four major higher education decision problems. These are: resource allocation; performance measurement; budgeting; and scheduling. Design/methodology/approach: Related articles appearing in the international journals from 1996 to 2005 are gathered and analyzed so that…

Modeling the value for money of changing clinical practice change: a stochastic application in diabetes care.

PubMed

Hoomans, Ties; Abrams, Keith R; Ament, Andre J H A; Evers, Silvia M A A; Severens, Johan L

2009-10-01

Decision making about resource allocation for guideline implementation to change clinical practice is inevitably undertaken in a context of uncertainty surrounding the cost-effectiveness of both clinical guidelines and implementation strategies. Adopting a total net benefit approach, a model was recently developed to overcome problems with the use of combined ratio statistics when analyzing decision uncertainty. To demonstrate the stochastic application of the model for informing decision making about the adoption of an audit and feedback strategy for implementing a guideline recommending intensive blood glucose control in type 2 diabetes in primary care in the Netherlands. An integrated Bayesian approach to decision modeling and evidence synthesis is adopted, using Markov Chain Monte Carlo simulation in WinBUGs. Data on model parameters is gathered from various sources, with effectiveness of implementation being estimated using pooled, random-effects meta-analysis. Decision uncertainty is illustrated using cost-effectiveness acceptability curves and frontier. Decisions about whether to adopt intensified glycemic control and whether to adopt audit and feedback alter for the maximum values that decision makers are willing to pay for health gain. Through simultaneously incorporating uncertain economic evidence on both guidance and implementation strategy, the cost-effectiveness acceptability curves and cost-effectiveness acceptability frontier show an increase in decision uncertainty concerning guideline implementation. The stochastic application in diabetes care demonstrates that the model provides a simple and useful tool for quantifying and exploring the (combined) uncertainty associated with decision making about adopting guidelines and implementation strategies and, therefore, for informing decisions about efficient resource allocation to change clinical practice.

D-Side: A Facility and Workforce Planning Group Multi-criteria Decision Support System for Johnson Space Center

NASA Technical Reports Server (NTRS)

Tavana, Madjid

2005-01-01

"To understand and protect our home planet, to explore the universe and search for life, and to inspire the next generation of explorers" is NASA's mission. The Systems Management Office at Johnson Space Center (JSC) is searching for methods to effectively manage the Center's resources to meet NASA's mission. D-Side is a group multi-criteria decision support system (GMDSS) developed to support facility decisions at JSC. D-Side uses a series of sequential and structured processes to plot facilities in a three-dimensional (3-D) graph on the basis of each facility alignment with NASA's mission and goals, the extent to which other facilities are dependent on the facility, and the dollar value of capital investments that have been postponed at the facility relative to the facility replacement value. A similarity factor rank orders facilities based on their Euclidean distance from Ideal and Nadir points. These similarity factors are then used to allocate capital improvement resources across facilities. We also present a parallel model that can be used to support decisions concerning allocation of human resources investments across workforce units. Finally, we present results from a pilot study where 12 experienced facility managers from NASA used D-Side and the organization's current approach to rank order and allocate funds for capital improvement across 20 facilities. Users evaluated D-Side favorably in terms of ease of use, the quality of the decision-making process, decision quality, and overall value-added. Their evaluations of D-Side were significantly more favorable than their evaluations of the current approach. Keywords: NASA, Multi-Criteria Decision Making, Decision Support System, AHP, Euclidean Distance, 3-D Modeling, Facility Planning, Workforce Planning.

Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

PubMed

Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

2012-01-01

Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

Key factors that influence government policies and decision making about healthcare priorities: Lessons for the field of eating disorders.

PubMed

Whiteford, Harvey; Weissman, Ruth Striegel

2017-03-01

Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies. Beyond setting priorities for resource allocation, governments also become involved where there is a need for regulation to maintain quality in the delivery of healthcare. By providing field-specific examples for each factor, we illustrate how advocates in the eating disorder field may use evidence to inform government policy about resource allocation and regulation in support of individuals with an eating disorder. © 2017 Wiley Periodicals, Inc.

A Cost-Effectiveness Evaluation Approach to Improving Resource Allocations for School Systems. Administering for Change Program. A Professional Paper.

ERIC Educational Resources Information Center

Temkin, Sanford

This dissertation begins with a description of some methods employed in making public-sector resource-allocation decisions, with conclusions on the appropriateness of each method for evaluating the ongoing programs of a school system. The second section has been rewritten and published as "A Comprehensive Theory of Cost-Effectiveness" (EA 002…

Nonprofit Decision Making and Resource Allocation: The Importance of Membership Preferences, Community Needs, and Interorganizational Ties.

ERIC Educational Resources Information Center

Markham, William T.; Johnson, Margaret A.; Bonjean, Charles M.

1999-01-01

Results of a study of community service organizations (n=12) and their communities indicate that distribution of volunteer funds and time was unrelated to community needs as measured by objective indicators. The most important determinants of resource allocation are members' perceptions of the severity of problems and their willingness to work in…

Why Do Students Choose Not to Follow All Instructions When Completing Assessment Tasks?

ERIC Educational Resources Information Center

Fleet, Wendy

2013-01-01

As academics we often assume that allocating marks to a task will influence student decision-making when it comes to completing that task. Marks are used by lecturers to indicate the relative importance of each of the criteria used for marking the assessment task and we expect the student to respond to the marks' allocation. This Postcard suggests…

Pressure Point On Campus: Academic Program Planning and Resource Allocation in Conflict with the Bargaining Table.

ERIC Educational Resources Information Center

Kieft, Raymond

Considered are the nature and extent of some of the basic conflicts that arise when two, future-oriented, decision-making processes--institutional program planning/resource allocation and collective bargaining--are both present on the same campus. The identified conflicts come from the experiences of a university that was one of the first in the…

Outcome based state budget allocation for diabetes prevention programs using multi-criteria optimization with robust weights.

PubMed

Mehrotra, Sanjay; Kim, Kibaek

2011-12-01

We consider the problem of outcomes based budget allocations to chronic disease prevention programs across the United States (US) to achieve greater geographical healthcare equity. We use Diabetes Prevention and Control Programs (DPCP) by the Center for Disease Control and Prevention (CDC) as an example. We present a multi-criteria robust weighted sum model for such multi-criteria decision making in a group decision setting. The principal component analysis and an inverse linear programming techniques are presented and used to study the actual 2009 budget allocation by CDC. Our results show that the CDC budget allocation process for the DPCPs is not likely model based. In our empirical study, the relative weights for different prevalence and comorbidity factors and the corresponding budgets obtained under different weight regions are discussed. Parametric analysis suggests that money should be allocated to states to promote diabetes education and to increase patient-healthcare provider interactions to reduce disparity across the US.

The once and future application of cost-effectiveness analysis.

PubMed

Berger, M L

1999-09-01

Cost-effectiveness analysis (CEA) is used by payers to make coverage decisions, by providers to make formulary decisions, and by large purchasers/employers and policymakers to choose health care performance measures. However, it continues to be poorly utilized in the marketplace because of overriding financial imperatives to control costs and a low apparent willingness to pay for quality. There is no obvious relationship between the cost-effectiveness of life-saving interventions and their application. Health care decision makers consider financial impact, safety, and effectiveness before cost-effectiveness. WHY IS CEA NOT MORE WIDELY APPLIED? Most health care providers have a short-term parochial financial perspective, whereas CEA takes a long-term view that captures all costs, benefits, and hazards, regardless of to whom they accrue. In addition, a history of poor standardization of methods, unrealistic expectations that CEA could answer fundamental ethical and political issues, and society's failure to accept the need for allocating scarce resources more judiciously, have contributed to relatively little use of the method by decision makers. HOW WILL CEA FIND GREATER UTILITY IN THE FUTURE? As decision makers take a longer-term view and understand that CEA can provide a quantitative perspective on important resource allocation decisions, including the distributional consequences of alternative choices, CEA is likely to find greater use. However, it must be embedded within a framework that promotes confidence in the social justice of health care decision making through ongoing dialogue about how the value of health and health care are defined.

Georgia concrete pavement performance and longevity.

DOT National Transportation Integrated Search

2012-02-01

The Georgia Department of Transportation (GDOT) has effectively utilized its pavement management system (PMS) to make informed, data-driven pavement maintenance decisions, including project selection, project prioritization, and funding allocation. C...

Alchemy to reason: Effective use of Cumulative Effects Assessment in resource management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hegmann, George, E-mail: george.hegmann@stantec.com; Yarranton, G.A., E-mail: yarran@shaw.ca

2011-09-15

Cumulative Effects Assessment (CEA) is a tool that can be useful in making decisions about natural resource management and allocation. The decisions to be made include those (i) necessary to construct planning and regulatory frameworks to control development activity so that societal goals will be achieved and (ii) whether or not to approve individual development projects, with or without conditions. The evolution of CEA into a more successful tool cannot occur independently of the evolution of decision making processes. Currently progress is painfully slow on both fronts. This paper explores some opportunities to accelerate improvements in decision making in naturalmore » resource management and in the utility of CEA as a tool to assist in making such decisions. The focus of the paper is on how to define the public interest by determining what is acceptable.« less

How decisions happen: focal points and blind spots in interdependent decision making.

PubMed

Halevy, Nir; Chou, Eileen Y

2014-03-01

Decision makers often simplify decision problems by ignoring readily available information. The current multimethod research investigated which types of information about interdependence situations are psychologically prominent to decision makers and which tend to go unnoticed. Study 1 used eye-tracking measures to investigate how decision makers allocate their attention in interdependence situations and revealed that individuals fixated on mutual cooperation earlier and longer as compared with alternative combinations of strategies and outcomes. In addition, participants' behavioral cooperation was consistent with their attention allocation. Study 2 introduced a novel information-search paradigm: Participants exchanged yes/no questions and answers to discover which of 25 different games their counterpart chose. Analyzing the contents of participants' questions showed that, consistent with Study 1, participants focused primarily on desirable outcomes and symmetric behavioral choices. Study 3 revealed that outcome desirability is a robust basis of psychological prominence across different types of social relations; in contrast, the psychological prominence of symmetry was moderated by the nature of social relations. Study 4 revealed that whether different bases of psychological prominence directed individuals' attention to the same aspects of the decision-making task moderated the effect of information availability on decision latency and cooperation rates. Taken together, these findings contribute to the mapping of bounded rationality, demonstrate how people think about their interdependence, and enhance our understanding of how decisions happen. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Assessing and quantifying public transit access.

DOT National Transportation Integrated Search

2014-03-01

Measuring access to transit services is important in evaluating existing services, predicting travel demands, allocating transportation investments and making decisions on land development. A composite index for assessing accessibility of public tran...

A political economy analysis of decision-making on natural disaster preparedness in Kenya.

PubMed

Rono-Bett, Karen C

2018-01-01

Most deaths from natural disasters occur in low- or middle-income countries; among them, countries in the Horn of Africa - where Kenya lies. Between September 2015 and September 2016, 23.4 million people in this region faced food insecurity because of the 2015 El Niño, characterised by floods and droughts. The importance of effective government decision-making on preparedness and response are critical to saving lives during such disasters. But this decision-making process occurs in a political context which is marred by uncertainty with other factors at play. Yet, good practice requires making investments on a 'no-regrets' basis. This article looks at the factors influencing Kenya's decision-making process for natural disasters, the preparedness for the 2015 El Niño as a case study. I explored what stakeholders understand by 'no-regrets investments' and its application. I assessed financial allocations by government and donors to disaster preparedness. Based on key informant interviews, focus group discussions and financial analyses, this article presents evidence at national and subnational levels. The findings indicate that in making decisions relating to preparedness, the government seeks information primarily from sources it trusts - other government departments, its communities and the media. With no existing legal frameworks guiding Kenya's disaster preparedness, the coordination of preparedness is not strong. It appears that there is a lack of political will to prioritise these frameworks. The no-regrets approach is applied predominantly by non-state actors. Because there have been 'non-events' in the past, government has become overcautious in committing resources on a no-regrets basis. Government allocation to preparedness exceeds donor funding by almost tenfold.

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

Priority setting and the ethics of resource allocation within VA healthcare facilities: results of a survey.

PubMed

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa M; Altemose, Jane A; Fox, Ellen

2008-01-01

Setting priorities and the subsequent allocation of resources is a major ethical issue facing healthcare facilities, including the Veterans Health Administration (VHA), the largest integrated healthcare delivery network in the United States. Yet despite the importance of priority setting and its impact on those who receive and those who provide care, we know relatively little about how clinicians and managers view allocation processes within their facilities. The purpose of this secondary analysis of survey data was to characterize staff members' perceptions regarding the fairness of healthcare ethics practices related to resource allocation in Veterans Administration (VA) facilities. The specific aim of the study was to compare the responses of clinicians, clinician managers, and non-clinician managers with respect to these survey items. We utilized a paper and web-based survey and a cross-sectional design of VHA clinicians and managers. Our sample consisted of a purposive stratified sample of 109 managers and a stratified random sample of 269 clinicians employed 20 or more hours per week in one of four VA medical centers. The four medical centers were participating as field sites selected to test the logistics of administering and reporting results of the Integrated Ethics Staff Survey, an assessment tool aimed at characterizing a broad range of ethical practices within a healthcare organization. In general, clinicians were more critical than clinician managers or non-clinician managers of the institutions' allocation processes and of the impact of resource decisions on patient care. Clinicians commonly reported that they did not (a) understand their facility's decision-making processes, (b) receive explanations from management regarding the reasons behind important allocation decisions, or (b) perceive that they were influential in allocation decisions. In addition, clinicians and managers both perceived that education related to the ethics of resource allocation was insufficient and that their facilities could increase their effectiveness in identifying and resolving ethical problems related to resource allocation. How well a healthcare facility ensures fairness in the way it allocates its resources across programs and services depends on multiple factors, including awareness by decision makers that setting priorities and allocating resources is a moral enterprise (moral awareness), the availability of a consistent process that includes important stakeholder groups (procedural justice), and concurrence by stakeholders that decisions represent outcomes that fairly balance competing interests and have a positive net effect on the quality of care (distributive justice). In this study, clinicians and managers alike identified the need for improvement in healthcare ethics practices related to resource allocation.

To give or not to give: children's and adolescents' sharing and moral negotiations in economic decision situations.

PubMed

Gummerum, Michaela; Keller, Monika; Takezawa, Masanori; Mata, Jutta

2008-01-01

This study interconnects developmental psychology of fair and moral behavior with economic game theory. One hundred eighty-nine 9- to 17-year-old students shared a sum of money as individuals and groups with another anonymous group (dictator game). Individual allocations did not differ by age but did by gender and were predicted by participants' preferences for fair allocations. Group decision making followed a majority process. Level of moral reasoning did not predict individual offers, but group members with a higher moral reasoning ability were more influential during group negotiations and in influencing group outcomes. The youngest participants justified offers more frequently by referring to simple distribution principles. Older participants employed more complex reasons to justify deviations from allocation principles.

How Do College Campuses Make Decisions about Allocating Resources for Student Mental Health? Findings from Key Participant Interviews

ERIC Educational Resources Information Center

Hunt, Justin B.; Watkins, Daphne; Eisenberg, Daniel

2012-01-01

Given the significant burden of mental illness among young adults, colleges offer a promising venue for prevention and treatment, which can help set late adolescents and young adults on a path to success and wellbeing. Despite the potential benefits, there have been no published studies of how campuses decide about allocating resources for mental…

Reduction of Decision-Making Time in the Air Defense Management

DTIC Science & Technology

2013-06-01

Cohen, Freeman, & Thompson, 1997), “Threat Evaluation and Weapon Allocation” ( Turan , 2012) and Evaluating the Performance of TEWA Systems (Fredrik...uses these threat values to propose weapon allocation ( Turan , 2012). Turan studied only static based weapon-target allocation. She evaluates and... Turan : - Proximity parameters (CPA, Time to CPA, CPA in units of time, time before hit, distance), - Capability parameters (target type, weapon

Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Ramsey, Wayne; King, Richard; Green, Sally

2018-05-30

This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes.

The business of radiology: cost accounting.

PubMed

Camponovo, Ernest J

2004-08-01

Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

An intuitionistic fuzzy multi-objective non-linear programming model for sustainable irrigation water allocation under the combination of dry and wet conditions

NASA Astrophysics Data System (ADS)

Li, Mo; Fu, Qiang; Singh, Vijay P.; Ma, Mingwei; Liu, Xiao

2017-12-01

Water scarcity causes conflicts among natural resources, society and economy and reinforces the need for optimal allocation of irrigation water resources in a sustainable way. Uncertainties caused by natural conditions and human activities make optimal allocation more complex. An intuitionistic fuzzy multi-objective non-linear programming (IFMONLP) model for irrigation water allocation under the combination of dry and wet conditions is developed to help decision makers mitigate water scarcity. The model is capable of quantitatively solving multiple problems including crop yield increase, blue water saving, and water supply cost reduction to obtain a balanced water allocation scheme using a multi-objective non-linear programming technique. Moreover, it can deal with uncertainty as well as hesitation based on the introduction of intuitionistic fuzzy numbers. Consideration of the combination of dry and wet conditions for water availability and precipitation makes it possible to gain insights into the various irrigation water allocations, and joint probabilities based on copula functions provide decision makers an average standard for irrigation. A case study on optimally allocating both surface water and groundwater to different growth periods of rice in different subareas in Heping irrigation area, Qing'an County, northeast China shows the potential and applicability of the developed model. Results show that the crop yield increase target especially in tillering and elongation stages is a prevailing concern when more water is available, and trading schemes can mitigate water supply cost and save water with an increased grain output. Results also reveal that the water allocation schemes are sensitive to the variation of water availability and precipitation with uncertain characteristics. The IFMONLP model is applicable for most irrigation areas with limited water supplies to determine irrigation water strategies under a fuzzy environment.

Protecting resources for primary health care under fiscal federalism: options for resource allocation.

PubMed

Okorafor, Okore A; Thomas, Stephen

2007-11-01

The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved.

Monitoring and decision making by people in man machine systems

NASA Technical Reports Server (NTRS)

Johannsen, G.

1979-01-01

The analysis of human monitoring and decision making behavior as well as its modeling are described. Classic and optimal control theoretical, monitoring models are surveyed. The relationship between attention allocation and eye movements is discussed. As an example of applications, the evaluation of predictor displays by means of the optimal control model is explained. Fault detection involving continuous signals and decision making behavior of a human operator engaged in fault diagnosis during different operation and maintenance situations are illustrated. Computer aided decision making is considered as a queueing problem. It is shown to what extent computer aids can be based on the state of human activity as measured by psychophysiological quantities. Finally, management information systems for different application areas are mentioned. The possibilities of mathematical modeling of human behavior in complex man machine systems are also critically assessed.

Fair Resource Allocation to Health Research: Priority Topics for Bioethics Scholarship.

PubMed

Pratt, Bridget; Hyder, Adnan A

2017-07-01

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. © 2017 John Wiley & Sons Ltd.

Bloodstain pattern classification: Accuracy, effect of contextual information and the role of analyst characteristics.

PubMed

Osborne, Nikola K P; Taylor, Michael C; Healey, Matthew; Zajac, Rachel

2016-03-01

It is becoming increasingly apparent that contextual information can exert a considerable influence on decisions about forensic evidence. Here, we explored accuracy and contextual influence in bloodstain pattern classification, and how these variables might relate to analyst characteristics. Thirty-nine bloodstain pattern analysts with varying degrees of experience each completed measures of compliance, decision-making style, and need for closure. Analysts then examined a bloodstain pattern without any additional contextual information, and allocated votes to listed pattern types according to favoured and less favoured classifications. Next, if they believed it would assist with their classification, analysts could request items of contextual information - from commonly encountered sources of information in bloodstain pattern analysis - and update their vote allocation. We calculated a shift score for each item of contextual information based on vote reallocation. Almost all forms of contextual information influenced decision-making, with medical findings leading to the highest shift scores. Although there was a small positive association between shift scores and the degree to which analysts displayed an intuitive decision-making style, shift scores did not vary meaningfully as a function of experience or the other characteristics measured. Almost all of the erroneous classifications were made by novice analysts. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

Less power or powerless? Egocentric empathy gaps and the irony of having little versus no power in social decision making.

PubMed

Handgraaf, Michel J J; Van Dijk, Eric; Vermunt, Riël C; Wilke, Henk A M; De Dreu, Carsten K W

2008-11-01

The authors investigate the effect of power differences and associated expectations in social decision making. Using a modified ultimatum game, the authors show that allocators lower their offers to recipients when the power difference shifts in favor of the allocator. Remarkably, however, when recipients are completely powerless, offers increase. This effect is mediated by a change in framing of the situation: When the opponent is without power, feelings of social responsibility are evoked. On the recipient side, the authors show that recipients do not anticipate these higher outcomes resulting from powerlessness. They prefer more power over less, expecting higher outcomes when they are more powerful, especially when less power entails powerlessness. Results are discussed in relation to empathy gaps and social responsibility. (c) 2008 APA, all rights reserved.

Resource allocation and funding challenges for regional local health departments in Nebraska.

PubMed

Chen, Li-Wu; Jacobson, Janelle; Roberts, Sara; Palm, David

2012-01-01

This study examined the mechanism of resource allocation among member counties and the funding challenges of regional health departments (RHDs) in Nebraska. DESIGN AND STUDY SETTING: In 2009, we conducted a qualitative case study of 2 Nebraska RHDs to gain insight into their experiences of making resource allocation decisions and confronting funding challenges. The 2 RHD sites were selected for this case study on the basis of their heterogeneity in terms of population distribution in member counties. Sixteen semistructured in-person interviews were conducted with RHD directors, staff, and board of health members. Interview data were coded and analyzed using NVivo qualitative analysis software (QSR International [Americas] Inc., Cambridge, MA). Our findings suggested that the directors of RHDs play an integral role in making resource allocation decisions on the basis of community needs, not on a formula or on individual county population size. Interviewees also reported that the size of the vulnerable population served by the RHD had a significant impact on the level of resources for RHD's programs. The RHD's decisions about resource allocation were also dependent on the amount and type of resources received from the state. Interviewees identified inadequacy and instability of funding as the 2 main funding challenges for their RHD. These challenges negatively impacted workforce capacity and the long-term sustainability of some programs. Regional health departments may not benefit from better leveraging resources and building a stronger structural capacity unless the issues of funding inadequacy and instability are addressed. Strategies that can be used by RHDs to address these funding challenges include seeking grants to support programs, leveraging existing resources, and building community partnerships to share resources. Future research is needed to identify RHDs' optimal workforce capacity, required funding level, and potential funding mechanisms.

Physicians as gatekeepers: illness certification as a rationing device.

PubMed

Stone, D A

1979-01-01

Illness or disability is often used as an eligibility criterion by public programs that distribute money, services, privileges, and exemptions. Physicians then play a central role in the allocation process. But physicians are caught between a large pool of applicants who want some benefit, on the one hand, and an organization with limited resources to distribute, on the other hand. Three conflicts are engendered in this gatekeeping role: the tension between trusting and mistrusting information provided by the patient, the tension between erring on the false positive side and the false negative side in diagnostic decision-making, and the tension between doing everything possible for each patient and allocating limited resources among several needy clients. Several non-medical factors influence the ultimate outcome of this allocation process, which, in theory, rests on clinical decision-making: the specificity and restrictiveness of the formal definitions of illness and disability used by a program; the structure of the determination process; the overall policy of the organization on distribution of benefits; and the ability of the organization to use administrative review, direct incentives, and written standards to control the certifying behavior of physicians.

Are alternative investments the right approach for your organization?

PubMed

French, Charles J; Dodd, Thomas H

2010-04-01

The decision by a healthcare provider to implement and monitor an alternative investment program requires careful consideration and planning. There are several things an organization should do when making this decision: Begin slowly. Consider access and liquidity. Don't force the investment to fill a target allocation. View an alternative investment as an opportunity investment."

Community College Presidents' Perspectives of Dichotomous Events: The Consequences of the Great Recession & Coincidental Increased Enrollment

ERIC Educational Resources Information Center

Carlson, Corey W.

2013-01-01

The community college, like all of higher education, has been significantly impacted by the Great Recession and coincidental increased enrollment. The purpose of this qualitative study was to examine the decision making processes of community college presidents as related to resource allocation and the impact of these decisions on the…

Corporate funding of human services agencies.

PubMed

Zippay, A

1992-05-01

This article reviews national trends in the organization of corporate giving to human services agencies, examines how corporations make funding decisions, and reports the results of a case study of philanthropic giving among 29 companies in Cambridge, Massachusetts. The study found that most corporations use an informal rather than a formal process for making funding decisions, with many firms relying on tradition, social contacts, and intuition to guide allocations. Suggestions that social services administrators can use to enhance development planning at their agencies are provided.

A supplier selection and order allocation problem with stochastic demands

NASA Astrophysics Data System (ADS)

Zhou, Yun; Zhao, Lei; Zhao, Xiaobo; Jiang, Jianhua

2011-08-01

We consider a system comprising a retailer and a set of candidate suppliers that operates within a finite planning horizon of multiple periods. The retailer replenishes its inventory from the suppliers and satisfies stochastic customer demands. At the beginning of each period, the retailer makes decisions on the replenishment quantity, supplier selection and order allocation among the selected suppliers. An optimisation problem is formulated to minimise the total expected system cost, which includes an outer level stochastic dynamic program for the optimal replenishment quantity and an inner level integer program for supplier selection and order allocation with a given replenishment quantity. For the inner level subproblem, we develop a polynomial algorithm to obtain optimal decisions. For the outer level subproblem, we propose an efficient heuristic for the system with integer-valued inventory, based on the structural properties of the system with real-valued inventory. We investigate the efficiency of the proposed solution approach, as well as the impact of parameters on the optimal replenishment decision with numerical experiments.

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

PubMed Central

Teerawattananon, Yot; Russell, Steve

2008-01-01

Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions. PMID:18817579

Deep Rationality: The Evolutionary Economics of Decision Making.

PubMed

Kenrick, Douglas T; Griskevicius, Vladas; Sundie, Jill M; Li, Norman P; Li, Yexin Jessica; Neuberg, Steven L

2009-10-01

What is a "rational" decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research.

Deep Rationality: The Evolutionary Economics of Decision Making

PubMed Central

Kenrick, Douglas T.; Griskevicius, Vladas; Sundie, Jill M.; Li, Norman P.; Li, Yexin Jessica; Neuberg, Steven L.

2009-01-01

What is a “rational” decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research. PMID:20686634

Reinforcement Learning Multi-Agent Modeling of Decision-Making Agents for the Study of Transboundary Surface Water Conflicts with Application to the Syr Darya River Basin

NASA Astrophysics Data System (ADS)

Riegels, N.; Siegfried, T.; Pereira Cardenal, S. J.; Jensen, R. A.; Bauer-Gottwein, P.

2008-12-01

In most economics--driven approaches to optimizing water use at the river basin scale, the system is modelled deterministically with the goal of maximizing overall benefits. However, actual operation and allocation decisions must be made under hydrologic and economic uncertainty. In addition, river basins often cross political boundaries, and different states may not be motivated to cooperate so as to maximize basin- scale benefits. Even within states, competing agents such as irrigation districts, municipal water agencies, and large industrial users may not have incentives to cooperate to realize efficiency gains identified in basin- level studies. More traditional simulation--optimization approaches assume pre-commitment by individual agents and stakeholders and unconditional compliance on each side. While this can help determine attainable gains and tradeoffs from efficient management, such hardwired policies do not account for dynamic feedback between agents themselves or between agents and their environments (e.g. due to climate change etc.). In reality however, we are dealing with an out-of-equilibrium multi-agent system, where there is neither global knowledge nor global control, but rather continuous strategic interaction between decision making agents. Based on the theory of stochastic games, we present a computational framework that allows for studying the dynamic feedback between decision--making agents themselves and an inherently uncertain environment in a spatially and temporally distributed manner. Agents with decision-making control over water allocation such as countries, irrigation districts, and municipalities are represented by reinforcement learning agents and coupled to a detailed hydrologic--economic model. This approach emphasizes learning by agents from their continuous interaction with other agents and the environment. It provides a convenient framework for the solution of the problem of dynamic decision-making in a mixed cooperative / non-cooperative environment with which different institutional setups and incentive systems can be studied so to identify reasonable ways to reach desirable, Pareto--optimal allocation outcomes. Preliminary results from an application to the Syr Darya river basin in Central Asia will be presented and discussed. The Syr Darya River is a classic example of a transboundary river basin in which basin-wide efficiency gains identified in optimization studies have not been sufficient to induce cooperative management of the river by the riparian states.

An Empirical Study of the Application of Decision Making Model Using Judgement in the Allocation of Resources to Competing Educational Programs. Final Report.

ERIC Educational Resources Information Center

Tuscher, Leroy J.

The purpose of the study was to provide "baseline" data for determining the feasibility of further investigation into the use of quantitive judgmental data in evaluating school programs for determining program budget allocations. The specific objectives were to: 1) Apply a Cost-Utility Model to a "real world" situation in a public secondary…

The Emperor's New Clothes: The h-Index as a Guide to Resource Allocation in Higher Education

ERIC Educational Resources Information Center

Barnes, Cameron

2014-01-01

This article calls into question the use of the h-index as an aid to decision-making in the higher education sector. The h-index is increasingly employed by institutions, funding bodies and even governments as a guide to the allocation of resources. This practice is contrary to the evidence that the h-index is intrinsically meaningless, a point…

Offspring Size and Reproductive Allocation in Harvester Ants.

PubMed

Wiernasz, Diane C; Cole, Blaine J

2018-01-01

A fundamental decision that an organism must make is how to allocate resources to offspring, with respect to both size and number. The two major theoretical approaches to this problem, optimal offspring size and optimistic brood size models, make different predictions that may be reconciled by including how offspring fitness is related to size. We extended the reasoning of Trivers and Willard (1973) to derive a general model of how parents should allocate additional resources with respect to the number of males and females produced, and among individuals of each sex, based on the fitness payoffs of each. We then predicted how harvester ant colonies should invest additional resources and tested three hypotheses derived from our model, using data from 3 years of food supplementation bracketed by 6 years without food addition. All major results were predicted by our model: food supplementation increased the number of reproductives produced. Male, but not female, size increased with food addition; the greatest increases in male size occurred in colonies that made small females. We discuss how use of a fitness landscape improves quantitative predictions about allocation decisions. When parents can invest differentially in offspring of different types, the best strategy will depend on parental state as well as the effect of investment on offspring fitness.

75 FR 39541 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... before making important decisions such as adopting new policies and allocating or redirecting significant... allow for a more indepth understanding of individuals' attitudes, beliefs, motivations, and feelings...

Allocating resources during a crisis: you can't always get what you want.

PubMed

Hick, John L; DeVries, Aaron S; Fink-Kocken, Paula; Braun, Jane E; Marchetti, Judy

2012-04-01

During a disaster or disease outbreak, health care providers may have to make difficult decisions about how to allocate scarce resources. A committee convened by the Minnesota Department of Health has recently focused on this issue as part of statewide disaster preparedness planning. This article presents the group's recommendation that health care facilities need to plan for shortages and introduces resources and strategies that can be used in planning. It also discusses ethical considerations that must be taken into account when shortages occur and decisions must be made about how to distribute equipment, supplies, or medications in short supply.

What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.

PubMed

Page, Katie; Barnett, Adrain G; Graves, Nicholas

2017-02-14

Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is the better value for making resource decisions, and we describe our valuation method and estimations for costing this important resource. We performed a contingent valuation using 37 Australian Chief Executive Officers' (CEOs) willingness to pay (WTP) to release bed days in their hospitals, both generally and using specific cases. We provide a succinct thematic analysis from qualitative interviews post survey completion, which provide insight into the decision making process. On average CEOs are willing to pay a marginal rate of $216 for a ward bed day and $436 for an Intensive Care Unit (ICU) bed day, with estimates of uncertainty being greater for ICU beds. These estimates are significantly lower (four times for ward beds and seven times for ICU beds) than the traditional accounting costs often used. Key themes to emerge from the interviews include the importance of national funding and targets, and their associated incentive structures, as well as the aversion to discuss bed days as an economic resource. This study highlights the importance for valuing bed days as an economic resource to inform cost effectiveness models and thus improve hospital decision making and resource allocation. Significantly under or over valuing the resource is very likely to result in sub-optimal decision making. We discuss the importance of recognising the opportunity costs of this resource and highlight areas for future research.

Decision-making under surprise and uncertainty: Arsenic contamination of water supplies

NASA Astrophysics Data System (ADS)

Randhir, Timothy O.; Mozumder, Pallab; Halim, Nafisa

2018-05-01

With ignorance and potential surprise dominating decision making in water resources, a framework for dealing with such uncertainty is a critical need in hydrology. We operationalize the 'potential surprise' criterion proposed by Shackle, Vickers, and Katzner (SVK) to derive decision rules to manage water resources under uncertainty and ignorance. We apply this framework to managing water supply systems in Bangladesh that face severe, naturally occurring arsenic contamination. The uncertainty involved with arsenic in water supplies makes the application of conventional analysis of decision-making ineffective. Given the uncertainty and surprise involved in such cases, we find that optimal decisions tend to favor actions that avoid irreversible outcomes instead of conventional cost-effective actions. We observe that a diversification of the water supply system also emerges as a robust strategy to avert unintended outcomes of water contamination. Shallow wells had a slight higher optimal level (36%) compare to deep wells and surface treatment which had allocation levels of roughly 32% under each. The approach can be applied in a variety of other cases that involve decision making under uncertainty and surprise, a frequent situation in natural resources management.

IS THE LINK BETWEEN HEALTH AND WEALTH CONSIDERED IN DECISION MAKING? RESULTS FROM A QUALITATIVE STUDY.

PubMed

Garau, Martina; Shah, Koonal Kirit; Sharma, Priya; Towse, Adrian

2015-01-01

The aim of this study was to explore whether wealth effects of health interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. To analyze reasons for including, or not including, wealth effects. Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom). There is evidence suggesting that health interventions can produce economic gains for patients and national economies. However, we found that the link between health and wealth does not influence decision making in any country with the exception of Sweden. This is due to a combination of factors, including system fragmentation, methodological issues, and the economic recession forcing national governments to focus on short-term measures. In countries with established HTA processes and methods allowing, in principle, the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and see a more systematic consideration of wealth effect in decision making. This would be consistent with principles of efficient priority setting. Barriers for the consideration of wealth effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, governments should consider all relevant effects from public investments, including healthcare, even when benefits can only be captured in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns.

Planning attitudes, lay philosophies, and water allocation: A preliminary analysis and research agenda

NASA Astrophysics Data System (ADS)

Syme, Geoffrey J.; Nancarrow, Blair E.

Despite the important societal consequences of water policy, community attitudes toward planning, ethics, and equity for allocation of water have received little research attention. This preliminary research was conducted to assess the range and structure of planning attitudes and equity and ethical considerations which might be relevant to the general public's evaluation of water allocation systems. The relationship of these to priorities for water allocation were also examined. The results showed a complex structure for planning attitudes. There were also generalized but clearly defined community approaches to water allocation. A number of significant relationships between planning attitudes and philosophies of allocation were shown. Planning attitudes also related to priorities for water allocation. In practical terms the research provides some preliminary, ethically based evaluative criteria which could be applied to allocation decision-making systems. Theoretical research possibilities are also outlined.

Incorporating uncertainty of management costs in sensitivity analyses of matrix population models.

PubMed

Salomon, Yacov; McCarthy, Michael A; Taylor, Peter; Wintle, Brendan A

2013-02-01

The importance of accounting for economic costs when making environmental-management decisions subject to resource constraints has been increasingly recognized in recent years. In contrast, uncertainty associated with such costs has often been ignored. We developed a method, on the basis of economic theory, that accounts for the uncertainty in population-management decisions. We considered the case where, rather than taking fixed values, model parameters are random variables that represent the situation when parameters are not precisely known. Hence, the outcome is not precisely known either. Instead of maximizing the expected outcome, we maximized the probability of obtaining an outcome above a threshold of acceptability. We derived explicit analytical expressions for the optimal allocation and its associated probability, as a function of the threshold of acceptability, where the model parameters were distributed according to normal and uniform distributions. To illustrate our approach we revisited a previous study that incorporated cost-efficiency analyses in management decisions that were based on perturbation analyses of matrix population models. Incorporating derivations from this study into our framework, we extended the model to address potential uncertainties. We then applied these results to 2 case studies: management of a Koala (Phascolarctos cinereus) population and conservation of an olive ridley sea turtle (Lepidochelys olivacea) population. For low aspirations, that is, when the threshold of acceptability is relatively low, the optimal strategy was obtained by diversifying the allocation of funds. Conversely, for high aspirations, the budget was directed toward management actions with the highest potential effect on the population. The exact optimal allocation was sensitive to the choice of uncertainty model. Our results highlight the importance of accounting for uncertainty when making decisions and suggest that more effort should be placed on understanding the distributional characteristics of such uncertainty. Our approach provides a tool to improve decision making. © 2013 Society for Conservation Biology.

Buying and Using Tomorrow's Computers in Today's Tertiary Institutions.

ERIC Educational Resources Information Center

Sungalia, Helen

1980-01-01

Higher-education administrators are alerted to the advent of the microprocessor and the capabilities of desk computers. The potential use of the microcomputer in administrative decision making, efficiency, and resource allocation are reviewed briefly. (MSE)

National fuel-treatment budgeting in US federal agencies: capturing opportunities for transparent decision-making

Treesearch

Keith M. Reynolds; Paul F. Hessburg; Robert E. Keane; James P. Menakis

2009-01-01

The Ecosystem Management Decision Support (EMDS) system has been used by the US Department of Agriculture, Forest Service and Bureaus of the Department of the Interior since 2006 to evaluate wildfire potential across all administrative units in the continental US, and to establish priorities for allocating fuel-treatment budgets. This article discusses an EMDS fuels-...

Mapping ecological risks with a portfolio-based technique: incorporating uncertainty and decision-making preferences

Treesearch

Denys Yemshanov; Frank H. Koch; Mark Ducey; Klaus Koehler

2013-01-01

Geographic mapping of risks is a useful analytical step in ecological risk assessments and in particular, in analyses aimed to estimate risks associated with introductions of invasive organisms. In this paper, we approach invasive species risk mapping as a portfolio allocation problem and apply techniques from decision theory to build an invasion risk map that combines...

Clinic Workflow Simulations using Secondary EHR Data

PubMed Central

Hribar, Michelle R.; Biermann, David; Read-Brown, Sarah; Reznick, Leah; Lombardi, Lorinna; Parikh, Mansi; Chamberlain, Winston; Yackel, Thomas R.; Chiang, Michael F.

2016-01-01

Clinicians today face increased patient loads, decreased reimbursements and potential negative productivity impacts of using electronic health records (EHR), but have little guidance on how to improve clinic efficiency. Discrete event simulation models are powerful tools for evaluating clinical workflow and improving efficiency, particularly when they are built from secondary EHR timing data. The purpose of this study is to demonstrate that these simulation models can be used for resource allocation decision making as well as for evaluating novel scheduling strategies in outpatient ophthalmology clinics. Key findings from this study are that: 1) secondary use of EHR timestamp data in simulation models represents clinic workflow, 2) simulations provide insight into the best allocation of resources in a clinic, 3) simulations provide critical information for schedule creation and decision making by clinic managers, and 4) simulation models built from EHR data are potentially generalizable. PMID:28269861

Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression

PubMed Central

Petrovic, Nada; Alderson, David L.; Carlson, Jean M.

2012-01-01

Challenges associated with the allocation of limited resources to mitigate the impact of natural disasters inspire fundamentally new theoretical questions for dynamic decision making in coupled human and natural systems. Wildfires are one of several types of disaster phenomena, including oil spills and disease epidemics, where (1) the disaster evolves on the same timescale as the response effort, and (2) delays in response can lead to increased disaster severity and thus greater demand for resources. We introduce a minimal stochastic process to represent wildfire progression that nonetheless accurately captures the heavy tailed statistical distribution of fire sizes observed in nature. We then couple this model for fire spread to a series of response models that isolate fundamental tradeoffs both in the strength and timing of response and also in division of limited resources across multiple competing suppression efforts. Using this framework, we compute optimal strategies for decision making scenarios that arise in fire response policy. PMID:22514605

[Strategic decisions in public psychiatric institutions: a proposed method for resource analysis and allocation].

PubMed

Micheletti, Pierre; Chierici, Piero; Durang, Xavier; Salvador, Nathalie; Lopez, Nathalie

2011-01-01

Because of its sector-based organization and extra-hospital care, public psychiatry has a unique position in healthcare. This paper describes the tools and procedures used to analyze and allocate the resources of the "Centre Hospitalier Alpes-Isère", a hospital serving a catchment population of 530,000 adults. A consensus-based approach was used to validate the selected indicators and included the participation of a geographer. Five levels of resource allocation were identified and classified using a decision tree. At each level, the relevant authorities and criteria were identified as key components of the decision-making process. This paper describes the first three levels of care provision. Focusing on adult care, a comparative assessment of the resources allocated to general psychiatric care and specialist care was conducted, in addition to a comparative assessment of the resources allocated to each of the hospital's four local centers. Geographical accessibility to extramural facilities was also assessed. A study of the characteristics of each general psychiatry clinic revealed significant disparities. The paper highlights several issues: the poor knowledge of psychiatric epidemiological data relating to the population within the catchment area, the difficulty of assessing non-consolidated data or indicators from multiple sources, and the limited and partial nature of geographical data for characterizing and evaluating health care in the hospital's peripheral clinics. Several studies are currently underway to assess the operational effectiveness of the tools and procedures used to analyze and allocate resources.

Exploring decision-making for environmental health services: perspectives from four cities.

PubMed

Hunt, C; Lewin, S

2000-01-01

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Prioritization of Stockpile Maintenance with Layered Pareto Fronts

DOE PAGES

Burke, Sarah E.; Anderson-Cook, Christine M.; Lu, Lu; ...

2017-10-11

Difficult choices are required for a decision-making process where resources and budgets are increasingly constrained. This study demonstrates a structured decision-making approach using layered Pareto fronts to identify priorities about how to allocate funds between munitions stockpiles based on their estimated reliability, the urgency of needing available units, and the consequences if adequate numbers of units are not available. This case study, while specific to the characteristics of a group of munitions stockpiles, illustrates the general process of structured decision-making based on first identifying appropriate metrics that summarize the important dimensions of the decision, and then objectively eliminating non-contenders frommore » further consideration. Finally, the final subjective stage incorporates user priorities to select the four stockpiles to receive additional maintenance and surveillance funds based on understanding the trade-offs and robustness to various user priorities.« less

Satisficing in split-second decision making is characterized by strategic cue discounting.

PubMed

Oh, Hanna; Beck, Jeffrey M; Zhu, Pingping; Sommer, Marc A; Ferrari, Silvia; Egner, Tobias

2016-12-01

Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through satisficing, fast but "good-enough" heuristic decision making that prioritizes some sources of information (cues) while ignoring others. However, the decision-making strategies we adopt under uncertainty and time pressure, for example during emergencies that demand split-second choices, are presently unknown. To characterize these decision strategies quantitatively, the present study examined how people solve a novel multicue probabilistic classification task under varying time pressure, by tracking shifts in decision strategies using variational Bayesian inference. We found that under low time pressure, participants correctly weighted and integrated all available cues to arrive at near-optimal decisions. With increasingly demanding, subsecond time pressures, however, participants systematically discounted a subset of the cue information by dropping the least informative cue(s) from their decision making process. Thus, the human cognitive apparatus copes with uncertainty and severe time pressure by adopting a "drop-the-worst" cue decision making strategy that minimizes cognitive time and effort investment while preserving the consideration of the most diagnostic cue information, thus maintaining "good-enough" accuracy. This advance in our understanding of satisficing strategies could form the basis of predicting human choices in high time pressure scenarios. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Attitudes of rehabilitation medicine doctors toward medical ethics in Malaysia.

PubMed

Mazlina, M; Julia, P E

2011-06-01

Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care. We surveyed 74 rehabilitation physicians and residents in Malaysia using a self-administered descriptive questionnaire. The questions covered medical ethics issues on allocation of resources, patient confidentiality, discharge planning, goal-setting, reimbursement documentation, decision-making capacity and withdrawal of life support. The overall response rate was 69 percent. More than 80 percent of respondents would disclose confidential information to their team members if it would affect the rehabilitation process. More than two-thirds of respondents would not allocate scarce rehabilitation resources if the functional outcome is marginally positive. Issues involving patients' autonomy in decision-making, both in life-threatening and non-life-threatening situations, showed mix responses. The least common response was on the issue of discharge planning, where 51 percent of respondents would send a patient back to a nursing home with suboptimal care if there were no other alternatives. The attitude of Malaysian rehabilitation doctors toward ethical issues is reflective of the level of maturity of rehabilitation medicine in Malaysia. Issues on allocation of resources, discharge planning and decision-making capacity are significantly influenced by limited rehabilitation facilities in parts of the country. The lack of influence from external factors, such as a developed health insurance system, contributes to the difference in attitude between rehabilitation doctors in Malaysia and those in developed countries.

Exploring the Influence of Smallholders' Perceptions Regarding Water Availability on Crop Choice and Water Allocation Through Socio-Hydrological Modeling

NASA Astrophysics Data System (ADS)

Kuil, L.; Evans, T.; McCord, P. F.; Salinas, J. L.; Blöschl, G.

2018-04-01

While it is known that farmers adopt different decision-making behaviors to cope with stresses, it remains challenging to capture this diversity in formal model frameworks that are used to advance theory and inform policy. Guided by cognitive theory and the theory of bounded rationality, this research develops a novel, socio-hydrological model framework that can explore how a farmer's perception of water availability impacts crop choice and water allocation. The model is informed by a rich empirical data set at the household level collected during 2013 in Kenya's Upper Ewaso Ng'iro basin that shows that the crop type cultivated is correlated with water availability. The model is able to simulate this pattern and shows that near-optimal or "satisficing" crop patterns can emerge also when farmers were to make use of simple decision rules and have diverse perceptions on water availability. By focusing on farmer decision making it also captures the rebound effect, i.e., as additional water becomes available through the improvement of crop efficiencies it will be reallocated on the farm instead of flowing downstream, as a farmer will adjust his (her) water allocation and crop pattern to the new water conditions. This study is valuable as it is consistent with the theory of bounded rationality, and thus offers an alternative, descriptive model in addition to normative models. The framework can be used to understand the potential impact of climate change on the socio-hydrological system, to simulate and test various assumptions regarding farmer behavior and to evaluate policy interventions.

Stochastic multi-objective auto-optimization for resource allocation decision-making in fixed-input health systems.

PubMed

Bastian, Nathaniel D; Ekin, Tahir; Kang, Hyojung; Griffin, Paul M; Fulton, Lawrence V; Grannan, Benjamin C

2017-06-01

The management of hospitals within fixed-input health systems such as the U.S. Military Health System (MHS) can be challenging due to the large number of hospitals, as well as the uncertainty in input resources and achievable outputs. This paper introduces a stochastic multi-objective auto-optimization model (SMAOM) for resource allocation decision-making in fixed-input health systems. The model can automatically identify where to re-allocate system input resources at the hospital level in order to optimize overall system performance, while considering uncertainty in the model parameters. The model is applied to 128 hospitals in the three services (Air Force, Army, and Navy) in the MHS using hospital-level data from 2009 - 2013. The results are compared to the traditional input-oriented variable returns-to-scale Data Envelopment Analysis (DEA) model. The application of SMAOM to the MHS increases the expected system-wide technical efficiency by 18 % over the DEA model while also accounting for uncertainty of health system inputs and outputs. The developed method is useful for decision-makers in the Defense Health Agency (DHA), who have a strategic level objective of integrating clinical and business processes through better sharing of resources across the MHS and through system-wide standardization across the services. It is also less sensitive to data outliers or sampling errors than traditional DEA methods.

Patient involvement in health care decision making: a review.

PubMed

Vahdat, Shaghayegh; Hamzehgardeshi, Leila; Hessam, Somayeh; Hamzehgardeshi, Zeinab

2014-01-01

Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions. Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making. To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article. BASED ON THE REVIEW OF ARTICLES AND BOOKS, TOPICS WERE DIVIDED INTO SIX GENERAL CATEGORIES: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making. IN MOST STUDIES, FACTORS INFLUENCING PATIENT PARTICIPATION CONSISTED OF: factors associated with health care professionals such as doctor-patient relationship, recognition of patient's knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.

A centre-free approach for resource allocation with lower bounds

NASA Astrophysics Data System (ADS)

Obando, Germán; Quijano, Nicanor; Rakoto-Ravalontsalama, Naly

2017-09-01

Since complexity and scale of systems are continuously increasing, there is a growing interest in developing distributed algorithms that are capable to address information constraints, specially for solving optimisation and decision-making problems. In this paper, we propose a novel method to solve distributed resource allocation problems that include lower bound constraints. The optimisation process is carried out by a set of agents that use a communication network to coordinate their decisions. Convergence and optimality of the method are guaranteed under some mild assumptions related to the convexity of the problem and the connectivity of the underlying graph. Finally, we compare our approach with other techniques reported in the literature, and we present some engineering applications.

Managing healthcare budgets in times of austerity: the role of program budgeting and marginal analysis.

PubMed

Mitton, Craig; Dionne, Francois; Donaldson, Cam

2014-04-01

Given limited resources, priority setting or choice making will remain a reality at all levels of publicly funded healthcare across countries for many years to come. The pressures may well be even more acute as the impact of the economic crisis of 2008 continues to play out but, even as economies begin to turn around, resources within healthcare will be limited, thus some form of rationing will be required. Over the last few decades, research on healthcare priority setting has focused on methods of implementation as well as on the development of approaches related to fairness and legitimacy and on more technical aspects of decision making including the use of multi-criteria decision analysis. Recently, research has led to better understanding of evaluating priority setting activity including defining 'success' and articulating key elements for high performance. This body of research, however, often goes untapped by those charged with making challenging decisions and as such, in line with prevailing public sector incentives, decisions are often reliant on historical allocation patterns and/or political negotiation. These archaic and ineffective approaches not only lead to poor decisions in terms of value for money but further do not reflect basic ethical conditions that can lead to fairness in the decision-making process. The purpose of this paper is to outline a comprehensive approach to priority setting and resource allocation that has been used in different contexts across countries. This will provide decision makers with a single point of access for a basic understanding of relevant tools when faced with having to make difficult decisions about what healthcare services to fund and what not to fund. The paper also addresses several key issues related to priority setting including how health technology assessments can be used, how performance can be improved at a practical level, and what ongoing resource management practice should look like. In terms of future research, one of the most important areas of priority setting that needs further attention is how best to engage public members.

Patient and health professional preferences for organ allocation and procurement, end-of-life care and organization of care for patients with chronic kidney disease using a discrete choice experiment.

PubMed

Davison, Sara N; Kromm, Seija K; Currie, Gillian R

2010-07-01

Clinical practice, policy and research, and the ethical bases upon which they are founded, should be systematically and transparently informed by both patient and professional values. A discrete choice experiment was utilized to understand and quantify the preferences of 351 Canadian patients and healthcare providers in relation to ethically challenging aspects of the management of chronic kidney disease (CKD): procurement and allocation of organs for transplantation, end-of-life care discussions and decision making and the identities of those providing primary care. Patients and health professionals had clear preferences for detailed prognostic information, early advance care planning, shared end-of-life decision making, coordinated models of care that enhance interaction and communication between primary and tertiary care and a more utilitarian approach of best match over first come, first served for allocating deceased donor kidneys. These data also suggest that the innovative strategies of non-directed anonymous donation and paired kidney exchange that are slowly being implemented internationally will be acceptable to both patients and healthcare providers. Current models of CKD care do not consistently reflect the preferences or priorities of either health professionals or patients.

Role of pharmacoeconomic analysis in R&D decision making: when, where, how?

PubMed

Miller, Paul

2005-01-01

Pharmacoeconomics is vitally important to drug manufacturers in terms of communicating to external decision-makers (payers, prescribers, patients) the value of their products, achieving regulatory and reimbursement approval and contributing to commercial success. Since development of new drugs is long, costly and risky, and decisions must be made how to allocate considerable research and development (R&D) resources, pharmacoeconomics also has an essential role informing internal decision-making (within a company) during drug development. The use of pharmacoeconomics in early development phases is likely to enhance the efficiency of R&D resource use and also provide a solid foundation for communicating product value to external decision-makers further downstream, increasing the likelihood of regulatory (reimbursement) approval and commercial success. This paper puts the case for use of pharmacoeconomic analyses earlier in the development process and outlines five techniques (clinical trial simulation [CTS], option pricing [OP], investment appraisal [IA], threshold analysis [TA] and value of information [VOI] analysis) that can provide useful input into the design of clinical development programmes, portfolio management and optimal pricing strategy. CTS can estimate efficacy and tolerability profiles before clinical data are available. OP can show the value of different clinical programme designs, sequencing of studies and stop decisions. IA can compare expected net present value (NPV) of different product profiles or study designs. TA can be used to understand development drug profile requirements given partial data. VOI can assist risk management by quantifying uncertainty and assessing the economic viability of gathering further information on the development drug. No amount of pharmacoeconomic data can make a bad drug good; what it can do is enhance the drug developers understanding of the characteristics of that drug. Decision-making, in light of this information, is likely to be better than that without it, whether it leads to faster termination of uneconomic projects or the allocation of more appropriate resources to attractive projects.

Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression

DTIC Science & Technology

2012-04-13

S, Martı́nez-Falero E, Pérez-González JM (2002) Optimiza- tion of the resources management in fighting wildfires . Environmental Management 30: 352...Dynamic Resource Allocation in Disaster Response: Tradeoffs in Wildfire Suppression Nada Petrovic1*, David L. Alderson2, Jean M. Carlson3 1Center for...inspire fundamentally new theoretical questions for dynamic decision making in coupled human and natural systems. Wildfires are one of several types of

Budgeting Approaches in Community Colleges

ERIC Educational Resources Information Center

Palmer, James C.

2014-01-01

Several budgeting approaches have been initiated as alternatives to the traditional, incremental process. These include formula budgeting; zero-base budgeting; planning, programming, and budgeting systems; and responsibility center budgeting. Each is premised on assumptions about how organizations might best make resource allocation decisions.…

Are Universities Rational Organizations?

ERIC Educational Resources Information Center

Dufty, N. F.

1980-01-01

Administrators in higher education frequently assume a type of rationality based on bureaucratic or political models of organizations, or some combination of the two. This assumption is questioned, and suggestions are made for models of decision making, resource allocation, and policy formation and implementation. (MSE)

Drought Water Right Curtailment

NASA Astrophysics Data System (ADS)

Walker, W.; Tweet, A.; Magnuson-Skeels, B.; Whittington, C.; Arnold, B.; Lund, J. R.

2016-12-01

California's water rights system allocates water based on priority, where lower priority, "junior" rights are curtailed first in a drought. The Drought Water Rights Allocation Tool (DWRAT) was developed to integrate water right allocation models with legal objectives to suggest water rights curtailments during drought. DWRAT incorporates water right use and priorities with a flow-forecasting model to mathematically represent water law and hydrology and suggest water allocations among water rights holders. DWRAT is compiled within an Excel workbook, with an interface and an open-source solver. By implementing California water rights law as an algorithm, DWRAT provides a precise and transparent framework for the complicated and often controversial technical aspects of curtailing water rights use during drought. DWRAT models have been developed for use in the Eel, Russian, and Sacramento river basins. In this study, an initial DWRAT model has been developed for the San Joaquin watershed, which incorporates all water rights holders in the basin and reference gage flows for major tributaries. The San Joaquin DWRAT can assess water allocation reliability by determining probability of rights holders' curtailment for a range of hydrologic conditions. Forecasted flow values can be input to the model to provide decision makers with the ability to make curtailment and water supply strategy decisions. Environmental flow allocations will be further integrated into the model to protect and improve ecosystem water reliability.

Stochastic Optimization For Water Resources Allocation

NASA Astrophysics Data System (ADS)

Yamout, G.; Hatfield, K.

2003-12-01

For more than 40 years, water resources allocation problems have been addressed using deterministic mathematical optimization. When data uncertainties exist, these methods could lead to solutions that are sub-optimal or even infeasible. While optimization models have been proposed for water resources decision-making under uncertainty, no attempts have been made to address the uncertainties in water allocation problems in an integrated approach. This paper presents an Integrated Dynamic, Multi-stage, Feedback-controlled, Linear, Stochastic, and Distributed parameter optimization approach to solve a problem of water resources allocation. It attempts to capture (1) the conflict caused by competing objectives, (2) environmental degradation produced by resource consumption, and finally (3) the uncertainty and risk generated by the inherently random nature of state and decision parameters involved in such a problem. A theoretical system is defined throughout its different elements. These elements consisting mainly of water resource components and end-users are described in terms of quantity, quality, and present and future associated risks and uncertainties. Models are identified, modified, and interfaced together to constitute an integrated water allocation optimization framework. This effort is a novel approach to confront the water allocation optimization problem while accounting for uncertainties associated with all its elements; thus resulting in a solution that correctly reflects the physical problem in hand.

Out of Alignment? Limitations of the Global Burden of Disease in Assessing the Allocation of Global Health Aid

PubMed Central

Voigt, Kristin; King, Nicholas B

2017-01-01

Abstract The Global Burden of Disease (GBD) project quantifies the impact of different health conditions by combining information about morbidity and premature mortality within a single metric, the Disability Adjusted Life Year. One important goal for the GBD project has been to inform decisions about global health priorities. A number of recent studies have used GBD data to argue that global health funding fails to align with the GBD. We argue that these studies’ shared assumption that global health resources should ‘align’ with the burden of disease is unfounded and has troubling implications. First, since the allocation of resources involves difficult trade-offs between different, potentially competing goals, any ‘misalignment’ of allocation and disease burdens need not necessarily indicate that the allocation of funds fails to meet recipient countries’ needs or interests. Second, using alignment as a baseline implicitly makes controversial assumptions about how harms of different magnitudes affecting different numbers of individuals should be aggregated. We discuss two alternative ways in which GBD data could help inform decisions about resource allocation, neither of which gives more than a limited role to GBD data. PMID:29731809

Health technology assessment in Saudi Arabia.

PubMed

Al-Aqeel, Sinaa

2018-05-16

The Saudi government, similar to any other government, is committed to making public spending more efficient, using resources more effectively, and limiting waste. Health technology assessment (HTA) is a tool that informs policy and decision makers regarding the formulation of safe and effective policies that are patient-focused and help to achieve efficiency when allocating limited health-care resources. Areas covered: After a brief description of HTA in the international context, this review provides a brief introduction to Saudi Arabia's health-care system, followed by a delineation of the decision maker(s) and influencers and the decision-making process for pricing and reimbursement. The article then discusses the current status of HTA in Saudi Arabia and proposes four strategic objectives that can form the first step in the development of a formal HTA process. Expert commentary: In Saudi Arabia, facilitators for incorporating HTA into the decision-making process exist. Future local research is needed to guide the implementation of full HTA.

Method for optimizing resource allocation in a government organization. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Afarin, James

1994-01-01

The managers in Federal agencies are challenged to control the extensive activities in government and still provide high-quality products and services to the American taxpayers. Considering today's complex social and economic environment and the $3.8 billion daily cost of operating the Federal Government, it is evident that there is a need to develop decision-making tools for accurate resource allocation and total quality management. The goal of this thesis is to provide a methodical process that will aid managers in Federal Government to make budgetary decisions based on the cost of services, the agency's objectives, and the customers' perception of the agency's product. A general resource allocation procedure was developed in this study that can be applied to any government organization. A government organization, hereafter the 'organization,' is assumed to be a multidivision enterprise. This procedure was applied to a small organization for the proof of the concept. This organization is the Technical Services Directorate (TSD) at the NASA Lewis Research Center in Cleveland, Ohio. As part of the procedure, a nonlinear programming model was developed to account for the resources of the organization, the outputs produced by the organization, the decision-maker's views, and the customers' satisfaction with the organization. The information on the resources of the organization was acquired from current budget levels of the organization and the human resources assigned to the divisions. The outputs of the organization were defined and measured by identifying metrics that assess the outputs, the most challenging task in this study. The decision-maker's views are represented in the model as weights assigned to the various outputs and were quantified by using the analytic hierarchy process. The customer's opinions regarding the outputs of the organization were collected through questionnaires that were designed for each division individually. Following the philosophy of total quality management, information on customers' satisfaction is presented in the model as the quality of output. The model is a nonlinear one whose objective is to maximize customers' satisfaction such that the total cost of operation does not exceed the organization's budget. This model represents a structured approach or policy mechanism, at the agency level, to make capital investment decisions based on the priorities of the agency and the quality of outputs. This procedure applied to TSD resulted in a resources allocation scheme that was reasonable and acceptable to the decision-makers and, as expected, dependent on the assumptions and accuracy of the data used in the model.

Infer More, Describe Less: More Powerful Survey Conclusions through Easy Inferential Tests

ERIC Educational Resources Information Center

Hightower, Christy; Scott, Kerry

2012-01-01

Many librarians use data from surveys to make decisions about how to spend money or allocate staff, often making use of popular online tools like Survey Monkey. In this era of reduced budgets, low staffing, stiff competition for new resources, and increasingly complex choices, it is especially important that librarians know how to get strong,…

Capturing a Commander's decision making style

NASA Astrophysics Data System (ADS)

Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

2017-05-01

A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

Investigation of Multi-Criteria Decision Consistency: A Triplex Approach to Optimal Oilfield Portfolio Investment Decisions

NASA Astrophysics Data System (ADS)

Qaradaghi, Mohammed

Complexity of the capital intensive oil and gas portfolio investments is continuously growing. It is manifested in the constant increase in the type, number and degree of risks and uncertainties, which consequently lead to more challenging decision making problems. A typical complex decision making problem in petroleum exploration and production (E&P) is the selection and prioritization of oilfields/projects in a portfolio investment. Prioritizing oilfields maybe required for different purposes, including the achievement of a targeted production and allocation of limited available development resources. These resources cannot be distributed evenly nor can they be allocated based on the oilfield size or production capacity alone since various other factors need to be considered simultaneously. These factors may include subsurface complexity, size of reservoir, plateau production and needed infrastructure in addition to other issues of strategic concern, such as socio-economic, environmental and fiscal policies, particularly when the decision making involves governments or national oil companies. Therefore, it would be imperative to employ decision aiding tools that not only address these factors, but also incorporate the decision makers' preferences clearly and accurately. However, the tools commonly used in project portfolio selection and optimization, including intuitive approaches, vary in their focus and strength in addressing the different criteria involved in such decision problems. They are also disadvantaged by a number of drawbacks, which may include lacking the capacity to address multiple and interrelated criteria, uncertainty and risk, project relationship with regard to value contribution and optimum resource utilization, non-monetary attributes, decision maker's knowledge and expertise, in addition to varying levels of ease of use and other practical and theoretical drawbacks. These drawbacks have motivated researchers to investigate other tools and techniques that can provide more flexibility and inclusiveness in the decision making process, such as Multi-Criteria Decision Making (MCDM) methods. However, it can be observed that the MCDM literature: 1) is primarily focused on suggesting certain MCDM techniques to specific problems without providing sufficient evidence for their selection, 2) is inadequate in addressing MCDM in E&P portfolio selection and prioritization compared with other fields, and 3) does not address prioritizing brownfields (i.e., developed oilfields). This research study aims at addressing the above drawbacks through combining three MCDM methods (i.e., AHP, PROMETHEE and TOPSIS) into a single decision making tool that can support optimal oilfield portfolio investment decisions by helping determine the share of each oilfield of the total development resources allocated. Selecting these methods is reinforced by a pre-deployment and post-deployment validation framework. In addition, this study proposes a two-dimensional consistency test to verify the output coherence or prioritization stability of the MCDM methods in comparison with an intuitive approach. Nine scenarios representing all possible outcomes of the internal and external consistency tests are further proposed to reach a conclusion. The methodology is applied to a case study of six major oilfields in Iraq to generate percentage shares of each oilfield of a total production target that is in line with Iraq's aspiration to increase oil production. However, the methodology is intended to be applicable to other E&P portfolio investment prioritization scenarios by taking the specific contextual characteristics into consideration.

Nature of collective decision-making by simple yes/no decision units.

PubMed

Hasegawa, Eisuke; Mizumoto, Nobuaki; Kobayashi, Kazuya; Dobata, Shigeto; Yoshimura, Jin; Watanabe, Saori; Murakami, Yuuka; Matsuura, Kenji

2017-10-31

The study of collective decision-making spans various fields such as brain and behavioural sciences, economics, management sciences, and artificial intelligence. Despite these interdisciplinary applications, little is known regarding how a group of simple 'yes/no' units, such as neurons in the brain, can select the best option among multiple options. One prerequisite for achieving such correct choices by the brain is correct evaluation of relative option quality, which enables a collective decision maker to efficiently choose the best option. Here, we applied a sensory discrimination mechanism using yes/no units with differential thresholds to a model for making a collective choice among multiple options. The performance corresponding to the correct choice was shown to be affected by various parameters. High performance can be achieved by tuning the threshold distribution with the options' quality distribution. The number of yes/no units allocated to each option and its variability profoundly affects performance. When this variability is large, a quorum decision becomes superior to a majority decision under some conditions. The general features of this collective decision-making by a group of simple yes/no units revealed in this study suggest that this mechanism may be useful in applications across various fields.

Addiction as a BAD, a Behavioral Allocation Disorder.

PubMed

Lamb, R J; Ginsburg, Brett C

2018-01-01

Addiction is continued drug use despite its harm. As one always has alternatives, addiction can be construed as a decision to allocate behavior to drug use. While decision making is commonly discussed and studied as if it resulted from deliberative, evaluative processes, such processes are actually only rarely involved in behavior allocation. These deliberative processes are too slow, effortful and inefficient to guide behavior other than when necessary. Rather, most actions are guided by faster, more automatic processes, often labeled habits. Habits are mostly adaptive, and result from repeated reinforcement leading to over-learned behavior. Habitual behavior occurs rapidly in response to particular contexts, and the behavior occurring first is that which occurs, i.e., the behavior that is decided upon. Thus, as drug use becomes habitual, drug use is likely to be chosen over other available activities in that particular context. However, while drug use becoming habitual is necessary for addiction to develop, it is not sufficient. Typically, constraints limit even habitual drug use to safer levels. These constraints might include limiting occasions for use; and, almost always, constraints on amount consumed. However, in a minority of individuals, drug use is not sufficiently constrained and addiction develops. This review discusses the nature of these constraints, and how they might fail. These failures do not result from abnormal learning processes, but rather unfortunate interactions between a person and their environment over time. These accumulate in the maladaptive allocation of behavior to drug use. This Behavior Allocation Disorder (BAD) can be reversed; occasionally easily when the environment significantly changes, but more often by the arduous application of deliberative processes generally absent from decision making. These deliberative processes must continue until new more adaptive habits become the most probable behavior in the contexts encountered. As alternatives to drug use become the most probable behavior, relapse risk diminishes. Copyright © 2017 Elsevier Inc. All rights reserved.

Optimality versus stability in water resource allocation.

PubMed

Read, Laura; Madani, Kaveh; Inanloo, Bahareh

2014-01-15

Water allocation is a growing concern in a developing world where limited resources like fresh water are in greater demand by more parties. Negotiations over allocations often involve multiple groups with disparate social, economic, and political status and needs, who are seeking a management solution for a wide range of demands. Optimization techniques for identifying the Pareto-optimal (social planner solution) to multi-criteria multi-participant problems are commonly implemented, although often reaching agreement for this solution is difficult. In negotiations with multiple-decision makers, parties who base decisions on individual rationality may find the social planner solution to be unfair, thus creating a need to evaluate the willingness to cooperate and practicality of a cooperative allocation solution, i.e., the solution's stability. This paper suggests seeking solutions for multi-participant resource allocation problems through an economics-based power index allocation method. This method can inform on allocation schemes that quantify a party's willingness to participate in a negotiation rather than opt for no agreement. Through comparison of the suggested method with a range of distance-based multi-criteria decision making rules, namely, least squares, MAXIMIN, MINIMAX, and compromise programming, this paper shows that optimality and stability can produce different allocation solutions. The mismatch between the socially-optimal alternative and the most stable alternative can potentially result in parties leaving the negotiation as they may be too dissatisfied with their resource share. This finding has important policy implications as it justifies why stakeholders may not accept the socially optimal solution in practice, and underlies the necessity of considering stability where it may be more appropriate to give up an unstable Pareto-optimal solution for an inferior stable one. Authors suggest assessing the stability of an allocation solution as an additional component to an analysis that seeks to distribute water in a negotiated process. Copyright © 2013 Elsevier Ltd. All rights reserved.

Directional Slack-Based Measure for the Inverse Data Envelopment Analysis

PubMed Central

Abu Bakar, Mohd Rizam; Lee, Lai Soon; Jaafar, Azmi B.; Heydar, Maryam

2014-01-01

A novel technique has been introduced in this research which lends its basis to the Directional Slack-Based Measure for the inverse Data Envelopment Analysis. In practice, the current research endeavors to elucidate the inverse directional slack-based measure model within a new production possibility set. On one occasion, there is a modification imposed on the output (input) quantities of an efficient decision making unit. In detail, the efficient decision making unit in this method was omitted from the present production possibility set but substituted by the considered efficient decision making unit while its input and output quantities were subsequently modified. The efficiency score of the entire DMUs will be retained in this approach. Also, there would be an improvement in the efficiency score. The proposed approach was investigated in this study with reference to a resource allocation problem. It is possible to simultaneously consider any upsurges (declines) of certain outputs associated with the efficient decision making unit. The significance of the represented model is accentuated by presenting numerical examples. PMID:24883350

Allocating scarce medical resources to the overweight.

PubMed

Furnham, Adrian; Loganathan, Niroosha; McClelland, Alastair

2010-01-01

A programmatic research effort investigated how lay people weigh information on hypothetical patients when making decisions regarding the allocation of scarce medical resources. This study is partly replicative and partly innovative, and looks particularly at whether overweight patients would be discriminated against in allocating resources. This study aims to determine the importance given to specific patient characteristics when lay participants are asked to allocate scarce medical resources. In all, 156 British adults (82 males, 73 females), aged 19 to 84 years, took part. There were few students. Participants completed a questionnaire requiring them to rank 16 hypothetical patients for access to a kidney dialysis machine.The demographic information presented regarding each hypothetical patient differed on four dimensions: gender, weight, mental health, and religiousness. There were significant main effects for gender, weight, and mental health; females, patients of normal weight, and the mentally well were ranked the highest priority for access to a kidney dialysis machine. Participants discriminated most regarding the weight of hypothetical patients. Different patient characteristics, unrelated to medical prognoses, particularly being overweight, may have an impact on decisions regarding the use of scarce medical resources.

Why orphan drug coverage reimbursement decision-making needs patient and public involvement.

PubMed

Douglas, Conor M W; Wilcox, Elizabeth; Burgess, Michael; Lynd, Larry D

2015-05-01

Recently there has been an increase in the active involvement of publics and patients in healthcare and research, which is extending their roles beyond the passive recipients of medicines. However, there has been noticeably less work engaging them into decision-making for healthcare rationing exercises, priority setting, health technology assessment, and coverage decision-making. This is particularly evident in reimbursement decision-making for 'orphan drugs' or drugs for rare diseases. Medicinal products for rare disease offer particular challenges in coverage decision-making because they often lack the 'evidence of efficacy' profiles of common drugs that have been trialed on larger populations. Furthermore, many of these drugs are priced in the high range, and with limited health care budgets the prospective opportunity costs of funding them means that those resources cannot be allocated elsewhere. Here we outline why decision-making for drugs for rare diseases could benefit from increased levels of publics and patients involvement, suggest some possible forms that involvement could take, and advocate for empirical experimentation in this area to evaluate the effects of such involvement. Focus is given to the Canadian context in which we are based; however, potentialities and challenges relating to involvement in this area are likely to be similar elsewhere. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Young children are more willing to accept group decisions in which they have had a voice.

PubMed

Grocke, Patricia; Rossano, Federico; Tomasello, Michael

2018-02-01

People accept an unequal distribution of resources if they judge that the decision-making process was fair. In this study, 3- and 5-year-old children played an allocation game with two puppets. The puppets decided against a fair distribution in all conditions, but they allowed children to have various degrees of participation in the decision-making process. Children of both ages protested less when they were first asked to agree with the puppets' decision compared with when there was no agreement. When ignored, the younger children protested less than the older children-perhaps because they did not expect to have a say in the process-whereas they protested more when they were given an opportunity to voice their opinion-perhaps because their stated opinion was ignored. These results suggest that during the preschool years, children begin to expect to be asked for their opinion in a decision, and they accept disadvantageous decisions if they feel that they have had a voice in the decision-making process. Copyright © 2017 Elsevier Inc. All rights reserved.

A hybrid fuzzy logic/constraint satisfaction problem approach to automatic decision making in simulation game models.

PubMed

Braathen, Sverre; Sendstad, Ole Jakob

2004-08-01

Possible techniques for representing automatic decision-making behavior approximating human experts in complex simulation model experiments are of interest. Here, fuzzy logic (FL) and constraint satisfaction problem (CSP) methods are applied in a hybrid design of automatic decision making in simulation game models. The decision processes of a military headquarters are used as a model for the FL/CSP decision agents choice of variables and rulebases. The hybrid decision agent design is applied in two different types of simulation games to test the general applicability of the design. The first application is a two-sided zero-sum sequential resource allocation game with imperfect information interpreted as an air campaign game. The second example is a network flow stochastic board game designed to capture important aspects of land manoeuvre operations. The proposed design is shown to perform well also in this complex game with a very large (billionsize) action set. Training of the automatic FL/CSP decision agents against selected performance measures is also shown and results are presented together with directions for future research.

Improving the Selection, Classification, and Utilization of Army Enlisted Personnel: Final Report on Project A

DTIC Science & Technology

1991-08-01

being used in both current and long-range research programs that are expected to make the Army more effective in matching the requirements for first- and... make substantial improvements to the existing selection and classifi- cation system. xi IMPROVING THE SELECTION, CLASSIFICATION, AND UTILIZATION OF...basis for new methods of allocating personnel, and making near-real-time decisions on the best match between characteristics of an individual enlistee

Don't tell on me: Experimental evidence of asymmetric information in transnational households*

PubMed Central

Ambler, Kate

2014-01-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information. PMID:25558123

Don't tell on me: Experimental evidence of asymmetric information in transnational households.

PubMed

Ambler, Kate

2015-03-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information.

A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

PubMed

Cooke, Mary; Hurley, Ciarán

2008-05-01

We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

Defense Analysis: The Decision Process

DTIC Science & Technology

1985-07-01

problems ot resource allocation. Includes chapters on tormulating the problem, the research ettort, evaluation ot alternatives, interpretations of...Economics and Decision Making. He is a graduate of Colgate University (BA, Psychology) and received his Masters degree at the Naval Post Graduate School...Analysis 62 ’, ’The Steps irn Subject iye Aiuslysis 66 " Identify the Factors 66 Discusss the Factors 67 Evaluate Each Factor 67 Summa r y 68 Chapter VII

Data quality system using reference dictionaries and edit distance algorithms

NASA Astrophysics Data System (ADS)

Karbarz, Radosław; Mulawka, Jan

2015-09-01

The real art of management it is important to make smart decisions, what in most of the cases is not a trivial task. Those decisions may lead to determination of production level, funds allocation for investments etc. Most of the parameters in decision-making process such as: interest rate, goods value or exchange rate may change. It is well know that these parameters in the decision-making are based on the data contained in datamarts or data warehouse. However, if the information derived from the processed data sets is the basis for the most important management decisions, it is required that the data is accurate, complete and current. In order to achieve high quality data and to gain from them measurable business benefits, data quality system should be used. The article describes the approach to the problem, shows the algorithms in details and their usage. Finally the test results are provide. Test results show the best algorithms (in terms of quality and quantity) for different parameters and data distribution.

Human Views: Extensions to the Department of Defense Architecture Framework

DTIC Science & Technology

2008-09-01

évaluent et prédisent les implications. Étant donné la complexité inhérente aux relations dans les S de S, l’absence de VH bien définies et universellement ...n.d.): 1. A Planning, Programming, Budgeting, and Execution process is used to conduct strategic planning and make resource allocation decisions; 2...Responsibilities in the form of functions and tasks have been allocated to each MMEV crew member. In addition, a set of competency requirements (e.g., KSA) has

Health technology funding decision-making processes around the world: the same, yet different.

PubMed

Stafinski, Tania; Menon, Devidas; Philippon, Donald J; McCabe, Christopher

2011-06-01

All healthcare systems routinely make resource allocation decisions that trade off potential health gains to different patient populations. However, when such trade-offs relate to the introduction of new, promising health technologies, perceived 'winners' and 'losers' are more apparent. In recent years, public scrutiny over such decisions has intensified, raising the need to better understand how they are currently made and how they might be improved. The objective of this paper is to critically review and compare current processes for making health technology funding decisions at the regional, state/provincial and national level in 20 countries. A comprehensive search for published, peer-reviewed and grey literature describing actual national, state/provincial and regional/institutional technology decision-making processes was conducted. Information was extracted by two independent reviewers and tabulated to facilitate qualitative comparative analyses. To identify strengths and weaknesses of processes identified, websites of corresponding organizations were searched for commissioned reviews/evaluations, which were subsequently analysed using standard qualitative methods. A total of 21 national, four provincial/state and six regional/institutional-level processes were found. Although information on each one varied, they could be grouped into four sequential categories: (i) identification of the decision problem; (ii) information inputs; (iii) elements of the decision-making process; and (iv) public accountability and decision implementation. While information requirements of all processes appeared substantial and decision-making factors comprehensive, the way in which they were utilized was often unclear, as were approaches used to incorporate social values or equity arguments into decisions. A comprehensive inventory of approaches to implementing the four main components of all technology funding decision-making processes was compiled, from which areas for future work or research aimed at improving the acceptability of decisions were identified. They include the explication of decision criteria and social values underpinning processes.

Allocating conservation resources between areas where persistence of a species is uncertain.

PubMed

McDonald-Madden, Eve; Chadès, Iadine; McCarthy, Michael A; Linkie, Matthew; Possingham, Hugh P

2011-04-01

Research on the allocation of resources to manage threatened species typically assumes that the state of the system is completely observable; for example whether a species is present or not. The majority of this research has converged on modeling problems as Markov decision processes (MDP), which give an optimal strategy driven by the current state of the system being managed. However, the presence of threatened species in an area can be uncertain. Typically, resource allocation among multiple conservation areas has been based on the biggest expected benefit (return on investment) but fails to incorporate the risk of imperfect detection. We provide the first decision-making framework for confronting the trade-off between information and return on investment, and we illustrate the approach for populations of the Sumatran tiger (Panthera tigris sumatrae) in Kerinci Seblat National Park. The problem is posed as a partially observable Markov decision process (POMDP), which extends MDP to incorporate incomplete detection and allows decisions based on our confidence in particular states. POMDP has previously been used for making optimal management decisions for a single population of a threatened species. We extend this work by investigating two populations, enabling us to explore the importance of variation in expected return on investment between populations on how we should act. We compare the performance of optimal strategies derived assuming complete (MDP) and incomplete (POMDP) observability. We find that uncertainty about the presence of a species affects how we should act. Further, we show that assuming full knowledge of a species presence will deliver poorer strategic outcomes than if uncertainty about a species status is explicitly considered. MDP solutions perform up to 90% worse than the POMDP for highly cryptic species, and they only converge in performance when we are certain of observing the species during management: an unlikely scenario for many threatened species. This study illustrates an approach to allocating limited resources to threatened species where the conservation status of the species in different areas is uncertain. The results highlight the importance of including partial observability in future models of optimal species management when the species of concern is cryptic in nature.

Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial.

PubMed

Niedermeier, Martin; Weisleitner, Andreas; Lamm, Claus; Ledochowski, Larissa; Frühauf, Anika; Wille, Maria; Burtscher, Martin; Kopp, Martin

2017-05-01

Decision making is impaired in hypoxic environments, which may have serious or even lethal consequences for mountaineers. An acclimatisation period prior to high altitude exposures may help to overcome adverse effects of hypoxia. Thus, we investigated possible effects of short-term pre-acclimatisation on decision making in hypoxia. In a randomized controlled study design, 52 healthy participants were allocated to a hypoxia group (HG: short-term pre-acclimatisation by the use of intermittent hypoxia 7×1h at F i O 2 =12.6%, equivalent to 4500m) or a control group (CG: sham pre-acclimatisation 7×1h at F i O 2 =20.9%, equivalent to 600m). The number of risky decisions was assessed using the Game of Dice Task at four time points during a 12-hours stay in hypoxia (F i O 2 =12.6%). 42 (HG: 27, CG: 25) participants completed the study. The number of risky decisions was significantly (p=0.048 as determined by 4×2 ANCOVA) reduced in the hypoxia group compared to the control group, partial η 2 =0.11, when the age-effect on decision making was controlled. Self-reported positive affective valence prior to decision making was negatively related to the number of risky decisions, r<-0.38. Short-term pre-acclimatisation might influence decision making in hypoxia in a positive way and might be considered as a risk-reducing preparation method prior to exposures to hypoxic environments. Positive affective states seem to have a medium-sized protective effect against risky decision making. Copyright © 2017 Elsevier Inc. All rights reserved.

Distinguishing values from science in decision making: Setting harvest quotas for mountain lions in Montana

USGS Publications Warehouse

Mitchell, Michael S.; Cooley, Hilary; Gude, Justin A.; Kolbe, Jay; Nowak, J. Joshua; Proffitt, Kelly M.; Sells, Sarah N.; Thompson, Mike

2018-01-01

The relative roles of science and human values can be difficult to distinguish when informal processes are used to make complex and contentious decisions in wildlife management. Structured Decision Making (SDM) offers a formal process for making such decisions, where scientific results and concepts can be disentangled from the values of differing stakeholders. We used SDM to formally integrate science and human values for a citizen working group of ungulate hunting advocates, lion hunting advocates, and outfitters convened to address the contentious allocation of harvest quotas for mountain lions (Puma concolor) in west‐central Montana, USA, during 2014. A science team consisting of mountain lion biologists and population ecologists convened to support the working group. The science team used integrated population models that incorporated 4 estimates of mountain lion density to estimate population trajectories for 5 alternative harvest quotas developed by the working group. Results of the modeling predicted that effects of each harvest quota were consistent across the 4 density estimates; harvest quotas affected predicted population trajectories for 5 years after implementation but differences were not strong. Based on these results, the focus of the working group changed to differences in values among stakeholders that were the true impediment to allocating harvest quotas. By distinguishing roles of science and human values in this process, the working group was able to collaboratively recommend a compromise solution. This solution differed little from the status quo that had been the focus of debate, but the SDM process produced understanding and buy‐in among stakeholders involved, reducing disagreements, misunderstanding, and unproductive arguments founded on informal application of scientific data and concepts. Whereas investments involved in conducting SDM may be unnecessary for many decisions in wildlife management, the investment may be beneficial for complex, contentious, and multiobjective decisions that integrate science and human values.

Patient Involvement in Health Care Decision Making: A Review

PubMed Central

Vahdat, Shaghayegh; Hamzehgardeshi, Leila; Hessam, Somayeh; Hamzehgardeshi, Zeinab

2014-01-01

Background: Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions. Objectives: Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making. Materials and Methods: To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article. Results: Based on the review of articles and books, topics were divided into six general categories: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making. Conclusions: In most studies, factors influencing patient participation consisted of: factors associated with health care professionals such as doctor-patient relationship, recognition of patient’s knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services. PMID:24719703

Corporate Funding of Human Services Agencies.

ERIC Educational Resources Information Center

Zippay, Allison

1992-01-01

Conducted case study of philanthropic giving among 29 companies in Cambridge, Massachusetts. Found that most corporations used informal rather than formal process for making funding decisions, with many firms relying on tradition, social contacts, and intuition to guide allocations. Findings suggest ways that social services administrators can…

Financial Aid Administration Today: Considerations for Campus Leaders.

ERIC Educational Resources Information Center

Hart, Natala K.

1996-01-01

In serving students, financial aid officers must address issues outside the scope of the financial aid program, including admissions, academic policy, institutional bureaucracy, student consumer education, and pricing. These require policy decisions and resource allocations the financial aid administrator cannot make alone. Cooperation and support…

Managerial Accounting in Library and Information Science Education.

ERIC Educational Resources Information Center

Hayes, Robert M.

1983-01-01

Explores meaning of managerial accounting in libraries and discusses instructional program for students of library and information science based on experience in School of Library and Information Science at University of California, Los Angeles. Management decision making (budgeting, performance evaluation, overhead, resource allocation,…

The Real Education for Healthy Youth Act: Honest, Age Appropriate Sexual Health Education for Responsible Decision Making. Policy Brief

ERIC Educational Resources Information Center

Phillip, Jendayi

2012-01-01

The Real Education for Healthy Youth Act (S. 1782/H.R. 3324), introduced in November 2011 by Senator Frank Lautenberg (D-NJ) and Representative Barbara Lee (D-CA), would ensure that federal funding is allocated to comprehensive sexual health education programs that provide young people with the skills and information they need to make informed,…

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

Managing resources in NHS dentistry: the views of decision-makers in primary care organisations.

PubMed

Holmes, R D; Donaldson, C; Exley, C; Steele, J G

2008-09-27

To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations. This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method. The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners. To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

Managing the Risks of Climate Change and Terrorism

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosa, Eugene; Dietz, Tom; Moss, Richard H.

2012-04-07

Society has difficult decisions to make about how best to allocate its resources to ensure future sustainability. Risk assessment can be a valuable tool: it has long been used to support decisions to address environmental problems. But in a time when the risks to sustainability range from climate change to terrorism, applying risk assessment to sustainability will require careful rethinking. For new threats, we will need a new approach to risk assessment.

A Multi-Objective Decision-Making Model for Resources Allocation in Humanitarian Relief

DTIC Science & Technology

2007-03-01

Applied Mathematics and Computation 163, 2005, pp756 19. Malczewski, J., GIS and Multicriteria Decision Analysis , John Wiley and Sons, New York... used when interpreting the results of the analysis . (Raimo et al. 2002) (7) Sensitivity analysis Sensitivity analysis in a DA process answers...Budget Scenario Analysis The MILP is solved ( using LINDO 6.1) for high, medium and low budget scenarios in both damage degree levels. Tables 17 and

Rawlsian maximin rule operates as a common cognitive anchor in distributive justice and risky decisions

PubMed Central

Kameda, Tatsuya; Inukai, Keigo; Higuchi, Satomi; Ogawa, Akitoshi; Kim, Hackjin; Matsuda, Tetsuya; Sakagami, Masamichi

2016-01-01

Distributive justice concerns the moral principles by which we seek to allocate resources fairly among diverse members of a society. Although the concept of fair allocation is one of the fundamental building blocks for societies, there is no clear consensus on how to achieve “socially just” allocations. Here, we examine neurocognitive commonalities of distributive judgments and risky decisions. We explore the hypothesis that people’s allocation decisions for others are closely related to economic decisions for oneself at behavioral, cognitive, and neural levels, via a concern about the minimum, worst-off position. In a series of experiments using attention-monitoring and brain-imaging techniques, we investigated this “maximin” concern (maximizing the minimum possible payoff) via responses in two seemingly disparate tasks: third-party distribution of rewards for others, and choosing gambles for self. The experiments revealed three robust results: (i) participants’ distributive choices closely matched their risk preferences—“Rawlsians,” who maximized the worst-off position in distributions for others, avoided riskier gambles for themselves, whereas “utilitarians,” who favored the largest-total distributions, preferred riskier but more profitable gambles; (ii) across such individual choice preferences, however, participants generally showed the greatest spontaneous attention to information about the worst possible outcomes in both tasks; and (iii) this robust concern about the minimum outcomes was correlated with activation of the right temporoparietal junction (RTPJ), the region associated with perspective taking. The results provide convergent evidence that social distribution for others is psychologically linked to risky decision making for self, drawing on common cognitive–neural processes with spontaneous perspective taking of the worst-off position. PMID:27688764

76 FR 20354 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Advisory... Ethics Subcommittee will submit recommendations on Ethical Considerations for Non-communicable Disease Interventions as well as on Ethical Considerations for Decision Making Regarding Allocation of Mechanical...

Integrating rangeland and pastureland assessment methods into a national grazingland assessment approach

USDA-ARS?s Scientific Manuscript database

Grazingland resource allocation and decision making at the national scale need to be based on comparable metrics. However, in the USA, rangelands and pasturelands have traditionally been assessed using different methods and indicators. These differences in assessment methods limit the ability to con...

76 FR 32217 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... for an indepth understanding of individuals' attitudes, beliefs, motivations, and feelings. The... develop messages and other communications but will generally conduct further research before making important decisions, such as adopting new policies and allocating or redirecting significant resources to...

[Basic principles and methodological considerations of health economic evaluations].

PubMed

Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

2011-01-01

Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

Transforming organizational culture through nursing shared governance.

PubMed

Newman, Karen Profitt

2011-03-01

Nursing shared governance (NSG) provides a framework for the professionalization of nursing, provides a broader distribution of decision making across the profession, and allocates decisions based on accountability and role expectations. Shared governance defines staff-based decisions, accountability, roles, and ownership of staff in those activities that directly affect nurses' lives and practice. Although NSG is a somewhat ambiguous concept with a vast application, examining it from the perspective of structure, process, and outcomes can more clearly outline a successful strategy for implementation and growth. Copyright © 2011 Elsevier Inc. All rights reserved.

Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.

PubMed

Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique

2017-05-01

The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.

The ethics of attaching research conditions to access to new health technologies.

PubMed

Holland, Stephen; Hope, Tony

2012-06-01

Decisions on which new health technologies to provide are controversial because of the scarcity of healthcare resources, the competing demands of payers, providers and patients and the uncertainty of the evidence base. Given this, additional information about new health technologies is often considered valuable. One response is to make access to a new health technology conditional on further research. Access can be restricted to patients who participate in a research study, such as a randomised controlled trial; alternatively, a new treatment can be made generally available, but only on condition that further evidence is collected (eg, on long-term outcomes and adverse events, in patient registries). The National Institute for Health and Clinical Excellence (NICE), which provides guidance on which new health technologies to make available under the UK's NHS, for example, has made some research conditional recommendations, and the current interest in such options suggests that they are likely to become more prevalent in the future. This paper identifies and discusses the main ethical issues created by this distinctive range of recommendations. We argue that decisions to put research conditions on access to new technologies are compatible with widely accepted values, principles and practices relevant to resource allocation. However, there are important features of these distinctive judgements that must be taken into account by resource allocation decision-making bodies and research ethics committees, and that require new sorts of empirical data.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 10: operationalising disinvestment in a conceptual framework for resource allocation.

PubMed

Harris, Claire; Green, Sally; Elshaug, Adam G

2017-09-08

This is the tenth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. After more than a decade of research, there is little published evidence of active and successful disinvestment. The paucity of frameworks, methods and tools is reported to be a factor in the lack of success. However there are clear and consistent messages in the literature that can be used to inform development of a framework for operationalising disinvestment. This paper, along with the conceptual review of disinvestment in Paper 9 of this series, aims to integrate the findings of the SHARE Program with the existing disinvestment literature to address the lack of information regarding systematic organisation-wide approaches to disinvestment at the local health service level. A framework for disinvestment in a local healthcare setting is proposed. Definitions for essential terms and key concepts underpinning the framework have been made explicit to address the lack of consistent terminology. Given the negative connotations of the word 'disinvestment' and the problems inherent in considering disinvestment in isolation, the basis for the proposed framework is 'resource allocation' to address the spectrum of decision-making from investment to disinvestment. The focus is positive: optimising healthcare, improving health outcomes, using resources effectively. The framework is based on three components: a program for decision-making, projects to implement decisions and evaluate outcomes, and research to understand and improve the program and project activities. The program consists of principles for decision-making and settings that provide opportunities to introduce systematic prompts and triggers to initiate disinvestment. The projects follow the steps in the disinvestment process. Potential methods and tools are presented, however the framework does not stipulate project design or conduct; allowing application of any theories, methods or tools at each step. Barriers are discussed and examples illustrating constituent elements are provided. The framework can be employed at network, institutional, departmental, ward or committee level. It is proposed as an organisation-wide application, embedded within existing systems and processes, which can be responsive to needs and priorities at the level of implementation. It can be used in policy, management or clinical contexts.

Exposing ecological and economic costs of the research-implementation gap and compromises in decision making.

PubMed

Kareksela, Santtu; Moilanen, Atte; Ristaniemi, Olli; Välivaara, Reima; Kotiaho, Janne S

2018-02-01

The frequently discussed gap between conservation science and practice is manifest in the gap between spatial conservation prioritization plans and their implementation. We analyzed the research-implementation gap of one zoning case by comparing results of a spatial prioritization analysis aimed at avoiding ecological impact of peat mining in a regional zoning process with the final zoning plan. We examined the relatively complex planning process to determine the gaps among research, zoning, and decision making. We quantified the ecological costs of the differing trade-offs between ecological and socioeconomic factors included in the different zoning suggestions by comparing the landscape-level loss of ecological features (species occurrences, habitat area, etc.) between the different solutions for spatial allocation of peat mining. We also discussed with the scientists and planners the reasons for differing zoning suggestions. The implemented plan differed from the scientists suggestion in that its focus was individual ecological features rather than all the ecological features for which there were data; planners and decision makers considered effects of peat mining on areas not included in the prioritization analysis; zoning was not truly seen as a resource-allocation process and not emphasized in general minimizing ecological losses while satisfying economic needs (peat-mining potential); and decision makers based their prioritization of sites on site-level information showing high ecological value and on single legislative factors instead of finding a cost-effective landscape-level solution. We believe that if the zoning and decision-making processes are very complex, then the usefulness of science-based prioritization tools is likely to be reduced. Nevertheless, we found that high-end tools were useful in clearly exposing trade-offs between conservation and resource utilization. © 2017 Society for Conservation Biology.

Numbers Are Not Enough. Why e-Learning Analytics Failed to Inform an Institutional Strategic Plan

ERIC Educational Resources Information Center

Macfadyen, Leah P.; Dawson, Shane

2012-01-01

Learning analytics offers higher education valuable insights that can inform strategic decision-making regarding resource allocation for educational excellence. Research demonstrates that learning management systems (LMSs) can increase student sense of community, support learning communities and enhance student engagement and success, and LMSs…

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2013 CFR

2013-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2012 CFR

2012-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2014 CFR

2014-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

Cypress College Strategic Plan, 2000-2004.

ERIC Educational Resources Information Center

Cypress Coll., CA.

This document outlines Cypress College's Strategic Plan to be used to guide decision-making and resource allocation for the years 2000 through 2004. The Strategic Plan begins with the Cypress College Vision Statement: building a college-wide learning community for student success. The Mission Statement states that Cypress College is committed to…

Portfolio Based Management

ERIC Educational Resources Information Center

Daigneau, William A.

2010-01-01

In this article, the author talks about Portfolio Management, a concept used to make allocation decisions in the world of financial investments. While much has been written about Portfolio theory, and the term is widely used in the facilities management industry, little is really understood about the concept and its real-world application. The…

Predicting Fire Season Severity in the Pacific Northwest

Treesearch

Paul Werth

2006-01-01

Projections of fire season severity that integrate historical weather and fire information can be used by fire managers when making decisions about allocating and prioritizing firefighting resources. They enable fire managers to anticipate fire activity and pre-position resources to maximize public and firefighter safety, reduce environmental impacts, and lower...

Cost Accounting and Accountability for Early Education Programs for Handicapped Children.

ERIC Educational Resources Information Center

Gingold, William

The paper offers some basic information for making decisions about allocating and accounting for resources provided to young handicapped children. Sections address the following topics: reasons for costing, audiences for cost accounting and accountability information, and a process for cost accounting and accountability (defining cost categories,…

The Mystique of University Endowments.

ERIC Educational Resources Information Center

Kemeny, John G.

1983-01-01

Whether a university has a "balanced budget" is influenced by board decisions on investment, endowment utilization, and allocation of unrestricted gifts. One can only hope to protect endowment against inflation under economic conditions that make it possible to achieve a total return rate significantly higher than the rate of inflation.…

Soldier Decision-Making for Allocation of Intelligence, Surveillance, and Reconnaissance Assets

DTIC Science & Technology

2014-06-01

Judgments; also called Algoritmic or Statistical Judgements Computer Science , Psychology, and Statistics Actuarial or algorithmic...Jan. 2011. [17] R. M. Dawes, D. Faust, and P. E. Meehl, “Clinical versus Actuarial Judgment,” Science , vol. 243, no. 4899, pp. 1668–1674, 1989. [18...School of Computer Science

Using Data to Advance Learning Outcomes in Schools

ERIC Educational Resources Information Center

VanDerHeyden, Amanda; Harvey, Mark

2013-01-01

This article describes the emergence and influence of evidence-based practice and data-based decision making in educational systems. Increasingly, educators and consumers want to know that resources allocated to educational efforts yield strong effects for all learners. This trend is reflected by the widespread influence of evidence-based practice…

76 FR 6802 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... they allow for a more indepth understanding of consumers' attitudes, beliefs, motivations, and feelings... test and refine their ideas but will generally conduct further research before making important decisions, such as adopting new policies and allocating or redirecting significant resources to support...

78 FR 27444 - Forum Investment Advisors, LLC, et al.;

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... securities into, and receive securities from, the series in connection with the purchase and redemption of... settlement date. \\5\\ In a forward commitment transaction, the buyer/seller enters into a contract to purchase... Investment Manager, will make investment decisions with respect to assets of each Fund allocated by the...

On the Efficient Allocation of Resources for Hypothesis Evaluation in Machine Learning: A Statistical Approach

NASA Technical Reports Server (NTRS)

Chien, S.; Gratch, J.; Burl, M.

1994-01-01

In this report we consider a decision-making problem of selecting a strategy from a set of alternatives on the basis of incomplete information (e.g., a finite number of observations): the system can, however, gather additional information at some cost.

A review of cost measures for the economic impact of domestic violence.

PubMed

Chan, Ko Ling; Cho, Esther Yin-Nei

2010-07-01

Although economic analyses of domestic violence typically guide decisions concerning resource allocation, allowing policy makers to make better informed decisions on how to prioritize and allocate scarce resources, the methods adopted to calculate domestic violence costs have varied widely from study to study. In particular, only a few studies have reviewed the cost measures of the economic impact of domestic violence. This article reviews and compares these measures by covering approaches to categorizing costs, the cost components, and ways to estimate them and recommends an integrated framework that brings the various approaches together. Some issues still need to be addressed when further developing measures such as including omitted but significant measures and expanding the time horizons of others. The implications for future study of domestic violence costs are discussed.

Allocating health care resources: a questionnaire experiment on the predictive success of rules.

PubMed

Ahlert, Marlies; Schwettmann, Lars

2017-06-26

The topic of this paper is related to equity in health within a country. In public health care sectors of many countries decisions on priority setting with respect to treatment of different types of diseases or patient groups are implicitly or explicitly made. Priorities are realized by allocation decisions for medical resources where moral judgments play an important role with respect to goals and measures that should be applied. The aim of this study is to explore the moral intuitions held in the German society related to priorities in medical treatment. We use an experimental questionnaire method established in the Empirical Social Choice literature. Participants are asked to make decisions in a sequence of distributive problems where a limited amount of treatment time has to be allocated to hypothetically described patients. The decision problems serve as an intuition pump. Situations are systematically varied with respect to patients' initial health levels, their ability to benefit from treatment time, and the amount of treatment time available. Subjects are also asked to describe their deliberations. We focus on the acceptance of different allocation principles including equity concepts and utilitarian properties. We investigate rule characteristics like order preservation or monotonicity with respect to resources, severity, or effectiveness. We check the consistency of individual choices with stated reasoning. The goals and allocation principles revealed show that the moral intuitions held by our experimental subjects are much more complex than the principles commonly applied in health economic theory. Especially, cost-utility principles are rarely applied, whereas the goal of equality of health gain is observed more often. The principle not to leave any patient untreated is very dominant. We also observe the degrees to which extent certain monotonicity principles, known from welfare economics, are followed. Subjects were able to describe their moral judgments in written statements. We also find evidence that they followed their respective intuitions very consistently in their decisions. Findings of the kind presented in this paper may serve as an important input for the public and political discussion when decisions on priorities in the public health care sector are formed.

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.

How Qualitative Research Informs Clinical and Policy Decision Making in Transplantation: A Review.

PubMed

Tong, Allison; Morton, Rachael L; Webster, Angela C

2016-09-01

Patient-centered care is no longer just a buzzword. It is now widely touted as a cornerstone in delivering quality care across all fields of medicine. However, patient-centered strategies and interventions necessitate evidence about patients' decision-making processes, values, priorities, and needs. Qualitative research is particularly well suited to understanding the experience and perspective of patients, donors, clinicians, and policy makers on a wide range of transplantation-related topics including organ donation and allocation, adherence to prescribed therapy, pretransplant and posttransplant care, implementation of clinical guidelines, and doctor-patient communication. In transplantation, evidence derived from qualitative research has been integrated into strategies for shared decision-making, patient educational resources, process evaluations of trials, clinical guidelines, and policies. The aim of this article is to outline key concepts and methods used in qualitative research, guide the appraisal of qualitative studies, and assist clinicians to understand how qualitative research may inform their practice and policy.

Establishing a baseline to measure change in political will and the use of data for decision-making in maternal and newborn health in six African countries.

PubMed

Nove, Andrea; Hulton, Louise; Martin-Hilber, Adriane; Matthews, Zoe

2014-10-01

The Evidence for Action (E4A) program assumes that both resource allocation and quality of care can improve via a strategy that combines evidence and advocacy to stimulate accountability. The present paper explains the methods used to collect baseline monitoring data using two tools developed to inform program design in six focus countries. The first tool is designed to understand the extent to which decision-makers have access to the data they need, when they need it, and in meaningful formats, and then to use the data to prioritize, plan, and allocate resources. The second tool seeks the views of people working in the area of maternal and newborn health (MNH) about political will, including: quality of care, the political and financial priority accorded to MNH, and the extent to which MNH decision-makers are accountable to service users. Findings indicate significant potential to improve access to and use of data for decision-making, particularly at subnational levels. Respondents across all six program countries reported lack of access by ordinary citizens to information on the health and MNH budget, and data on MNH outcomes. In all six countries there was a perceived inequity in the distribution of resources and a perception that politicians do not fully understand the priorities of their constituents. Copyright © 2014. Published by Elsevier Ireland Ltd.

Decision science: a scientific approach to enhance public health budgeting.

PubMed

Honoré, Peggy A; Fos, Peter J; Smith, Torney; Riley, Michael; Kramarz, Kim

2010-01-01

The allocation of resources for public health programming is a complicated and daunting responsibility. Financial decision-making processes within public health agencies are especially difficult when not supported with techniques for prioritizing and ranking alternatives. This article presents a case study of a decision analysis software model that was applied to the process of identifying funding priorities for public health services in the Spokane Regional Health District. Results on the use of this decision support system provide insights into how decision science models, which have been used for decades in business and industry, can be successfully applied to public health budgeting as a means of strengthening agency financial management processes.

A brief history of decision making.

PubMed

Buchanan, Leigh; O'Connell, Andrew

2006-01-01

Sometime around the middle of the past century, telephone executive Chester Barnard imported the term decision making from public administration into the business world. There it began to replace narrower terms, like "resource allocation" and "policy making," shifting the way managers thought about their role from continuous, Hamlet-like deliberation toward a crisp series of conclusions reached and actions taken. Yet, decision making is, of course, a broad and ancient human pursuit, flowing back to a time when people sought guidance from the stars. From those earliest days, we have strived to invent better tools for the purpose, from the Hindu-Arabic systems for numbering and algebra, to Aristotle's systematic empiricism, to friar Occam's advances in logic, to Francis Bacon's inductive reasoning, to Descartes's application of the scientific method. A growing sophistication with managing risk, along with a nuanced understanding of human behavior and advances in technology that support and mimic cognitive processes, has improved decision making in many situations. Even so, the history of decision-making strategies--captured in this time line and examined in the four accompanying essays on risk, group dynamics, technology, and instinct--has not marched steadily toward perfect rationalism. Twentieth-century theorists showed that the costs of acquiring information lead executives to make do with only good-enough decisions. Worse, people decide against their own economic interests even when they know better. And in the absence of emotion, it's impossible to make any decisions at all. Erroneous framing, bounded awareness, excessive optimism: The debunking of Descartes's rational man threatens to swamp our confidence in our choices. Is it really surprising, then, that even as technology dramatically increases our access to information, Malcolm Gladwell extols the virtues of gut decisions made, literally, in the blink of an eye?

Effects of reflection on clinical decision-making of intensive care unit nurses.

PubMed

Razieh, Shahrokhi; Somayeh, Ghafari; Fariba, Haghani

2018-07-01

Nurses are one of the most influential factors in overcoming the main challenges faced by health systems throughout the world. Every health system should, hence, empower nurses in clinical judgment and decision-making skills. This study evaluated the effects of implementing Tanner's reflection method on clinical decision-making of nurses working in an intensive care unit (ICU). This study used an experimental, pretest, posttest design. The setting was the intensive care unit of Amin Hospital Isfahan, Iran. The convenience sample included 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). This clinical trial was performed on 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). The nurses were selected by census sampling and randomly allocated to either the case or the control group. Data were collected using a questionnaire containing demographic characteristics and the clinical decision-making scale developed by Laurie and Salantera (NDMI-14). The questionnaire was completed before and one week after the intervention. The data were analyzed using SPSS 21.0. The two groups were not significantly different in terms of the level and mean scores of clinical decision-making before the intervention (P = 0.786). Based on the results of independent t-test, the mean score of clinical decision-making one week after the intervention was significantly higher in the case group than in the control group (P = 0.009; t = -2.69). The results of Mann Whitney test showed that one week after the intervention, the nurses' level of clinical decision-making in the case group rose to the next level (P = 0.001). Reflection could improve the clinical decision-making of ICU nurses. It is, thus, recommended to incorporate this method into the nursing curriculum and care practices. Copyright © 2018. Published by Elsevier Ltd.

Children's understanding of equity in the context of inequality.

PubMed

Rizzo, Michael T; Killen, Melanie

2016-11-01

In the context of a pre-existing resource inequality, the concerns for strict equality (allocating the same number of resources to all recipients) conflict with the concerns for equity (allocating resources to rectify the inequality). This study demonstrated age-related changes in children's (3-8 years old, N = 133) ability to simultaneously weigh the concerns for equality and equity through the analysis of children's judgements, allocations, and reasoning in the context of a pre-existing inequality. Three- to 4-year-olds took equity into account in their judgements of allocations, but allocated resources equally in a behavioural task. In contrast, 5- to 6-year-olds rectified the inequality in their allocations, but judged both equitable and equal allocations to be fair. It was not until 7-8 years old that children focused on rectifying the inequality in their allocations and judgements, as well as judged equal allocations less positively than equitable allocations, thereby demonstrating a more complete understanding of the necessity of rectifying inequalities. The novel findings revealed age-related changes from 3 to 8 years old regarding how the concerns for equity and equality develop, and how children's judgements, allocations, and reasoning are coordinated when making allocation decisions. © 2016 The British Psychological Society.

Making the right decisions about new technologies: a perspective on criteria and preferences in hospitals.

PubMed

Gurtner, Sebastian

2014-01-01

Decision makers in hospitals are regularly faced with choices about the adoption of new technologies. Wrong decisions lead to a waste of resources and can have serious effects on the patients' and hospital's well-being. The goal of this research was to contribute to the understanding of decision making in hospitals. This study produced insights regarding relevant decision criteria and explored their specific relevance. An initial empirical survey was used to collect the relevant criteria for technological decision making in hospitals. In total, 220 experts in the field of health technology assessment from 34 countries participated in the survey. As a second step, the abovementioned criteria were used to form the basis of an analytic hierarchy process model. A group of 115 physicians, medical technical assistants, and other staff, all of whom worked in the field of radiooncology, prioritized the criteria. An analysis of variance was performed to explore differences among groups in terms of institutional and personal categorization variables. The first part of the research revealed seven key criteria for technological decision making in hospitals. The analytic hierarchy process model revealed that organizational impact was the most important criterion, followed by budget impact. The analysis of variance indicated that there were differences in the perceptions of the importance of the identified criteria. This exploration of the criteria for technological decision making in hospitals will help decision makers consider all of the relevant aspects, leading to more structured and rational decisions. For the optimal resource allocation, all of the relevant stakeholder perspectives and local issues must be considered appropriately.

Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective

PubMed Central

2016-01-01

When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247

Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial.

PubMed

Elwyn, Glyn; Pickles, Tim; Edwards, Adrian; Kinsey, Katharine; Brain, Kate; Newcombe, Robert G; Firth, Jill; Marrin, Katy; Nye, Alan; Wood, Fiona

2016-04-01

To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The accuracy and consistency of rural, remote and outpost triage nurse decision making in one Western Australia Country Health Service Region.

PubMed

Ekins, Kylie; Morphet, Julia

2015-11-01

The Australasian Triage Scale aims to ensure that the triage category allocated, reflects the urgency with which the patient needs medical assistance. This is dependent on triage nurse accuracy in decision making. The Australasian Triage Scale also aims to facilitate triage decision consistency between individuals and organisations. Various studies have explored the accuracy and consistency of triage decisions throughout Australia, yet no studies have specifically focussed on triage decision making in rural health services. Further, no standard has been identified by which accuracy or consistency should be measured. Australian emergency departments are measured against a set of standard performance indicators, including time from triage to patient review, and patient length of stay. There are currently no performance indicators for triage consistency. An online questionnaire was developed to collect demographic data and measure triage accuracy and consistency. The questionnaire utilised previously validated triage scenarios.(1) Triage decision accuracy was measured, and consistency was compared by health site type using Fleiss' kappa. Forty-six triage nurses participated in this study. The accuracy of participants' triage decision-making decreased with each less urgent triage category. Post-graduate qualifications had no bearing on triage accuracy. There was no significant difference in the consistency of decision-making between paediatric and adult scenarios. Overall inter-rater agreement using Fleiss' kappa coefficient, was 0.4. This represents a fair-to-good level of inter-rater agreement. A standard definition of accuracy and consistency in triage nurse decision making is required. Inaccurate triage decisions can result in increased morbidity and mortality. It is recommended that emergency department performance indicator thresholds be utilised as a benchmark for national triage consistency. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

A Review of the Impacts of Different Approaches for Diabetes Prevention and a Framework for Making Investment Decisions

PubMed Central

2018-01-01

This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions. This framework should also assist in the discussion of what parameters are needed from research to inform decision-making on what might be the optimal mix of strategies to reduce diabetes prevalence. PMID:29543711

The invisible hands made visible: recognizing the value of informal care in healthcare decision-making.

PubMed

van Exel, Job; Bobinac, Ana; Koopmanschap, Marc; Brouwer, Werner

2008-12-01

The healthcare sector depends heavily on the informal care provided by families and friends of those who are ill. Informal caregivers may experience significant burden as well as health and well-being effects. Resource allocation decisions, in particular from a societal perspective, should account explicitly for these effects in the social environment of patients. This is not only important to make a complete welfare economic assessment of treatments, but also to ensure the lasting involvement of informal caregivers in the care-giving process. Measurement and valuation techniques for the costs and effects of informal care have been developed and their use is becoming more common. Decision-makers in healthcare - and eventually families and patients - would be helped by more uniformity in methods.

A Review of the Impacts of Different Approaches for Diabetes Prevention and a Framework for Making Investment Decisions.

PubMed

Alva, Maria L

2018-03-15

This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions. This framework should also assist in the discussion of what parameters are needed from research to inform decision-making on what might be the optimal mix of strategies to reduce diabetes prevalence.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders.

PubMed

Connors, Brenda L; Rende, Richard; Colton, Timothy J

2013-01-01

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time-individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders

PubMed Central

Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

2013-01-01

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time—individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day. PMID:24069012

Analysis of Ordinary Public Fund and Its Impact on the Quality of Academic Programs in the Higher Education in the Subsystem of the Polytechnic Universities in Mexico

ERIC Educational Resources Information Center

Monroy, Pedro Salazar; Arcos-Vega, José L.; Garcia, Juan J. Sevilla

2017-01-01

In 2015, there was the need of making this study to determine the efficient and effectiveness management for making decisions in respect to the ordinary fund allocations and their impact on the quality of the academic programs into the Polytechnic engineering universities in Mexico. This analysis is very important for providing essential evidence…

Counterfactual Evaluation of Outcomes in Social Risk Decision-Making Situations: The Cognitive Developmental Paradox Revisited.

PubMed

Padrón, Iván; Rodrigo, María Jose; de Vega, Manuel

2016-01-01

We report a study that examined the existence of a cognitive developmental paradox in the counterfactual evaluation of decision-making outcomes. According to this paradox adolescents and young adults could be able to apply counterfactual reasoning and, yet, their counterfactual evaluation of outcomes could be biased in a salient socio-emotional context. To this aim, we analyzed the impact of health and social feedback on the counterfactual evaluation of outcomes in a laboratory decision-making task involving short narratives with the presence of peers. Forty risky (e.g., taking or refusing a drug), forty neutral decisions (e.g., eating a hamburger or a hotdog), and emotions felt following positive or negative outcomes were examined in 256 early, mid- and late adolescents, and young adults, evenly distributed. Results showed that emotional ratings to negative outcomes (regret and disappointment) but not to positive outcomes (relief and elation) were attenuated when feedback was provided. Evidence of development of cognitive decision-making capacities did also exist, as the capacity to perform faster emotional ratings and to differentially allocate more resources to the elaboration of emotional ratings when no feedback information was available increased with age. Overall, we interpret these findings as challenging the traditional cognitive developmental assumption that development necessarily proceeds from lesser to greater capacities, reflecting the impact of socio-emotional processes that could bias the counterfactual evaluation of social decision-making outcomes.

Public health equity in refugee situations

PubMed Central

2011-01-01

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions. PMID:21575218

Public health equity in refugee situations.

PubMed

Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

2011-05-16

Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

Deliberation favours social efficiency by making people disregard their relative shares: evidence from USA and India

PubMed Central

Corgnet, Brice; Espín, Antonio M.; Hernán-González, Roberto

2017-01-01

Groups make decisions on both the production and the distribution of resources. These decisions typically involve a tension between increasing the total level of group resources (i.e. social efficiency) and distributing these resources among group members (i.e. individuals' relative shares). This is the case because the redistribution process may destroy part of the resources, thus resulting in socially inefficient allocations. Here we apply a dual-process approach to understand the cognitive underpinnings of this fundamental tension. We conducted a set of experiments to examine the extent to which different allocation decisions respond to intuition or deliberation. In a newly developed approach, we assess intuition and deliberation at both the trait level (using the Cognitive Reflection Test, henceforth CRT) and the state level (through the experimental manipulation of response times). To test for robustness, experiments were conducted in two countries: the USA and India. Despite absolute-level differences across countries, in both locations we show that: (i) time pressure and low CRT scores are associated with individuals' concerns for their relative shares and (ii) time delay and high CRT scores are associated with individuals' concerns for social efficiency. These findings demonstrate that deliberation favours social efficiency by overriding individuals' intuitive tendency to focus on relative shares. PMID:28386421

A model of interaction between anticorruption authority and corruption groups

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neverova, Elena G.; Malafeyef, Oleg A.

The paper provides a model of interaction between anticorruption unit and corruption groups. The main policy functions of the anticorruption unit involve reducing corrupt practices in some entities through an optimal approach to resource allocation and effective anticorruption policy. We develop a model based on Markov decision-making process and use Howard’s policy-improvement algorithm for solving an optimal decision strategy. We examine the assumption that corruption groups retaliate against the anticorruption authority to protect themselves. This model was implemented through stochastic game.

Data Systems Linking Resources to Actions and Outcomes: One of the Nation's Most Pressing Education Challenges

ERIC Educational Resources Information Center

Guthrie, James W.

2007-01-01

The inadequacy of present-day public school financial and performance reporting restricts policymakers. With existing spending and activity information now generally available, public officials can determine only overall education resource levels and make allocative decisions only among gross input categories such as relative amounts of labor and…

The Struggle to Satisfy Need: Exploring the Institutional Cues for Teaching Support Staff

ERIC Educational Resources Information Center

Winslett, Greg

2016-01-01

The decision-making around resource allocation in universities is complex. It plays out through the structures of governance and bureaucracy, through interactions with colleagues, workplace cultures and through day-to-day individual work practices. To survive and succeed within this complex environment, teaching support staff need to be sensitive…

The Power of 2: Partnership Paves the Way for Teacher Leadership Academy

ERIC Educational Resources Information Center

Harmon, Jeanne; Herren, Kip; Luke, Rod; Emry, Terese

2012-01-01

A clear vision is the essential foundation for making decisions about precious resources for implementing professional learning: (1) people; (2) time; and (3) money. The Auburn School District in Washington state learned firsthand how a clear vision drives resource allocation to support strategic actions and how effective partnerships can be the…

Estimating the Difference between Published and Unpublished Effect Sizes: A Meta-Review

ERIC Educational Resources Information Center

Polanin, Joshua R.; Tanner-Smith, Emily E.; Hennessy, Emily A.

2016-01-01

Practitioners and policymakers rely on meta-analyses to inform decision making around the allocation of resources to individuals and organizations. It is therefore paramount to consider the validity of these results. A well-documented threat to the validity of research synthesis results is the presence of publication bias, a phenomenon where…

Estimating the Difference between Published and Unpublished Effect Sizes: A Meta-Review

ERIC Educational Resources Information Center

Polanin, Joshua R.; Tanner-Smith, Emily E.; Hennessy, Emily A.

2016-01-01

Practitioners and policymakers rely on meta-analyses to inform decision-making around the allocation of resources to individuals and organizations. It is therefore paramount to consider the validity of these results. A well-documented threat to the validity of research synthesis results is the presence of publication bias, a phenomenon where…

Conflicting Pressures That Impinge Upon the Operational Effectiveness of Institutional Researchers: Challenges to the Practitioner.

ERIC Educational Resources Information Center

Gubasta, Joseph L.

The numerous issues and problems facing college and university decisionmakers and the ever increasing information needs of external agency representatives place conflicting pressures on institutional research personnel, forcing them to make difficult decisions regarding the allocation of their resources. Outlined are several such pressures. It is…

Probabilistic approach to long range planning of manpower

NASA Technical Reports Server (NTRS)

Lejk, R. A.

1967-01-01

Publication presents a total long range planning model for project oriented organizations. The total model consists of planning systems which originate - /1/ at the project level and consolidate into an overall plan, and /2/ from a budetary ceiling and allocate to the individual projects. Analysis of /1/ and /2/ is provided for management decision making.

Updating Rurality Index for Small Areas in Spain

ERIC Educational Resources Information Center

Prieto-Lara, Elisa; Ocana-Riola, Ricardo

2010-01-01

Nowadays, there is a wide debate about what rural means. An operational definition of rural concept is essential in order to measure health problems, optimize resource allocation and facilitate decision making aimed at closing the gap on inequity between areas. In 2005, the rurality index for Small Areas in Spain (IRAP) was developed using the…

A neotropical migratory bird prioritization for National Forests and Grasslands

Treesearch

Dick Roth; Richard Peterson

1997-01-01

The Rocky Mountain Region of the USDA Forest Service provides nesting habitat for 146 species of neotropical migratory birds. Interactive, prioritization databases were developed for each National Forest and National Grassland in the Region to assist land managers in making informed decisions about resource allocations. The data was processed using Paradox software....

Antecedents and Consequences of Career Decisional States in Adolescence

ERIC Educational Resources Information Center

Creed, Peter; Prideaux, Lee-Ann; Patton, Wendy

2005-01-01

This longitudinal study tested students in Grade 8 and again in Grade 10 on career (maturity, barriers, indecision, decision-making and self-efficacy), well-being (self-esteem, life satisfaction, and coping), and social (school achievement, paid work experience) variables. Students were allocated to decided or undecided conditions at T1, T2 and…

76 FR 51442 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change To List...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

...-Adviser has designed the following quantitative stock selection rules to make allocation decisions and to..., the Sub-Adviser's investment process is quantitative. Based on extensive historical research, the Sub... open-end fund's portfolio composition must be subject to procedures designed to prevent the use and...

Building Support for Student Success: A Framework for Achieving the Dream's State Policy Work

ERIC Educational Resources Information Center

Jobs for the Future, 2005

2005-01-01

This document is designed to help accelerate and strengthen state policy initiatives that promote student success; and derive lessons from this work about strategies for influencing the allocation of resources, the transparency of and accountability for results, and the rules that shape how institutions make decisions about priorities and…

Negative mood induction normalizes decision making in male cocaine dependent individuals.

PubMed

Fernández-Serrano, María José; Moreno-López, Laura; Pérez-García, Miguel; Viedma-Del Jesús, María I; Sánchez-Barrera, María B; Verdejo-García, Antonio

2011-10-01

Decision making is thought to play a key role in psychostimulant relapse, but very few studies have addressed the issue of how to counteract decision-making deficits in addicted individuals. According to the somatic marker framework, pervasive decision-making problems in addicted individuals may relate to abnormalities in the processing of emotional signals that work to anticipate the prospective outcomes of potential decisions. The present study was conducted to test whether the induction of different emotional states (positive, negative, or drug-related) could either normalize or further impair decision-making performance in male cocaine polysubstance-using individuals (CPSI), as indexed by the Iowa gambling task (IGT). Forty-two CPSI and 65 healthy control individuals (all males) were randomly allocated in four affective conditions using a parallel-group design. Participants in the different conditions performed the IGT during exposure to neutral, positive, negative, or drug-related sets of affective images. The results showed that the CPSI exposed to the negative affective context showed a preference for the risk-averse safe choices of the IGT and had a net performance indistinguishable from that of controls. On the other hand, CPSI exposed to positive, drug-related, and neutral contexts showed the typical pattern of disadvantageous performance in the IGT and performed significantly poorer than controls. The impact of the negative mood induction could not be explained in terms of baseline differences in decision-making skills, personality traits related to sensitivity to reward/punishment, or trait positive/negative affect. We conclude that negative mood induction can normalize decision-making performance in male CPSI, which may have important implications for the treatment of cocaine use-related disorders.

Does earmarked donor funding make it more or less likely that developing countries will allocate their resources towards programmes that yield the greatest health benefits?

PubMed

Waddington, Catriona

2004-09-01

It should not be assumed that earmarked donor funding automatically increases the allocation of developing-country resources towards programmes that yield the greatest health benefits. Sometimes it does, sometimes it does not--how the funding is designed can influence this. This is true particularly in the longer term, once the earmarked funding has ended. Even in the short term, total funding does not necessarily increase because of fungibility (i.e. recipient governments adjust their spending to offset donor funding preferences). The author explores six problems with earmarked funding: the multiplicity of earmarked funds confuses the situation for decision-makers; earmarking works against the spirit of the sectorwide approach; from the national perspective, it makes sense not to double-fund activities; local ownership of an activity is often compromised; earmarking can lead governments to accept interventions which they cannot afford in the longer term; and earmarking can distort local resource allocation.

Elderly Care and Intrafamily Resource Allocation when Children Migrate.

PubMed

Antman, Francisca M

2012-01-01

This paper considers the intrafamily allocation of elderly care in the context of international migration where migrant children may be able to provide financial assistance to their parents, but are unable to offer physical care. To investigate the interaction between siblings, I take a non-cooperative view of family decision-making and estimate best response functions for individual physical and financial contributions as a function of siblings' contributions. I address the endogeneity of siblings' contributions and individual migration decisions by using siblings' characteristics as instrumental variables as well as models including family fixed effects. For both migrants and non-migrants, I find evidence that financial contributions function as strategic complements while siblings' time contributions operate as strategic substitutes. This suggests that children's contributions toward elderly care may be based on both strategic bequest and public good motivations.

Elderly Care and Intrafamily Resource Allocation when Children Migrate *

PubMed Central

Antman, Francisca M.

2012-01-01

This paper considers the intrafamily allocation of elderly care in the context of international migration where migrant children may be able to provide financial assistance to their parents, but are unable to offer physical care. To investigate the interaction between siblings, I take a non-cooperative view of family decision-making and estimate best response functions for individual physical and financial contributions as a function of siblings’ contributions. I address the endogeneity of siblings’ contributions and individual migration decisions by using siblings’ characteristics as instrumental variables as well as models including family fixed effects. For both migrants and non-migrants, I find evidence that financial contributions function as strategic complements while siblings’ time contributions operate as strategic substitutes. This suggests that children’s contributions toward elderly care may be based on both strategic bequest and public good motivations. PMID:22518064

Does framing the hot hand belief change decision-making behavior in volleyball?

PubMed

Raab, Markus; MacMahon, Clare

2015-06-01

Previous discussions of the hot hand belief, wherein athletes believe that they have a greater chance of scoring after 2 or 3 hits (successes) compared with 2 or 3 misses, have focused on whether this is the case within game statistics. Researchers have argued that the perception of the hot hand in random sequences is a bias of the cognitive system. Yet most have failed to explore the impact of framing on the stability of the belief and the behavior based on it. The authors conducted 2 studies that manipulated the frame of a judgment task. In Study 1, framing was manipulated via instructions in a playmaker allocation paradigm in volleyball. In Study 2, the frame was manipulated by presenting videos for allocation decisions from either the actor or observer perspective. Both manipulations changed the hot hand belief and sequential choices. We found in both studies that the belief in continuation of positive or negative streaks is nonlinear and allocations to the same player after 3 successive hits are reduced. The authors argue that neither the hot hand belief nor hot hand behavior is stable, but rather, both are sensitive to decision frames. The results can inform coaches on the importance of how to provide information to athletes.

Two-stage seasonal streamflow forecasts to guide water resources decisions and water rights allocation

NASA Astrophysics Data System (ADS)

Block, P. J.; Gonzalez, E.; Bonnafous, L.

2011-12-01

Decision-making in water resources is inherently uncertain producing copious risks, ranging from operational (present) to planning (season-ahead) to design/adaptation (decadal) time-scales. These risks include human activity and climate variability/change. As the risks in designing and operating water systems and allocating available supplies vary systematically in time, prospects for predicting and managing such risks become increasingly attractive. Considerable effort has been undertaken to improve seasonal forecast skill and advocate for integration to reduce risk, however only minimal adoption is evident. Impediments are well defined, yet tailoring forecast products and allowing for flexible adoption assist in overcoming some obstacles. The semi-arid Elqui River basin in Chile is contending with increasing levels of water stress and demand coupled with insufficient investment in infrastructure, taxing its ability to meet agriculture, hydropower, and environmental requirements. The basin is fed from a retreating glacier, with allocation principles founded on a system of water rights and markets. A two-stage seasonal streamflow forecast at leads of one and two seasons prescribes the probability of reductions in the value of each water right, allowing water managers to inform their constituents in advance. A tool linking the streamflow forecast to a simple reservoir decision model also allows water managers to select a level of confidence in the forecast information.

Financial management and dental school equity, Part II: Tactics.

PubMed

Chambers, David W; Bergstrom, Roy

2004-04-01

Financial management includes all processes that build organizations' equity through accumulating assets in strategically important areas. The tactical aspects of financial management are budget deployment and monitoring. Budget deployment is the process of making sure that costs are fairly allocated. Budget monitoring addresses issues of effective uses and outcomes of resources. This article describes contemporary deployment and monitoring mechanisms, including revenue positive and marginal analysis, present value, program phases, options logic, activity-based costing, economic value added, cost of quality, variance reconciliation, and balanced scorecards. The way financial decisions are framed affects comparative decision-making and even influences the arithmetic of accounting. Familiarity with these concepts should make it possible for dental educators to more fully participate in discussions about the relationships between budgeting and program strategy.

Game Theoretic Modeling of Water Resources Allocation Under Hydro-Climatic Uncertainty

NASA Astrophysics Data System (ADS)

Brown, C.; Lall, U.; Siegfried, T.

2005-12-01

Typical hydrologic and economic modeling approaches rely on assumptions of climate stationarity and economic conditions of ideal markets and rational decision-makers. In this study, we incorporate hydroclimatic variability with a game theoretic approach to simulate and evaluate common water allocation paradigms. Game Theory may be particularly appropriate for modeling water allocation decisions. First, a game theoretic approach allows economic analysis in situations where price theory doesn't apply, which is typically the case in water resources where markets are thin, players are few, and rules of exchange are highly constrained by legal or cultural traditions. Previous studies confirm that game theory is applicable to water resources decision problems, yet applications and modeling based on these principles is only rarely observed in the literature. Second, there are numerous existing theoretical and empirical studies of specific games and human behavior that may be applied in the development of predictive water allocation models. With this framework, one can evaluate alternative orderings and rules regarding the fraction of available water that one is allowed to appropriate. Specific attributes of the players involved in water resources management complicate the determination of solutions to game theory models. While an analytical approach will be useful for providing general insights, the variety of preference structures of individual players in a realistic water scenario will likely require a simulation approach. We propose a simulation approach incorporating the rationality, self-interest and equilibrium concepts of game theory with an agent-based modeling framework that allows the distinct properties of each player to be expressed and allows the performance of the system to manifest the integrative effect of these factors. Underlying this framework, we apply a realistic representation of spatio-temporal hydrologic variability and incorporate the impact of decision-making a priori to hydrologic realizations and those made a posteriori on alternative allocation mechanisms. Outcomes are evaluated in terms of water productivity, net social benefit and equity. The performance of hydro-climate prediction modeling in each allocation mechanism will be assessed. Finally, year-to-year system performance and feedback pathways are explored. In this way, the system can be adaptively managed toward equitable and efficient water use.

A judgment and decision-making model for plant behavior.

PubMed

Karban, Richard; Orrock, John L

2018-06-12

Recently plant biologists have documented that plants, like animals, engage in many activities that can be considered as behaviors, although plant biologists currently lack a conceptual framework to understand these processes. Borrowing the well-established framework developed by psychologists, we propose that plant behaviors can be constructively modeled by identifying four distinct components: 1) a cue or stimulus that provides information, 2) a judgment whereby the plant perceives and processes this informative cue, 3) a decision whereby the plant chooses among several options based on their relative costs and benefits, and 4) action. Judgment for plants can be determined empirically by monitoring signaling associated with electrical, calcium, or hormonal fluxes. Decision-making can be evaluated empirically by monitoring gene expression or differential allocation of resources. We provide examples of the utility of this judgment and decision-making framework by considering cases in which plants either successfully or unsuccessfully induced resistance against attacking herbivores. Separating judgment from decision-making suggests new analytical paradigms (i.e., Bayesian methods for judgment and economic utility models for decision-making). Following this framework, we propose an experimental approach to plant behavior that explicitly manipulates the stimuli provided to plants, uses plants that vary in sensory abilities, and examines how environmental context affects plant responses. The concepts and approaches that follow from the judgment and decision-making framework can shape how we study and understand plant-herbivore interactions, biological invasions, plant responses to climate change, and the susceptibility of plants to evolutionary traps. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Improving Hospital-Wide Early Resource Allocation through Machine Learning.

PubMed

Gartner, Daniel; Padman, Rema

2015-01-01

The objective of this paper is to evaluate the extent to which early determination of diagnosis-related groups (DRGs) can be used for better allocation of scarce hospital resources. When elective patients seek admission, the true DRG, currently determined only at discharge, is unknown. We approach the problem of early DRG determination in three stages: (1) test how much a Naïve Bayes classifier can improve classification accuracy as compared to a hospital's current approach; (2) develop a statistical program that makes admission and scheduling decisions based on the patients' clincial pathways and scarce hospital resources; and (3) feed the DRG as classified by the Naïve Bayes classifier and the hospitals' baseline approach into the model (which we evaluate in simulation). Our results reveal that the DRG grouper performs poorly in classifying the DRG correctly before admission while the Naïve Bayes approach substantially improves the classification task. The results from the connection of the classification method with the mathematical program also reveal that resource allocation decisions can be more effective and efficient with the hybrid approach.

SAMICS Validation. SAMICS Support Study, Phase 3

NASA Technical Reports Server (NTRS)

1979-01-01

SAMICS provides a consistent basis for estimating array costs and compares production technology costs. A review and a validation of the SAMICS model are reported. The review had the following purposes: (1) to test the computational validity of the computer model by comparison with preliminary hand calculations based on conventional cost estimating techniques; (2) to review and improve the accuracy of the cost relationships being used by the model: and (3) to provide an independent verification to users of the model's value in decision making for allocation of research and developement funds and for investment in manufacturing capacity. It is concluded that the SAMICS model is a flexible, accurate, and useful tool for managerial decision making.

[The impact of ethical and moral competence in decision making on rationalism and rationing nursing interventions].

PubMed

Schwerdt, R

2005-08-01

The intraprofessional discourse about economical aspects in nursing from an ethical point of view has not taken place yet. To cope with the increasing restriction of resources, some preconditions have to be met: It is necessary to communicate issues in rationalizing and rationing in nursing openly. Person-oriented criteria in the nursing process indicate a high level of competence and user-oriented quality in nursing care. But nursing professionals do not decide in favor or against resources to perform this task on a high or poor quality level. Democratic decision-making on providing nursing services depends on a continuous societal discourse about allocation criteria.

Proposing integrated Shannon's entropy-inverse data envelopment analysis methods for resource allocation problem under a fuzzy environment

NASA Astrophysics Data System (ADS)

Çakır, Süleyman

2017-10-01

In this study, a two-phase methodology for resource allocation problems under a fuzzy environment is proposed. In the first phase, the imprecise Shannon's entropy method and the acceptability index are suggested, for the first time in the literature, to select input and output variables to be used in the data envelopment analysis (DEA) application. In the second step, an interval inverse DEA model is executed for resource allocation in a short run. In an effort to exemplify the practicality of the proposed fuzzy model, a real case application has been conducted involving 16 cement firms listed in Borsa Istanbul. The results of the case application indicated that the proposed hybrid model is a viable procedure to handle input-output selection and resource allocation problems under fuzzy conditions. The presented methodology can also lend itself to different applications such as multi-criteria decision-making problems.

Organizational values in the provision of access to care for the uninsured

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Background For the last 20 years, health provider organizations have made efforts to align mission, values, and everyday practices to ensure high-quality, high-value, and ethical care. However, little attention has been paid to the organizational values and practices of community-based programs that organize and facilitate access to care for uninsured populations. This study aimed to identify and describe organizational values relevant to resource allocation and policy decisions that affect the services offered to members, using the case of community access programs: county-based programs that provide access to care for the uninsured working poor. Methods Comparative and qualitative case study methodology was used, including document review, observations, and key informant interviews, at two geographically diverse programs. Results Nine values were identified as relevant to decision making: stewardship, quality care, access to care, service to others, community well-being, member independence, organizational excellence, decency, and fairness. The way these values were deployed in resource allocation decisions that affected services offered to the uninsured are illustrated in one example per site. Conclusions This study addresses the previous dearth in the literature regarding an empirical description of organizational values employed in decision making of community organizations. To assess the transferability of the values identified, we compared our empirical results to prior empirical and conceptual work in the United States and internationally and found substantial alignment. Future studies can examine whether the identified organizational values are reflective of those at other health care organizations. PMID:28781981

Ethical Issues in Public Health Practice in Michigan

PubMed Central

Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

2009-01-01

Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

The role of affect and cognition in health decision making.

PubMed

Keer, Mario; van den Putte, Bas; Neijens, Peter

2010-03-01

Both affective and cognitive evaluations of behaviours have been allocated various positions in theoretical models of decision making. Most often, they have been studied as direct determinants of either intention or overall evaluation, but these two possible positions have never been compared. The aim of this study was to determine whether affective and cognitive evaluations influence intention directly, or whether their influence is mediated by overall evaluation. A sample of 300 university students filled in questionnaires on their affective, cognitive, and overall evaluations in respect of 20 health behaviours. The data were interpreted using mediation analyses with the application of path modelling. Both affective and cognitive evaluations were found to have significantly predicted intention. The influence of affective evaluation was largely direct for each of the behaviours studied, whereas that of cognitive evaluation was partially direct and partially mediated by overall evaluation. These results indicate that decisions regarding the content of persuasive communication (affective vs. cognitive) are highly dependent on the theoretical model chosen. It is suggested that affective evaluation should be included as a direct determinant of intention in theories of decision making when predicting health behaviours.

Digital Geography and the Race for the White House

ERIC Educational Resources Information Center

Kenreich, Todd W.

2016-01-01

With the 2016 presidential election right around the corner, geography provides a dynamic view of the spatial patterns and processes that shape the electorate. The major presidential campaigns know that a winning strategy must use geography to make informed decisions about where to allocate limited resources such as money and staff. In the end,…

The Hot Hand Exists in Volleyball and Is Used for Allocation Decisions

ERIC Educational Resources Information Center

Raab, Markus; Gula, Bartosz; Gigerenzer, Gerd

2012-01-01

The "hot hand" belief in sports refers to the conviction that a player has a higher chance of making a shot after two or three successful shots than after two or three misses (resulting in "streaks"). This belief is usually considered a cognitive fallacy, although it has been conjectured that in basketball the defense will…

Rationing a "Free" Good: A Classroom Experiment

ERIC Educational Resources Information Center

Alden, Lori

2006-01-01

The author describes a classroom experiment that illustrates the welfare effects of allocating a good on a first-come, first-served basis. In the first round, each student must decide how long to wait in an imaginary line for candy, without knowing how much will be distributed or how long others are willing to wait. In making this decision, a…

Library Objectives and Performance Measures and Their Use in Decision Making

ERIC Educational Resources Information Center

Hamburg, Morris; And Others

1972-01-01

For optimal allocations of limited funds, it is necessary for libraries to develop measures of output. Various forms of user exposure to documents are discussed in an effort to develop such measures for public libraries. It is suggested that the accrual method of accounting be used to compare such measures with costs. (40 references) (Author/NH)

Realigning Resources for District Success: Duval County Public Schools Final Report

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

An Examination of the Relationships among Student Services Expenditures, Pell Grant Funding, and Completion Rates at Public Community Colleges

ERIC Educational Resources Information Center

Racioppi, Gerald William

2014-01-01

Because of shrinking budgets, increasing demand, and calls for more graduates, community college leaders are forced to make difficult resource allocation decisions. In many states, sizable percentages of the state funds available to community colleges are conditional on performance measures, including graduations; the number of states with funding…

How Do Parents Acquire Information to Support Their Child with a Disability and Navigate Individualised Funding Schemes?

ERIC Educational Resources Information Center

Tracey, Danielle; Johnston, Christine; Papps, Fiona Ann; Mahmic, Sylvana

2018-01-01

With the international trend towards individualised funding packages that allocate funds to individuals to spend on disability support needs, the challenge of ensuring parents can readily access useful information to make decisions becomes paramount. The present research used a two stage, mixed method sequential approach (with 291 parents surveyed…

78 FR 55322 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... issuer. See Rule 5131(e)(5). If the person responsible for making the allocation decision knows or has... is publishing this notice to solicit comments on the proposed rule change from interested persons. \\1... 5130(i)(9). Specifically, the spinning provision provides that no member or person associated with a...

Decision Making in Intercollegiate Athletics: One Institution's Journey to Maintain Title IX Compliance

ERIC Educational Resources Information Center

Rowland, John W.

2012-01-01

The allocation of resources and participation opportunities in intercollegiate athletics has been a debate among researchers for nearly 40 years. Title IX and traditionally male-dominated budgeting practices continue to be opposing forces that shape the financial and gender makeup of university athletic departments. In fact, the need to be Title…

Unmet Needs of Families of School-Aged Children with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Brown, Hilary K.; Ouellette-Kuntz, Helene; Hunter, Duncan; Kelley, Elizabeth; Cobigo, Virginie

2012-01-01

Background: To aid decision making regarding the allocation of limited resources, information is needed on the perceived unmet needs of parents of school-aged children with an autism spectrum disorder. Materials and Methods: A cross-sectional survey was conducted of 101 Canadian families of school-aged children with an autism spectrum disorder.…

Introduction to Strategic Planning in Student Affairs: A Model for Process and Elements of a Plan

ERIC Educational Resources Information Center

Ellis, Shannon E.

2010-01-01

Planning from a strategic perspective has been a mainstay of organizational management for decades. Founded in the private sector, strategic planning is now embraced by the nonprofit world as a catalyst for sound resource allocation, transformative decision making, and motivating staff. Student affairs professionals who think, plan, and act…

Legislative Decision Making in Higher Education: How to Get the Facts.

ERIC Educational Resources Information Center

Kroepsch, Robert H., Ed.

This conference report on legislative decisionmaking in higher education is primarily concerned with the financing of colleges and universities. Management systems information is provided, and sessions were held on "How can a state tell whether or not it is getting its money's worth?" and "How to allocate funds for various segments of higher…

Assigning Mathematics Instruction Time in Secondary Schools: What Are the Influential Factors?

ERIC Educational Resources Information Center

Prendergast, Mark; O'Meara, Niamh

2016-01-01

Similar to countries such as the Netherlands and the United Kingdom, secondary schools in Ireland can decide how to allocate instruction time between curriculum subjects. Although there are national guidelines available from the Department of Education and Skills (DES), the majority of schools make their own decisions about how much time they…

Realigning Resources for District Success: Duval County Public Schools Final Report. Executive Summary

ERIC Educational Resources Information Center

Travers, Jonathan; Ferris, Kristen

2011-01-01

Duval County Public Schools (DCPS) is poised to take action today that will lead to serving all students more effectively. Although the challenges are significant, including deep budget cuts, the district made the strategic choice to look thoroughly at how resources are currently allocated and now has a foundation for making decisions that will…

WEALTH, EXPENDITURES AND DECISION-MAKING FOR EDUCATION.

ERIC Educational Resources Information Center

JAMES, H. THOMAS; AND OTHERS

THE SECOND IN A SERIES OF STUDIES OF THE PROCESSES BY WHICH RESOURCES IN THE UNITED STATES ARE ALLOCATED TO THE SUPPORT OF PUBLIC EDUCATION IS PRESENTED. A RATIONALE FOR THE STUDY OF SCHOOL FINANCE WAS FORMULATED AND APPLIED TO EXPLAIN VARIATIONS IN EXPENDITURES ASSOCIATED WITH STATE EFFORTS TO EQUALIZE BOTH EDUCATIONAL BENEFITS AND TAX LOADS.…

State Plan for Technology for the State Board of Education of Ohio.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus.

The state plan for educational technology in Ohio has been developed to facilitate a basic understanding of the broad scope of technology and how it can affect learning positively. It is also intended to provide a framework for policy and resource allocation decision making. Massive systemic changes in curriculum, professional development, and…

US neurologists: attitudes on rationing.

PubMed

Holloway, R G; Ringel, S P; Bernat, J L; Keran, C M; Lawyer, B L

2000-11-28

To assess neurologists' attitudes on rationing health care and to determine whether neurologists would set healthcare priorities in ways that are consistent with cost-effectiveness research. Cost-effectiveness research can suggest ways to maximize health benefits within fixed budgets but is currently being underused in resource allocation decisions. The authors surveyed a random sample of neurologists practicing in the United States (response rate, 44.4%) with three hypothetical scenarios. Two scenarios were designed to address general attitudes on allocating finite resources with emphasis on formulary decisions for costly drugs. The third scenario was designed to assess whether neurologists would optimize the allocation of a fixed budget as recommended by cost-effectiveness analysis. Three-quarters of respondents thought that neurologists make daily decisions that effectively ration healthcare resources, and 60% felt a professional responsibility to consider the financial impact of individualized treatment decisions on other patients. Only 25% of respondents thought that there should be no restrictions placed on any of the five newer antiepileptic agents. In a 1995 survey, 75% of similarly sampled neurologists agreed that no restrictions should be placed on the availability of FDA-approved medications. Nearly half (46%) of respondents favored a less effective test and would be willing to let patients die to ensure the offering of a more equitable alternative. Most neurologists recognize the need to ration health care, and although they think cost-effectiveness research is one method to achieve efficient distribution of resources, many think that considerable attention should also be given to equity.

Risk management for optimal land use planning integrating ecosystem services values: A case study in Changsha, Middle China.

PubMed

Liang, Jie; Zhong, Minzhou; Zeng, Guangming; Chen, Gaojie; Hua, Shanshan; Li, Xiaodong; Yuan, Yujie; Wu, Haipeng; Gao, Xiang

2017-02-01

Land-use change has direct impact on ecosystem services and alters ecosystem services values (ESVs). Ecosystem services analysis is beneficial for land management and decisions. However, the application of ESVs for decision-making in land use decisions is scarce. In this paper, a method, integrating ESVs to balance future ecosystem-service benefit and risk, is developed to optimize investment in land for ecological conservation in land use planning. Using ecological conservation in land use planning in Changsha as an example, ESVs is regarded as the expected ecosystem-service benefit. And uncertainty of land use change is regarded as risk. This method can optimize allocation of investment in land to improve ecological benefit. The result shows that investment should be partial to Liuyang City to get higher benefit. The investment should also be shifted from Liuyang City to other regions to reduce risk. In practice, lower limit and upper limit for weight distribution, which affects optimal outcome and selection of investment allocation, should be set in investment. This method can reveal the optimal spatial allocation of investment to maximize the expected ecosystem-service benefit at a given level of risk or minimize risk at a given level of expected ecosystem-service benefit. Our results of optimal analyses highlight tradeoffs between future ecosystem-service benefit and uncertainty of land use change in land use decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

An information system to improve financial management, resource allocation and activity planning: evaluation results.

PubMed

Ruland, C M; Ravn, I H

2001-01-01

An important strategy for improving resource management and cost containment in health care is to develop information systems that assist hospital managers in financial management, resource allocation, and activity planning. A crucial part of such development is a rigorous evaluation to assess whether the system accomplishes it's intended goals. To evaluate CLASSICA, a Decision Support System (DSS), that assists nurse managers in financial management, resource allocation, staffing, and activity planning. Using a pre-post test design with control units, CLASSICA was evaluated in four test units. Baseline data and simultaneous parallel measures were collected prior to system implementation at test sites and control units. Using expense reports, staffing and financial statistics, surveys, interviews with nurse managers, and logs as data sources, CLASSICA was evaluated on: cost reduction, quality of management information; usefulness as decision support for improved financial management and decision-making; user satisfaction; and ease of use. Evaluation results showed a 41% reduction in expenditures for overtime and extra hours as compared to a 1.8% reduction in control units during the same time period. Users reported a significant improvement in management information; nurse managers stated that they had gained control over costs. The system helped them analyze the relationships between patient activity staffing, and cost of care. Users reported high satisfaction with the system, the information and decision support it provided, and its ease of use. These results suggest that CLASSICA is a DSS that successfully assists nurse managers in cost effective management of their units.

Misfortune may be a blessing in disguise: Fairness perception and emotion modulate decision making.

PubMed

Liu, Hong-Hsiang; Hwang, Yin-Dir; Hsieh, Ming H; Hsu, Yung-Fong; Lai, Wen-Sung

2017-08-01

Fairness perception and equality during social interactions frequently elicit affective arousal and affect decision making. By integrating the dictator game and a probabilistic gambling task, this study aimed to investigate the effects of a negative experience induced by perceived unfairness on decision making using behavioral, model fitting, and electrophysiological approaches. Participants were randomly assigned to the neutral, harsh, or kind groups, which consisted of various asset allocation scenarios to induce different levels of perceived unfairness. The monetary gain was subsequently considered the initial asset in a negatively rewarded, probabilistic gambling task in which the participants were instructed to maintain as much asset as possible. Our behavioral results indicated that the participants in the harsh group exhibited increased levels of negative emotions but retained greater total game scores than the participants in the other two groups. Parameter estimation of a reinforcement learning model using a Bayesian approach indicated that these participants were more loss aversive and consistent in decision making. Data from simultaneous ERP recordings further demonstrated that these participants exhibited larger feedback-related negativity to unexpected outcomes in the gambling task, which suggests enhanced reward sensitivity and signaling of reward prediction error. Collectively, our study suggests that a negative experience may be an advantage in the modulation of reward-based decision making. © 2017 Society for Psychophysiological Research.

Online decision support system for surface irrigation management

NASA Astrophysics Data System (ADS)

Wang, Wenchao; Cui, Yuanlai

2017-04-01

Irrigation has played an important role in agricultural production. Irrigation decision support system is developed for irrigation water management, which can raise irrigation efficiency with few added engineering services. An online irrigation decision support system (OIDSS), in consist of in-field sensors and central computer system, is designed for surface irrigation management in large irrigation district. Many functions have acquired in OIDSS, such as data acquisition and detection, real-time irrigation forecast, water allocation decision and irrigation information management. The OIDSS contains four parts: Data acquisition terminals, Web server, Client browser and Communication system. Data acquisition terminals are designed to measure paddy water level, soil water content in dry land, ponds water level, underground water level, and canals water level. A web server is responsible for collecting meteorological data, weather forecast data, the real-time field data, and manager's feedback data. Water allocation decisions are made in the web server. Client browser is responsible for friendly displaying, interacting with managers, and collecting managers' irrigation intention. Communication system includes internet and the GPRS network used by monitoring stations. The OIDSS's model is based on water balance approach for both lowland paddy and upland crops. Considering basic database of different crops water demands in the whole growth stages and irrigation system engineering information, the OIDSS can make efficient decision of water allocation with the help of real-time field water detection and weather forecast. This system uses technical methods to reduce requirements of user's specialized knowledge and can also take user's managerial experience into account. As the system is developed by the Browser/Server model, it is possible to make full use of the internet resources, to facilitate users at any place where internet exists. The OIDSS has been applied in Zhanghe Irrigation District (Center China) to manage the required irrigation deliveries. Two years' application indicates that the proposed OIDSS can achieve promising performance for surface irrigation. Historical data of rice growing period in 2014 has been applied to test the OIDSS: it gives out 3 irrigation decisions, which is consistent with actual irrigation times and the forecast irrigation dates are well fit with the actual situations; the corresponding amount of total irrigation decreases by 15.13% compared to those without using the OIDSS.

Interfacing to the brain’s motor decisions

PubMed Central

2017-01-01

It has been long known that neural activity, recorded with electrophysiological methods, contains rich information about a subject’s motor intentions, sensory experiences, allocation of attention, action planning, and even abstract thoughts. All these functions have been the subject of neurophysiological investigations, with the goal of understanding how neuronal activity represents behavioral parameters, sensory inputs, and cognitive functions. The field of brain-machine interfaces (BMIs) strives for a somewhat different goal: it endeavors to extract information from neural modulations to create a communication link between the brain and external devices. Although many remarkable successes have been already achieved in the BMI field, questions remain regarding the possibility of decoding high-order neural representations, such as decision making. Could BMIs be employed to decode the neural representations of decisions underlying goal-directed actions? In this review we lay out a framework that describes the computations underlying goal-directed actions as a multistep process performed by multiple cortical and subcortical areas. We then discuss how BMIs could connect to different decision-making steps and decode the neural processing ongoing before movements are initiated. Such decision-making BMIs could operate as a system with prediction that offers many advantages, such as shorter reaction time, better error processing, and improved unsupervised learning. To present the current state of the art, we review several recent BMIs incorporating decision-making components. PMID:28003406

Decentralization in Zambia: resource allocation and district performance.

PubMed

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or negative impact on services.

Who gets a lung transplant? Assessing the psychosocial decision-making process for transplant listing

PubMed Central

Skillings, Jared Lyon

In the United States, there is a significant shortage of available donor organs. This requires transplant professionals to hold simultaneous, yet divergent roles as (1) advocates for patients who are in need of a lifesaving transplant, and (2) responsible stewards in the allocation of scarce donor organs. In order to balance these roles, most transplant teams utilize a committee based decision-making process to select suitable candidates for the transplant waiting list. These committees use medical and psychosocial criteria to guide their decision to list a patient. Transplant regulatory bodies have established medical standards for identifying appropriate medical candidates for transplantation. However, transplant regulatory bodies have not developed policies to standardize psychosocial criteria for listing patients. This affords transplant centers the autonomy to develop their own psychosocial criteria for determining which patients will be placed on the transplant waiting list. This lack of a standardized policy has resulted in inconsistent psychosocial practices amongst transplant centers nationwide. Since there has been no formal review of the inconsistency in psychosocial policy and practice, this paper seeks to explore the non-standardized psychosocial approach to organ transplant listing. The authors review factors that are relevant to the standardization of the psychosocial decision-making process, including shared decision-making, clinician judgment, bias in decision-making and moral distress in transplant staff. We conclude with a discussion about the impact of these issues on psychosocial practices in solid organ transplantation. PMID:29043272

How General are Risk Preferences? Choices under Uncertainty in Different Domains*

PubMed Central

Einav, Liran; Finkelstein, Amy; Pascu, Iuliana; Cullen, Mark R.

2011-01-01

We analyze the extent to which individuals’ choices over five employer-provided insurance coverage decisions and one 401(k) investment decision exhibit systematic patterns, as would be implied by a general utility component of risk preferences. We provide evidence consistent with an important domain-general component that operates across all insurance choices. We find a considerably weaker relationship between one's insurance decisions and 401(k) asset allocation, although this relationship appears larger for more “financially sophisticated” individuals. Estimates from a stylized coverage choice model suggest that up to thirty percent of our sample makes choices that may be consistent across all six domains. PMID:24634517

A conceptual framework for economic optimization of an animal health surveillance portfolio.

PubMed

Guo, X; Claassen, G D H; Oude Lansink, A G J M; Saatkamp, H W

2016-04-01

Decision making on hazard surveillance in livestock product chains is a multi-hazard, multi-stakeholder, and multi-criteria process that includes a variety of decision alternatives. The multi-hazard aspect means that the allocation of the scarce resource for surveillance should be optimized from the point of view of a surveillance portfolio (SP) rather than a single hazard. In this paper, we present a novel conceptual approach for economic optimization of a SP to address the resource allocation problem for a surveillance organization from a theoretical perspective. This approach uses multi-criteria techniques to evaluate the performances of different settings of a SP, taking cost-benefit aspects of surveillance and stakeholders' preferences into account. The credibility of the approach has also been checked for conceptual validity, data needs and operational validity; the application potentials of the approach are also discussed.

Research priorities in health economics and funding for palliative care: views of an international think tank.

PubMed

Harding, Richard; Gomes, Barbara; Foley, Kathleen M; Higginson, Irene J

2009-07-01

At the conclusion of the November 2007 meeting, the assembled international expert group identified the research agenda. The adoption of this agenda would take forward health economic research in palliative care, and generate the necessary data for improved funding decision making, and resource allocation. Recommendations for study included international comparative research into the components of care and settings, evaluative studies, methodologic development and strategies to initiate studies, and make better use of data.

A review of alternative approaches to healthcare resource allocation.

PubMed

Petrou, S; Wolstenholme, J

2000-07-01

The resources available for healthcare are limited compared with demand, if not need, and all healthcare systems, regardless of their financing and organisation, employ mechanisms to ration or prioritise finite healthcare resources. This paper reviews alternative approaches that can be used to allocate healthcare resources. It discusses the problems encountered when allocating healthcare resources according to free market principles. It then proceeds to discuss the advantages and disadvantages of alternative resource allocation approaches that can be applied to public health systems. These include: (i) approaches based on the concept of meeting the needs of the population to maximising its capacity to benefit from interventions; (ii) economic approaches that identify the most efficient allocation of resources with the view of maximising health benefits or other measures of social welfare; (iii) approaches that seek to ration healthcare by age; and (iv) approaches that resolve resource allocation disputes through debate and bargaining. At present, there appears to be no consensus about the relative importance of the potentially conflicting principles that can be used to guide resource allocation decisions. It is concluded that whatever shape tomorrow's health service takes, the requirement to make equitable and efficient use of finite healthcare resources will remain.

Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol.

PubMed

Sarkies, Mitchell N; White, Jennifer; Morris, Meg E; Taylor, Nicholas F; Williams, Cylie; O'Brien, Lisa; Martin, Jenny; Bardoel, Anne; Holland, Anne E; Carey, Leeanne; Skinner, Elizabeth H; Bowles, Kelly-Ann; Grant, Kellie; Philip, Kathleen; Haines, Terry P

2018-04-24

It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers. This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up. Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice. This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ( ACTRN12618000029291 ). Universal Trial Number (UTN): U1111-1205-2621.

Motivation and effort in individuals with social anhedonia

PubMed Central

McCarthy, Julie M.; Treadway, Michael T.; Blanchard, Jack J.

2015-01-01

It has been proposed that anhedonia may, in part, reflect difficulties in reward processing and effortful decision-making. The current study aimed to replicate previous findings of effortful decision-making deficits associated with elevated anhedonia and expand upon these findings by investigating whether these decision-making deficits are specific to elevated social anhedonia or are also associated with elevated positive schizotypy characteristics. The current study compared controls (n = 40) to individuals elevated on social anhedonia (n = 30), and individuals elevated on perceptual aberration/magical ideation (n = 30) on the Effort Expenditure for Rewards Task (EEfRT). Across groups, participants chose a higher proportion of hard tasks with increasing probability of reward and reward magnitude, demonstrating sensitivity to probability and reward values. Contrary to our expectations, when the probability of reward was most uncertain (50% probability), at low and medium reward values, the social anhedonia group demonstrated more effortful decision-making than either individuals high in positive schizotypy or controls. The positive schizotypy group only differed from controls (making less effortful choices than controls) when reward probability was lowest (12%) and the magnitude of reward was the smallest. Our results suggest that social anhedonia is related to intact motivation and effort for monetary rewards, but that individuals with this characteristic display a unique and perhaps inefficient pattern of effort allocation when the probability of reward is most uncertain. Future research is needed to better understand effortful decision-making and the processing of reward across a range of individual difference characteristics. PMID:25888337

An interval-parameter mixed integer multi-objective programming for environment-oriented evacuation management

NASA Astrophysics Data System (ADS)

Wu, C. Z.; Huang, G. H.; Yan, X. P.; Cai, Y. P.; Li, Y. P.

2010-05-01

Large crowds are increasingly common at political, social, economic, cultural and sports events in urban areas. This has led to attention on the management of evacuations under such situations. In this study, we optimise an approximation method for vehicle allocation and route planning in case of an evacuation. This method, based on an interval-parameter multi-objective optimisation model, has potential for use in a flexible decision support system for evacuation management. The modeling solutions are obtained by sequentially solving two sub-models corresponding to lower- and upper-bounds for the desired objective function value. The interval solutions are feasible and stable in the given decision space, and this may reduce the negative effects of uncertainty, thereby improving decision makers' estimates under different conditions. The resulting model can be used for a systematic analysis of the complex relationships among evacuation time, cost and environmental considerations. The results of a case study used to validate the proposed model show that the model does generate useful solutions for planning evacuation management and practices. Furthermore, these results are useful for evacuation planners, not only in making vehicle allocation decisions but also for providing insight into the tradeoffs among evacuation time, environmental considerations and economic objectives.

Ethical dilemmas concerning decision-making within health care leadership: a systematic literature review.

PubMed

Zydziūnaite, Vilma; Suominen, Tarja; Astedt-Kurki, Päivi; Lepaite, Daiva

2010-01-01

The objective was to describe the research methods and research focuses on ethical dilemmas concerning decision-making within health care leadership. The search was conducted on Medline and PubMed databases (1998-2008). The systematic review included 21 selected articles. The ethical dilemmas concerning decision-making within health care leadership are related to three levels: institutional (particular organization), political and local interface (local governmental structure), and national (professional expertise and system). The terms that are used as adequate to the term of "ethical dilemma" are the following: "continuous balancing," "result of resource allocation," "gap between professional obligations and possibilities," "ethically controversial situation," "concern about interactions," "ethical difficulty," "outcome of medical choices," "concern about society access to health care resources," "ethically difficult/challenging situation," "(the consequence of) ethical concern/ethical issue." In qualitative studies, a semi-structured interview and qualitative content analysis are the most commonly applied methods; in quantitative studies, questionnaire surveys are employed. In the research literature, there is a lack of specification according to professional qualification of health care professionals concerning ethical dilemmas by decision-making within health care management/administration. The research on ethical dilemmas in health care leadership, management, and administration should integrate data about levels at which ethical dilemmas occur and investigate ethical dilemmas as complex phenomena because those are attached to decision-making and specific nuances of health care management/administration. In this article, the presented scientific problem requires extensive scientific discussions and research on ethical dilemmas concerning decision-making within health care leadership at various levels.

Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers.

PubMed

Zegeye, Elias Asfaw; Mbonigaba, Josue; Kaye, Sylvia Blanche; Wilkinson, Thomas

2017-02-01

Globally, economic evaluation (EE) is increasingly being considered as a critical tool for allocating scarce healthcare resources. However, such considerations are less documented in low-income countries, such as in Ethiopia. In particular, to date there has been no assessment conducted to evaluate the perception and practice of and barriers to health EE. This paper assesses the use and perceptions of EE in healthcare decision-making processes in Ethiopia. In-depth interview sessions with decision makers/healthcare managers and program coordinators across six regional health bureaus were conducted. A qualitative analysis approach was conducted on three thematic areas. A total of 57 decision makers/healthcare managers were interviewed from all tiers of the health sector in Ethiopia, ranging from the Federal Ministry of Health down to the lower levels of the health facility pyramid. At the high-level healthcare decision-making tier, only 56 % of those interviewed showed a good understanding of EE when explaining in terms of cost and consequences of alternative courses of action and value for money. From the specific program perspective, 50 % of the prevention of mother-to-child transmission of HIV/AIDS program coordinators indicated the relevance of EE to program planning and decision making. These respondents reported a limited application of costing studies on the HIV/AIDS prevention and control program, which were most commonly used during annual planning and budgeting. The study uncovered three important barriers to growth of EE in Ethiopia: a lack of awareness, a lack of expertise and skill, and the traditional decision-making culture.

An evidence-based shared decision making programme on the prevention of myocardial infarction in type 2 diabetes: protocol of a randomised-controlled trial.

PubMed

Buhse, Susanne; Heller, Tabitha; Kasper, Jürgen; Mühlhauser, Ingrid; Müller, Ulrich Alfons; Lehmann, Thomas; Lenz, Matthias

2013-10-19

Lack of patient involvement in decision making has been suggested as one reason for limited treatment success. Concepts such as shared decision making may contribute to high quality healthcare by supporting patients to make informed decisions together with their physicians.A multi-component shared decision making programme on the prevention of heart attack in type 2 diabetes has been developed. It aims at improving the quality of decision-making by providing evidence-based patient information, enhancing patients' knowledge, and supporting them to actively participate in decision-making. In this study the efficacy of the programme is evaluated in the setting of a diabetes clinic. A single blinded randomised-controlled trial is conducted to compare the shared decision making programme with a control-intervention. The intervention consists of an evidence-based patient decision aid on the prevention of myocardial infarction and a corresponding counselling module provided by diabetes educators. Similar in duration and structure, the control-intervention targets nutrition, sports, and stress coping. A total of 154 patients between 40 and 69 years of age with type 2 diabetes and no previous diagnosis of ischaemic heart disease or stroke are enrolled and allocated either to the intervention or the control-intervention. Primary outcome measure is the patients' knowledge on benefits and harms of heart attack prevention captured by a standardised knowledge test. Key secondary outcome measure is the achievement of treatment goals prioritised by the individual patient. Treatment goals refer to statin taking, HbA1c-, blood pressure levels and smoking status. Outcomes are assessed directly after the counselling and at 6 months follow-up. Analyses will be carried out on intention-to-treat basis. Concurrent qualitative methods are used to explore intervention fidelity and to gain insight into implementation processes. Interventions to facilitate evidence-based shared decision making represent an innovative approach in diabetes care. The results of this study will provide information on the efficacy of such a concept in the setting of a diabetes clinic in Germany. ISRCTN84636255.

Introducing priority setting and resource allocation in home and community care programs.

PubMed

Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

2008-01-01

To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

Scarce means with alternative uses: robbins' definition of economics and its extension to the behavioral and neurobiological study of animal decision making.

PubMed

Shizgal, Peter

2012-01-01

Almost 80 years ago, Lionel Robbins proposed a highly influential definition of the subject matter of economics: the allocation of scarce means that have alternative ends. Robbins confined his definition to human behavior, and he strove to separate economics from the natural sciences in general and from psychology in particular. Nonetheless, I extend his definition to the behavior of non-human animals, rooting my account in psychological processes and their neural underpinnings. Some historical developments are reviewed that render such a view more plausible today than would have been the case in Robbins' time. To illustrate a neuroeconomic perspective on decision making in non-human animals, I discuss research on the rewarding effect of electrical brain stimulation. Central to this discussion is an empirically based, functional/computational model of how the subjective intensity of the electrical reward is computed and combined with subjective costs so as to determine the allocation of time to the pursuit of reward. Some successes achieved by applying the model are discussed, along with limitations, and evidence is presented regarding the roles played by several different neural populations in processes posited by the model. I present a rationale for marshaling convergent experimental methods to ground psychological and computational processes in the activity of identified neural populations, and I discuss the strengths, weaknesses, and complementarity of the individual approaches. I then sketch some recent developments that hold great promise for advancing our understanding of structure-function relationships in neuroscience in general and in the neuroeconomic study of decision making in particular.

Scarce Means with Alternative Uses: Robbins’ Definition of Economics and Its Extension to the Behavioral and Neurobiological Study of Animal Decision Making

PubMed Central

Shizgal, Peter

2011-01-01

Almost 80 years ago, Lionel Robbins proposed a highly influential definition of the subject matter of economics: the allocation of scarce means that have alternative ends. Robbins confined his definition to human behavior, and he strove to separate economics from the natural sciences in general and from psychology in particular. Nonetheless, I extend his definition to the behavior of non-human animals, rooting my account in psychological processes and their neural underpinnings. Some historical developments are reviewed that render such a view more plausible today than would have been the case in Robbins’ time. To illustrate a neuroeconomic perspective on decision making in non-human animals, I discuss research on the rewarding effect of electrical brain stimulation. Central to this discussion is an empirically based, functional/computational model of how the subjective intensity of the electrical reward is computed and combined with subjective costs so as to determine the allocation of time to the pursuit of reward. Some successes achieved by applying the model are discussed, along with limitations, and evidence is presented regarding the roles played by several different neural populations in processes posited by the model. I present a rationale for marshaling convergent experimental methods to ground psychological and computational processes in the activity of identified neural populations, and I discuss the strengths, weaknesses, and complementarity of the individual approaches. I then sketch some recent developments that hold great promise for advancing our understanding of structure–function relationships in neuroscience in general and in the neuroeconomic study of decision making in particular. PMID:22363253

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

How resource allocation decisions are made in the health care market.

PubMed

Vogel, W B

2000-10-01

This paper describes how economists view resource allocation decisions in health care markets. The basic economic decisions that must be made in any economic system and the resource allocation decisions in a perfectly competitive market are described. An idealized market can achieve an efficient allocation of resources and is contrasted with a more realistic description of the numerous ways in which health care markets depart from the perfectly competitive ideal. The implications of these departures for health care policy are discussed, along with key controversies concerning reliance upon markets for resource allocation in health care. In particular, the failure of competitive markets to achieve what many consider an equitable distribution of health care is emphasized. The paper concludes with some practical observations on how pharmacists can use the increasing emphasis on economic efficiency to the advantage of their profession.

Older and wiser? An affective science perspective on age-related challenges in financial decision making

PubMed Central

Kensinger, Elizabeth A.; Munnell, Alicia H.; Sass, Steven A.; Dickerson, Brad C.; Wright, Christopher I.; Barrett, Lisa Feldman

2011-01-01

Financial planning decisionss are fundamentally affective in nature; they are decisions related to money, longevity and quality of life. Over the next several decades people will be increasingly responsible for managing their own assets and investments, and they will be subject to the affective influences on active, personal decision-making. Many of these crucial decisions are made and revised across the lifespan, including when to buy or sell a home, how to save for childrens’ education, how to manage healthcare costs, when to retire, how much to save for retirement and how to allocate retirement funds. As average life expectancy increases, many retirees will be faced with inadequate savings to live comfortably until the end of their lives. In the current article, we examine the problems of and potential solutions to inadequate financial planning through the lens of affective science, with an emphasis on how brain-based changes in affective processing with age might contribute to the challenge of financial planning. PMID:20587596

Older and wiser? An affective science perspective on age-related challenges in financial decision making.

PubMed

Weierich, Mariann R; Kensinger, Elizabeth A; Munnell, Alicia H; Sass, Steven A; Dickerson, Brad C; Wright, Christopher I; Barrett, Lisa Feldman

2011-04-01

Financial planning decisionss are fundamentally affective in nature; they are decisions related to money, longevity and quality of life. Over the next several decades people will be increasingly responsible for managing their own assets and investments, and they will be subject to the affective influences on active, personal decision-making. Many of these crucial decisions are made and revised across the lifespan, including when to buy or sell a home, how to save for childrens' education, how to manage healthcare costs, when to retire, how much to save for retirement and how to allocate retirement funds. As average life expectancy increases, many retirees will be faced with inadequate savings to live comfortably until the end of their lives. In the current article, we examine the problems of and potential solutions to inadequate financial planning through the lens of affective science, with an emphasis on how brain-based changes in affective processing with age might contribute to the challenge of financial planning.

Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

PubMed

Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Wilkinson, Thomas; Thiboonboon, Kittiphong; Rattanavipapong, Waranya; Walker, Damian G; Chalkidou, Kalipso; Teerawattananon, Yot

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

Demystifying governance and its role for transitions in urban social–ecological systems

Treesearch

T.A. Muñoz-Erickson; L.K. Campbell; D.L. Childers; J.M. Grove; D.M. Iwaniec; S.T.A. Pickett; Michelle Romolini; Erika S. Svendsen

2016-01-01

Governance is key to sustainable urban transitions. Governance is a system of social, power, and decision-making processes that acts as a key driver of resource allocation and use, yet ecologists even urban ecologists–seldom consider governance concepts in their work. Transitions to more sustainable futures are becoming increasingly important to the management of many...

Implementing LCFF: Early Lessons from the Field. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel

2014-01-01

The Local Control Funding Formula (LCFF) represents a fundamental transformation of the way California allocates state funds to school districts and the ways the state expects districts to make decisions about (and report on) the use of these funds. This is the first in a series of short briefs that aims to capture some key themes emerging from…

Gaze Allocation in a Dynamic Situation: Effects of Social Status and Speaking

ERIC Educational Resources Information Center

Foulsham, Tom; Cheng, Joey T.; Tracy, Jessica L.; Henrich, Joseph; Kingstone, Alan

2010-01-01

Human visual attention operates in a context that is complex, social and dynamic. To explore this, we recorded people taking part in a group decision-making task and then showed video clips of these situations to new participants while tracking their eye movements. Observers spent the majority of time looking at the people in the videos, and in…

Fostering Innovation: How User-Centered Design Can Help Us Get the Local Control Funding Formula Right. Policy and Practice Brief

ERIC Educational Resources Information Center

Knudson, Joel; Ramanathan, Arun; Carter, Allison; O'Day, Jennifer

2017-01-01

The Local Control Funding Formula (LCFF) has introduced positive and much-needed change to California's approach to K-12 education funding by allocating resources according to student need and freeing districts to make decisions that address local priorities. For all of LCFF's advantages, however, the Local Control Accountability Plans (LCAPs) in…

Roadmap for K-12 and Postsecondary Linkages: Key Focus Areas to Ensure Quality Implementation. Data for Action

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

States rely on data from both the K-12 and postsecondary sectors to inform policy discussions; chart the progress of students, schools, districts, colleges, and the state; pinpoint best practices and areas of need; allocate scarce resources; and make other important education decisions every day. However, states need to securely link limited, but…

Application of a Dynamic Programming Algorithm for Weapon Target Assignment

DTIC Science & Technology

2016-02-01

25] A . Turan , “Techniques for the Allocation of Resources Under Uncertainty,” Middle Eastern Technical University, Ankara, Turkey, 2012. [26] K...UNCLASSIFIED UNCLASSIFIED Application of a Dynamic Programming Algorithm for Weapon Target Assignment Lloyd Hammond Weapons and...optimisation techniques to support the decision making process. This report documents the methodology used to identify, develop and assess a

The Effect of School Based Management on Parent Behavior and the Quality of Education in Mexico

ERIC Educational Resources Information Center

Bando, Rosangela

2010-01-01

Institutional reforms have been proposed to improve the delivery and financing of education. School Based Management (SBM) is one such institutional reform where decision making is transferred to the school level. Funds are transferred directly to the school and parents, along with teachers and the principal, allocate and oversee the use of…

The Use of Linear Models for Determining School Workload and Activity Level.

ERIC Educational Resources Information Center

Vicino, Frank L.

This paper outlines the design and use of two linear models as decision-making tools in a school district. The problem to be solved was the allocation of resources for both clerical and custodial personnel. A solution was desired that could be quantified and documented and objectively serve the needs of the district. A clerical support model was…

Preserving Range and Airspace Access for the Air Force Mission: Striving for a Strategic Vantage Point

DTIC Science & Technology

2011-01-01

before public and private entities . This is one in a series of RAND reports that addresses improving the Air Force’s ability to connect operational...53 C. Joint Mission Framework ...by the lack of a common framework for making decisions about range use and resource allocation. This situation requires managers at all levels to

Posterior cingulate cortex mediates outcome-contingent allocation of behavior

PubMed Central

Hayden, Benjamin Y.; Nair, Amrita C.; McCoy, Allison N.; Platt, Michael L.

2008-01-01

SUMMARY Adaptive decision making requires selecting an action and then monitoring its consequences to improve future decisions. The neuronal mechanisms supporting action evaluation and subsequent behavioral modification, however, remain poorly understood. To investigate the contribution of posterior cingulate cortex (CGp) to these processes, we recorded activity of single neurons in monkeys performing a gambling task in which the reward outcome of each choice strongly influenced subsequent choices. We found that CGp neurons signaled reward outcomes in a nonlinear fashion, and that outcome-contingent modulations in firing rate persisted into subsequent trials. Moreover, firing rate on any one trial predicted switching to the alternative option on the next trial. Finally, microstimulation in CGp following risky choices promoted a preference reversal for the safe option on the following trial. Collectively, these results demonstrate that CGp directly contributes to the evaluative processes that support dynamic changes in decision making in volatile environments. PMID:18940585

Reflecting on the efficacy of cognitive mapping for decision-making in intellectual disability care: a case study.

PubMed

Duryan, Meri; Nikolik, Dragan; van Merode, Godefridus; Curfs, Leopold M G

2015-01-01

The central aspect of this study is a set of reflections on the efficacy of soft operational research techniques in understanding the dynamics of a complex system such as intellectual disability (ID) care providers. Organizations providing services to ID patients are complex and have many interacting stakeholders with often different and competing interests. Understanding the causes for failures in complex systems is crucial for appreciating the multiple perspectives of the key stakeholders of the system. Knowing the factors that adversely affect delivery of a patient-centred care by ID provider organizations offers the potential for identifying more effective resource-allocation solutions. The authors suggest cognitive mapping as a starting point for system dynamics modelling of optimal resource-allocation projects in ID care. The application of the method is illustrated via a case study in one of the ID care providers in the Netherlands. The paper discusses some of the practical implications of applying problem-structuring methods that support gathering feedback from vulnerable service users and front-line workers. The authors concluded that cognitive mapping technique can assist the management of healthcare organizations in strategic decision-making. Copyright © 2013 John Wiley & Sons, Ltd.

A fuzzy multi-objective model for capacity allocation and pricing policy of provider in data communication service with different QoS levels

NASA Astrophysics Data System (ADS)

Pan, Wei; Wang, Xianjia; Zhong, Yong-guang; Yu, Lean; Jie, Cao; Ran, Lun; Qiao, Han; Wang, Shouyang; Xu, Xianhao

2012-06-01

Data communication service has an important influence on e-commerce. The key challenge for the users is, ultimately, to select a suitable provider. However, in this article, we do not focus on this aspect but the viewpoint and decision-making of providers for order allocation and pricing policy when orders exceed service capacity. It is a multiple criteria decision-making problem such as profit and cancellation ratio. Meanwhile, we know realistic situations in which much of the input information is uncertain. Thus, it becomes very complex in a real-life environment. In this situation, fuzzy sets theory is the best tool for solving this problem. Our fuzzy model is formulated in such a way as to simultaneously consider the imprecision of information, price sensitive demand, stochastic variables, cancellation fee and the general membership function. For solving the problem, a new fuzzy programming is developed. Finally, a numerical example is presented to illustrate the proposed method. The results show that it is effective for determining the suitable order set and pricing policy of provider in data communication service with different quality of service (QoS) levels.

Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

PubMed

Peacock, Stuart J; Mitton, Craig; Ruta, Danny; Donaldson, Cam; Bate, Angela; Hedden, Lindsay

2010-10-01

Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice. In particular, local health service organizations - such as health authorities, health maintenance organizations, hospitals and healthcare trusts - have had difficulty implementing evidence from economic appraisals. Yet, in the context of making decisions between competing claims on scarce health service resources, economic tools and thinking have much to offer. The purpose of this article is to describe and discuss ten evidence-based guidelines for the successful design and implementation of a program budgeting and marginal analysis (PBMA) priority setting exercise. PBMA is a framework that explicitly recognizes the need to balance pragmatic and ethical considerations with economic rationality when making resource allocation decisions. While the ten guidelines are drawn from the PBMA framework, they may be generalized across a range of economic approaches to priority setting.

PROCRU: A model for analyzing flight crew procedures in approach to landing

NASA Technical Reports Server (NTRS)

Baron, S.; Zacharias, G.; Muraidharan, R.; Lancraft, R.

1982-01-01

A model for the human performance of approach and landing tasks that would provide a means for systematic exploration of questions concerning the impact of procedural and equipment design and the allocation of resources in the cockpit on performance and safety in approach-to-landing is discussed. A system model is needed that accounts for the interactions of crew, procedures, vehicle, approach geometry, and environment. The issues of interest revolve principally around allocation of tasks in the cockpit and crew performance with respect to the cognitive aspects of the tasks. The model must, therefore, deal effectively with information processing and decision-making aspects of human performance.

The influence of providing a clinical practice guideline on dental students' decision making.

PubMed

van der Sanden, Wil J M; Mettes, Dirk G; Plasschaert, Alphons J M; Mulder, Jan; Verdonschot, Emiel H

2004-02-01

The aim of this study was to assess the effect of the provision of a clinical practice guideline (CPG) on dental students' decisions to remove asymptomatic, impacted lower third molars. All dental students, who in 2001 were in the 3rd, 4th or 5th (final) year of their study at the Nijmegen College of Dental Sciences, were invited to participate. A pre-test-post-test control group design was used. Given 36 patient cases, all dental students were asked to assess the need for removal of asymptomatic, impacted lower third molars. All pre-test respondents were randomly allocated to the control or intervention group. After the provision of a CPG to the intervention group, both groups were asked to assess the same cases again. Frequencies of decisions to remove the third molars were calculated. Chi-square tests and anova were used to test the influence of study year and gender on the drop-out rate and on the effect of the provision of a CPG on students' treatment decisions. The decrease in indications to remove third molars by the intervention group was statistically significant (P < 0.05). In the control group, no significant decrease was observed. It was concluded that the provision of a CPG significantly influences dental students' decision making about treatment in a third-molar decision task. Students who used the CPG showed more guideline-conformed decision making.

Managing resources in NHS dentistry: using health economics to inform commissioning decisions.

PubMed

Holmes, Richard D; Steele, Jimmy; Exley, Catherine E; Donaldson, Cam

2011-05-31

The aim of this study is to develop, apply and evaluate an economics-based framework to assist commissioners in their management of finite resources for local dental services. In April 2006, Primary Care Trusts in England were charged with managing finite dental budgets for the first time, yet several independent reports have since criticised the variability in commissioning skills within these organisations. The study will explore the views of stakeholders (dentists, patients and commissioners) regarding priority setting and the criteria used for decision-making and resource allocation. Two inter-related case studies will explore the dental commissioning and resource allocation processes through the application of a pragmatic economics-based framework known as Programme Budgeting and Marginal Analysis. The study will adopt an action research approach. Qualitative methods including semi-structured interviews, focus groups, field notes and document analysis will record the views of participants and their involvement in the research process. The first case study will be based within a Primary Care Trust where mixed methods will record the views of dentists, patients and dental commissioners on issues, priorities and processes associated with managing local dental services. A Programme Budgeting and Marginal Analysis framework will be applied to determine the potential value of economic principles to the decision-making process. A further case study will be conducted in a secondary care dental teaching hospital using the same approach. Qualitative data will be analysed using thematic analysis and managed using a framework approach. The recent announcement by government regarding the proposed abolition of Primary Care Trusts may pose challenges for the research team regarding their engagement with the research study. However, whichever commissioning organisations are responsible for resource allocation for dental services in the future; resource scarcity is highly likely to remain an issue. Wider understanding of the complexities of priority setting and resource allocation at local levels are important considerations in the development of dental commissioning processes, national oral health policy and the future new dental contract which is expected to be implemented in April 2014.

Health care costs attributable to the treatment of rheumatoid arthritis.

PubMed

Sørensen, J

2004-01-01

A 'programme budget' for the resources used in the treatment and care of patients with rheumatoid arthritis (RA) was developed with a view of helping decision-makers assess the appropriateness of the current use of resources and to discuss future resource allocation. The programme budget was developed using data from several national administrative registers. Patients with RA were identified by hospital diagnostic codes. The incremental cost of treating RA was defined as the difference in resource use for patients with and without RA. Incremental mortality due to RA was defined in similar way. Cost data were estimated for 5-year age groups. Patients with RA used on average 3.2 times as many health care resources as people without RA. The average 1997 incremental costs of primary and hospital care were EUR 253 and EUR 2.660 per patient respectively, corresponding to a national incremental cost of EUR 30 million (2000 price level). RA resulted in an annual loss of 1,549 life years. The programme budget approach is a useful tool in resource allocation decision-making, but discussions of alternative resource allocations must be based on robust studies of effectiveness and cost-effectiveness in the treatment of patients with RA.

How system designers think: a study of design thinking in human factors engineering.

PubMed

Papantonopoulos, Sotiris

2004-11-01

The paper presents a descriptive study of design thinking in human factors engineering. The objective of the study is to analyse the role of interpretation in design thinking and the role of design practice in guiding interpretation. The study involved 10 system designers undertaking the allocation of cognitive functions in three production planning and control task scenarios. Allocation decisions were recorded and verbal protocols of the design process were collected to elicit the subjects' thought processes. Verbal protocol analysis showed that subjects carried out the design of cognitive task allocation as a problem of applying a selected automation technology from their initial design deliberations. This design strategy stands in contrast to the predominant view of system design that stipulates that user requirements should be thoroughly analysed prior to making any decisions about technology. Theoretical frameworks from design research and ontological design showed that the system design process may be better understood by recognizing the role of design hypotheses in system design, as well as the diverse interactions between interpretation and practice, means and ends, and design practice and the designer's pre-understanding which shape the design process. Ways to balance the bias exerted on the design process were discussed.

Social value and individual choice: The value of a choice-based decision-making process in a collectively funded health system.

PubMed

Espinoza, Manuel Antonio; Manca, Andrea; Claxton, Karl; Sculpher, Mark

2018-02-01

Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system. Copyright © 2017 John Wiley & Sons, Ltd.

The role of cognitive and emotional perspective taking in economic decision making in the ultimatum game.

PubMed

Takagishi, Haruto; Koizumi, Michiko; Fujii, Takayuki; Schug, Joanna; Kameshima, Shinya; Yamagishi, Toshio

2014-01-01

We conducted a simple resource allocation game known as the ultimatum game (UG) with preschoolers to examine the role of cognitive and emotional perspective-taking ability on allocation and rejection behavior. A total of 146 preschoolers played the UG and completed a false belief task and an emotional perspective-taking test. Results showed that cognitive perspective taking ability had a significant positive effect on the proposer's offer and a negative effect on the responder's rejection behavior, whereas emotional perspective taking ability did not impact either the proposer's or responder's behavior. These results imply that the ability to anticipate the responder's beliefs, but not their emotional state, plays an important role in the proposer's choice of a fair allocation in an UG, and that children who have not acquired theory of mind still reject unfair offers.

Sharing the cost of river basin adaptation portfolios to climate change: Insights from social justice and cooperative game theory

NASA Astrophysics Data System (ADS)

Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velazquez, Manuel

2016-10-01

The adaptation of water resource systems to the potential impacts of climate change requires mixed portfolios of supply and demand adaptation measures. The issue is not only to select efficient, robust, and flexible adaptation portfolios but also to find equitable strategies of cost allocation among the stakeholders. Our work addresses such cost allocation problems by applying two different theoretical approaches: social justice and cooperative game theory in a real case study. First of all, a cost-effective portfolio of adaptation measures at the basin scale is selected using a least-cost optimization model. Cost allocation solutions are then defined based on economic rationality concepts from cooperative game theory (the Core). Second, interviews are conducted to characterize stakeholders' perceptions of social justice principles associated with the definition of alternatives cost allocation rules. The comparison of the cost allocation scenarios leads to contrasted insights in order to inform the decision-making process at the river basin scale and potentially reap the efficiency gains from cooperation in the design of river basin adaptation portfolios.

Ethical considerations in resource allocation in a cochlear implant program.

PubMed

Westerberg, Brian D; Pijl, Sipke; McDonald, Michael

2008-04-01

To review processes of resource allocation and the ethical considerations relevant to the fair allocation of a limited number of cochlear implants to increasing numbers of potential recipients. Review of relevant considerations. Tertiary referral hospital. Editorial discussion of the ethical issues of resource allocation. Heterogeneity of audiometric thresholds, self-reported disability of hearing loss, age of the potential cochlear implant recipient, cost-effectiveness, access to resources, compliance with follow-up, social support available to the recipient, social consequences of hearing impairment, and other recipient-related factors. In a publicly funded health care system, there will always be a need for decision-making processes for allocation of finite fiscal resources. All candidates for cochlear implantation deserve fair consideration. However, they are a heterogeneous group in terms of needs and expected outcomes consisting of traditional and marginal candidates, with a wide range of benefit from acoustic amplification. We argue that implant programs should thoughtfully prioritize treatment on the basis of need and potential benefit. We reject queuing on the basis of "first-come, first-served" or on the basis of perceived social worth.

Decision tables and rule engines in organ allocation systems for optimal transparency and flexibility.

PubMed

Schaafsma, Murk; van der Deijl, Wilfred; Smits, Jacqueline M; Rahmel, Axel O; de Vries Robbé, Pieter F; Hoitsma, Andries J

2011-05-01

Organ allocation systems have become complex and difficult to comprehend. We introduced decision tables to specify the rules of allocation systems for different organs. A rule engine with decision tables as input was tested for the Kidney Allocation System (ETKAS). We compared this rule engine with the currently used ETKAS by running 11,000 historical match runs and by running the rule engine in parallel with the ETKAS on our allocation system. Decision tables were easy to implement and successful in verifying correctness, completeness, and consistency. The outcomes of the 11,000 historical matches in the rule engine and the ETKAS were exactly the same. Running the rule engine simultaneously in parallel and in real time with the ETKAS also produced no differences. Specifying organ allocation rules in decision tables is already a great step forward in enhancing the clarity of the systems. Yet, using these tables as rule engine input for matches optimizes the flexibility, simplicity and clarity of the whole process, from specification to the performed matches, and in addition this new method allows well controlled simulations. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion.

PubMed

Iskrov, Georgi; Dermendzhiev, Svetlan; Miteva-Katrandzhieva, Tsonka; Stefanov, Rumen

2016-01-01

Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies. This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria. Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation. New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies.

LOTUS 1-2-3 and Decision Support: Allocating the Monograph Budget.

ERIC Educational Resources Information Center

Perry-Holmes, Claudia

1985-01-01

Describes the use of electronic spreadsheet software for library decision support systems using personal computers. Discussion covers templates, formulas for allocating the materials budget, LOTUS 1-2-3 and budget allocations, choosing a formula, the spreadsheet itself, graphing capabilities, and advantages and disadvantages of templates. Six…

Documenting the decision structure in software development

NASA Technical Reports Server (NTRS)

Wild, J. Christian; Maly, Kurt; Shen, Stewart N.

1990-01-01

Current software development paradigms focus on the products of the development process. Much of the decision making process which produces these products is outside the scope of these paradigms. The Decision-Based Software Development (DBSD) paradigm views the design process as a series of interrelated decisions which involve the identification and articulation of problems, alternates, solutions and justifications. Decisions made by programmers and analysts are recorded in a project data base. Unresolved problems are also recorded and resources for their resolution are allocated by management according to the overall development strategy. This decision structure is linked to the products affected by the relevant decision and provides a process oriented view of the resulted system. Software maintenance uses this decision view of the system to understand the rationale behind the decisions affecting the part of the system to be modified. D-HyperCase, a prototype Decision-Based Hypermedia System is described and results of applying the DBSD approach during its development are presented.

Health-care decision-making processes in Latin America: problems and prospects for the use of economic evaluation.

PubMed

Iglesias, Cynthia P; Drummond, Michael F; Rovira, Joan

2005-01-01

The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific groups of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.

Globally optimal trial design for local decision making.

PubMed

Eckermann, Simon; Willan, Andrew R

2009-02-01

Value of information methods allows decision makers to identify efficient trial design following a principle of maximizing the expected value to decision makers of information from potential trial designs relative to their expected cost. However, in health technology assessment (HTA) the restrictive assumption has been made that, prospectively, there is only expected value of sample information from research commissioned within jurisdiction. This paper extends the framework for optimal trial design and decision making within jurisdiction to allow for optimal trial design across jurisdictions. This is illustrated in identifying an optimal trial design for decision making across the US, the UK and Australia for early versus late external cephalic version for pregnant women presenting in the breech position. The expected net gain from locally optimal trial designs of US$0.72M is shown to increase to US$1.14M with a globally optimal trial design. In general, the proposed method of globally optimal trial design improves on optimal trial design within jurisdictions by: (i) reflecting the global value of non-rival information; (ii) allowing optimal allocation of trial sample across jurisdictions; (iii) avoiding market failure associated with free-rider effects, sub-optimal spreading of fixed costs and heterogeneity of trial information with multiple trials. Copyright (c) 2008 John Wiley & Sons, Ltd.

Motivation and effort in individuals with social anhedonia.

PubMed

McCarthy, Julie M; Treadway, Michael T; Blanchard, Jack J

2015-06-01

It has been proposed that anhedonia may, in part, reflect difficulties in reward processing and effortful decision making. The current study aimed to replicate previous findings of effortful decision making deficits associated with elevated anhedonia and expand upon these findings by investigating whether these decision making deficits are specific to elevated social anhedonia or are also associated with elevated positive schizotypy characteristics. The current study compared controls (n=40) to individuals elevated on social anhedonia (n=30), and individuals elevated on perceptual aberration/magical ideation (n=30) on the Effort Expenditure for Rewards Task (EEfRT). Across groups, participants chose a higher proportion of hard tasks with increasing probability of reward and reward magnitude, demonstrating sensitivity to probability and reward values. Contrary to our expectations, when the probability of reward was most uncertain (50% probability), at low and medium reward values, the social anhedonia group demonstrated more effortful decision making than either individuals high in positive schizotypy or controls. The positive schizotypy group only differed from controls (making less effortful choices than controls) when reward probability was lowest (12%) and the magnitude of reward was the smallest. Our results suggest that social anhedonia is related to intact motivation and effort for monetary rewards, but that individuals with this characteristic display a unique and perhaps inefficient pattern of effort allocation when the probability of reward is most uncertain. Future research is needed to better understand effortful decision making and the processing of reward across a range of individual difference characteristics. Copyright © 2015 Elsevier B.V. All rights reserved.

3D technology of Sony Bloggie has no advantage in decision-making of tennis serve direction: A randomized placebo-controlled study.

PubMed

Liu, Sicong; Ritchie, Jason; Sáenz-Moncaleano, Camilo; Ward, Savanna K; Paulsen, Cody; Klein, Tyler; Gutierrez, Oscar; Tenenbaum, Gershon

2017-06-01

This study aimed at exploring whether 3D technology enhances tennis decision-making under the conceptual framework of human performance model. A 3 (skill-level: varsity, club, recreational) × 3 (experimental condition: placebo, weak 3D [W3D], strong 3D [S3D]) between-participant design was used. Allocated to experimental conditions by a skill-level stratified randomization, 105 tennis players judged tennis serve direction from video scenarios and rated their perceptions of enjoyment, flow, and presence during task performance. Results showed that varsity players made more accurate decisions than less skilled ones. Additionally, applying 3D technology to typical video displays reduced tennis players' decision-making accuracy, although wearing the 3D glasses led to a placebo effect that shortened the decision-making reaction time. The unexpected negative effect of 3D technology on decision-making was possibly due to participants being more familiar to W3D than to S3D, and relatedly, a suboptimal task-technology match. Future directions for advancing this area of research are offered. Highlights 3D technology augments binocular depth cues to tradition video displays, and thus results in the attainment of more authentic visual representation. This process enhances task fidelity in researching perceptual-cognitive skills in sports. The paper clarified both conceptual and methodological difficulties in testing 3D technology in sports settings. Namely, the nomenclature of video footage (with/without 3D technology) and the possible placebo effect (arising from wearing glasses of 3D technology) merit researchers' attention. Participants varying in level of domain-specific expertise were randomized into viewing conditions using a placebo-controlled design. Measurement consisted of both participants' subjective experience (i.e., presence, flow, and enjoyment) and objective performance (i.e., accuracy and reaction time) in a decision-making task. Findings revealed that wearing glasses of 3D technology resulted in a placebo effect that shortened participants' reaction times in decision-making. Moreover, participants' decision-making accuracy decreased when viewing video scenarios using 3D technology. The findings generated meaningful implications regarding applying 3D technology to sports research.

New algorithms for optimal reduction of technical risks

NASA Astrophysics Data System (ADS)

Todinov, M. T.

2013-06-01

The article features exact algorithms for reduction of technical risk by (1) optimal allocation of resources in the case where the total potential loss from several sources of risk is a sum of the potential losses from the individual sources; (2) optimal allocation of resources to achieve a maximum reduction of system failure; and (3) making an optimal choice among competing risky prospects. The article demonstrates that the number of activities in a risky prospect is a key consideration in selecting the risky prospect. As a result, the maximum expected profit criterion, widely used for making risk decisions, is fundamentally flawed, because it does not consider the impact of the number of risk-reward activities in the risky prospects. A popular view, that if a single risk-reward bet with positive expected profit is unacceptable then a sequence of such identical risk-reward bets is also unacceptable, has been analysed and proved incorrect.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

Inspection of Forrestal parking permit allocation and assignments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-12-16

The purpose of this inspection was to review the process cr allocating and assigning parking permits at the Forrestal building. Specifically, we sought to determine the roles and responsibilities of Department of Energy (DOE) officials involved in the administration of the Forrestal parking permit process during the period June 1, 1991 to February 1, 1992. We also sought to determine if the allocation and assignment of Forrestal building parking spaces was implemented in accordance with Federal and DOE requirements. For our review, we interviewed the Headquarters officials involved in the administration of the parking permit allocation and assignment process. Wemore » also reviewed parking permit files and associated documentation for the period June 1, 1991 through February 1, 1992. In addition, we conducted a limited sampling of parking permits that were revoked during July and August 1991 to assess if they were processed in compliance with applicable regulations. We found no evidence that the actions by the Special Assistant to the Secretary (White House Liaison) and the other members of the parking committee regarding the issuance and revocation of parking permits were for any reason other than a desire to ensure that only individuals having a legitimate basis for a parking permit were issued a permit. However, we found that decisions by the parking committee regarding revocation of permits and appeals of revocation decisions were not always documented, nor were there written guidelines or procedures to govern the activities of the committee. In our view, the lack of written guidelines and procedures resulted in the use of invalidated personal knowledge by the parking committee in making decisions involving the revocation of parking permits and led to inconsistencies in the notification of individuals about the associated appeal process.« less

Estimating the NIH efficient frontier.

PubMed

Bisias, Dimitrios; Lo, Andrew W; Watkins, James F

2012-01-01

The National Institutes of Health (NIH) is among the world's largest investors in biomedical research, with a mandate to: "…lengthen life, and reduce the burdens of illness and disability." Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions-one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes. Using data from 1965 to 2007, we provide estimates of the NIH "efficient frontier", the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself. Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences.

Some aspects of control of a large-scale dynamic system

NASA Technical Reports Server (NTRS)

Aoki, M.

1975-01-01

Techniques of predicting and/or controlling the dynamic behavior of large scale systems are discussed in terms of decentralized decision making. Topics discussed include: (1) control of large scale systems by dynamic team with delayed information sharing; (2) dynamic resource allocation problems by a team (hierarchical structure with a coordinator); and (3) some problems related to the construction of a model of reduced dimension.

Management Information Systems for Faculty Allocations in Institutions of Higher Education: A Case Study for the Universidad de Santiago de Chile.

ERIC Educational Resources Information Center

Karadima, Oscar

The transformation of the present manual system of data manipulation at the Universidad de Santiago de Chile into a computer-based information system capable of supporting decision making is proposed. The information system would be used to determine the number of faculty required by each academic department, based on the number of weekly hours…

Understanding Optimal Decision-Making in Wargaming III

DTIC Science & Technology

2015-10-01

attention - deficit / hyperactivity disorder assessed by the Keio version of the Wisconsin card sorting test. Brain and Development, 34(5), 354-359...immediate feedback regarding friendly, enemy, and total damage. In addition to latency response (LR), attention to feedback also was measured by...measures can detect poor attention allocation. This material is based upon work supported in part by the Army Research Office (62626- NS). The

Human interaction with an intelligent computer in multi-task situations

NASA Technical Reports Server (NTRS)

Rouse, W. B.

1975-01-01

A general formulation of human decision making in multiple task situations is presented. It includes a description of the state, event, and action space in which the multiple task supervisor operates. A specific application to a failure detection and correction situation is discussed and results of a simulation experiment presented. Issues considered include static vs. dynamic allocation of responsibility and competitive vs. cooperative intelligence.

The new form 990: taking a closer look.

PubMed

Speizman, Richard A

2008-04-01

The revised Form 990 will allow the IRS to better assess the risk presented by not-for-profit organizations. The forms will also allow for increased transparency and accountability. Ultimately, the information collected on Form 990 may influence important tax policy changes. Healthcare organizations should keep the varied purposes of the form in mind when making resource allocations and other decisions involving tax compliance.

ECHO: A Computer Based Test for the Measurement of Individualistic, Cooperative, Defensive, and Aggressive Models of Behavior. Occasional Paper No. 30.

ERIC Educational Resources Information Center

Krus, David J.; And Others

This paper describes a test which attempts to measure a group of personality traits by analyzing the actual behavior of the participant in a computer-simulated game. ECHO evolved from an extension and computerization of Horstein and Deutsch's allocation game. The computerized version of ECHO requires subjects to make decisions about the allocation…

Developing Cost Accounting and Decision Support Software for Comprehensive Community-Based Support Systems: An Analysis of Needs, Interest, and Readiness in the Field.

ERIC Educational Resources Information Center

Harrington, Robert; Jenkins, Peter; Marzke, Carolyn; Cohen, Carol

Prominent among the new models of social service delivery are organizations providing comprehensive, community-based supports and services (CCBSS) to children and their families. A needs analysis explored CCBSS sites' interest in and readiness to use a software tool designed to help them make more effective internal resource allocation decisions…

Gender of Children, Bargaining Power, and Intrahousehold Resource Allocation in China

ERIC Educational Resources Information Center

Li, Lixing; Wu, Xiaoyu

2011-01-01

Based on the prevalent son preference in China, this paper proposes a new measure of relative bargaining power within the household. Using data from China Health and Nutrition Survey, we show that a woman with a first-born son has a 3.9 percentage points' greater role in household decision-making than a woman with a first-born daughter. Having a…

Risk-based decision making for staggered bioterrorist attacks : resource allocation and risk reduction in "reload" scenarios.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lemaster, Michelle Nicole; Gay, David M.; Ehlen, Mark Andrew

2009-10-01

Staggered bioterrorist attacks with aerosolized pathogens on population centers present a formidable challenge to resource allocation and response planning. The response and planning will commence immediately after the detection of the first attack and with no or little information of the second attack. In this report, we outline a method by which resource allocation may be performed. It involves probabilistic reconstruction of the bioterrorist attack from partial observations of the outbreak, followed by an optimization-under-uncertainty approach to perform resource allocations. We consider both single-site and time-staggered multi-site attacks (i.e., a reload scenario) under conditions when resources (personnel and equipment whichmore » are difficult to gather and transport) are insufficient. Both communicable (plague) and non-communicable diseases (anthrax) are addressed, and we also consider cases when the data, the time-series of people reporting with symptoms, are confounded with a reporting delay. We demonstrate how our approach develops allocations profiles that have the potential to reduce the probability of an extremely adverse outcome in exchange for a more certain, but less adverse outcome. We explore the effect of placing limits on daily allocations. Further, since our method is data-driven, the resource allocation progressively improves as more data becomes available.« less

Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.

PubMed

Werntoft, Elisabet; Edberg, Anna-Karin

2011-08-01

To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model. The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

Rationing of resources: ethical issues in disasters and epidemic situations.

PubMed

Lin, Janet Y; Anderson-Shaw, Lisa

2009-01-01

In an epidemic situation or large-scale disaster, medical and human resources may be stretched to the point of exhaustion. Appropriate planning must incorporate plans of action that minimize public health morbidity and mortality while maximizing the appropriate use of medical and human healthcare resources. While the current novel H1N1 influenza has spread throughout the world, the severity of this strain of influenza appears to be relatively less virulent and lethal compared to the 1918 influenza pandemic. However, the presence of this new influenza strain has reignited interest in pandemic planning. Amongst other necessary resources needed to combat pandemic influenza, a major medical resource concern is the limited number of mechanical ventilators that would be available to be used to treat ill patients. Recent reported cases of avian influenza suggest that mechanical ventilation will be required for the successful recovery of many individuals ill with this strain of virus. However, should the need for ventilators exceed the number of available machines, how will care providers make the difficult ethical decisions as to who should be placed or who should remain on these machines as more influenza patients arrive in need of care? This paper presents a decision-making model for clinicians that is based upon the bioethical principles of beneficence and justice. The model begins with the basic assumptions of triage and progresses into a useful algorithm based upon utilitarian principles. The model is intended to be used as a guide for clinicians in making decisions about the allocation of scarce resources in a just manner and to serve as an impetus for institutions to create or adapt plans to address resource allocation issues should the need arise.

The financing gaps framework: using need, potential spending and expected spending to allocate development assistance for health

PubMed Central

Haakenstad, Annie; Templin, Tara; Lim, Stephen; Bump, Jesse B; Dieleman, Joseph

2018-01-01

Abstract As growth in development assistance for health levels off, development assistance partners must make allocation decisions within tighter budget constraints. Furthermore, with the advent of comprehensive and comparable burden of disease and health financing estimates, empirical evidence can increasingly be used to direct funding to those most in need. In our ‘financing gaps framework’, we propose a new approach for harnessing information to make decisions about health aid. The framework was designed to be forward-looking, goal-oriented, versatile and customizable to a range of organizational contexts and health aims. Our framework brings together expected health spending, potential health spending and spending need, to orient financing decisions around international health targets. As an example of how the framework could be applied, we develop a case study, focused on global goals for child health. The case study harnesses data from the Global Burden of Disease 2013 Study, Financing Global Health 2015, the WHO Global Health Observatory and National Health Accounts. Funding flows are tied to progress toward the Sustainable Development Goal’s target for reductions in under-five mortality. The flexibility and comprehensiveness of our framework makes it adaptable for use by a diverse set of governments, donors, policymakers and other stakeholders. The framework can be adapted to short‐ or long‐run time frames, cross‐country or subnational scales, and to a number of specific health focus areas. Depending on donor preferences, the framework can be deployed to incentivize local investments in health, ensuring the long-term sustainability of health systems in low- and middle-income countries, while also furnishing international support for progress toward global health goals. PMID:29415240

Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Brooke, Vanessa; Dyer, Tim; Waller, Cara; King, Richard; Ramsey, Wayne; Mortimer, Duncan

2017-05-25

This is the sixth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE program was established to investigate a systematic, integrated, evidence-based approach to disinvestment within a large Australian health service. This paper describes the methods employed in undertaking pilot disinvestment projects. It draws a number of lessons regarding the strengths and weaknesses of these methods; particularly regarding the crucial first step of identifying targets for disinvestment. Literature reviews, survey, interviews, consultation and workshops were used to capture and process the relevant information. A theoretical framework was adapted for evaluation and explication of disinvestment projects, including a taxonomy for the determinants of effectiveness, process of change and outcome measures. Implementation, evaluation and costing plans were developed. Four literature reviews were completed, surveys were received from 15 external experts, 65 interviews were conducted, 18 senior decision-makers attended a data gathering workshop, 22 experts and local informants were consulted, and four decision-making workshops were undertaken. Mechanisms to identify disinvestment targets and criteria for prioritisation and decision-making were investigated. A catalogue containing 184 evidence-based opportunities for disinvestment and an algorithm to identify disinvestment projects were developed. An Expression of Interest process identified two potential disinvestment projects. Seventeen additional projects were proposed through a non-systematic nomination process. Four of the 19 proposals were selected as pilot projects but only one reached the implementation stage. Factors with potential influence on the outcomes of disinvestment projects are discussed and barriers and enablers in the pilot projects are summarised. This study provides an in-depth insight into the experience of disinvestment in one local healthcare service. To our knowledge, this is the first paper to report the process of disinvestment from identification, through prioritisation and decision-making, to implementation and evaluation, and finally explication of the processes and outcomes.

Cost-effectiveness analysis and formulary decision making in England: findings from research.

PubMed

Williams, Iestyn P; Bryan, Stirling

2007-11-01

In a context of rapid technological advances in health care and increasing demand for expensive treatments, local formulary committees are key players in the management of scarce resources. However, little is known about the information and processes used when making decisions on the inclusion of new treatments. This paper reports research on the use of economic evaluations in technology coverage decisions in England, although the findings have a relevance to other health care systems with devolved responsibility for resource allocation. It reports a study of four local formulary committees in which both qualitative and quantitative data were collected. Our main research finding is that it is an exception for cost-effectiveness analysis to inform technology coverage decisions. Barriers to use include access and expertise levels, concerns relating to the independence of analyses and problems with implementation of study recommendations. Further barriers derive from the constraints on decision makers, a lack of clarity over functions and aims of local committees, and the challenge of disinvestment in medical technologies. The relative weakness of the research-practice dynamics in this context suggests the need for a rethinking of the role of both analysts and decision makers. Our research supports the view that in order to be useful, analysis needs to better reflect the constraints of the local decision-making environment. We also recommend that local decision-making committees and bodies in the National Health Service more clearly identify the 'problems' which they are charged with solving and how their outputs contribute to broader finance and commissioning functions. This would help to establish the ways in which the routine use of cost-effectiveness analysis might become a reality.

Social evaluation-induced amylase elevation and economic decision-making in the dictator game in humans.

PubMed

Takahashi, Taiki; Ikeda, Koki; Hasegawa, Toshikazu

2007-10-01

Little is known regarding the relationship between social evaluation-induced neuroendocrine responses and generosity in game-theoretic situations. Previous studies demonstrated that reputation formation plays a pivotal role in prosocial behavior. This study aimed to examine the relationships between a social evaluation-induced salivary alpha-amylase (sAA) response and generosity in the dictator game. The relationship is potentially important in neuroeconomics of altruism and game theory. We assessed sAA and allocated money in the dictator game in male students with and without social evaluation. RESULTS Social evaluation-responders allocated significantly more money than controls; while there was no significant correlation between social evaluation-induced sAA elevation and the allocated money. Social evaluation significantly increases generosity in the dictator game, and individual differences in trait characteristics such as altruism and reward sensitivity may be important determinants of generosity in the dictator game task.

Allocation Anatomy: How District Policies That Deploy Resources Can Support (or Undermine) District Reform Strategies

ERIC Educational Resources Information Center

Roza, Marguerite

2008-01-01

The goal of this paper is to explore the effects of micro-budgeting decisions and show how they might support or hamper district reform strategies. The study draws on public and private sector resource allocation literature to identify key elements of resource allocation decisions. These elements are used to highlight different allocation…

Interest representation in soviet policymaking: A case study of a West Siberian energy coalition

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, H.

1986-01-01

Dr. Chung examines a little-known facet of Soviet decision making - pressure group politics and policy formation. He focuses on the ''pro-Siberian'' forces involved with the development of energy resources in West Siberia, an area rich in oil and natural gas. Because West Siberia is a remote and relatively unexplored region, controversy arose over the location of the highest-yielding fields and the allocation of funds and materials. Dr. Chung shows that the decision to accelerate the development of the West Siberian energy complex was influenced strongly by a ''policy coalition'' composed primarily of local officials, enterprise managers, professionals, and academics.more » Demonstrating that this coalition is a stable and highly active pressure group, he illustrates how it gradually established ascendancy and eventually outflanked opposing elements in the government and planning agencies. He identifies key elements of the coalition's strategy, tracing the steps by which it swung the leadership over to its views on resource allocation.« less

Location-allocation models and new solution methodologies in telecommunication networks

NASA Astrophysics Data System (ADS)

Dinu, S.; Ciucur, V.

2016-08-01

When designing a telecommunications network topology, three types of interdependent decisions are combined: location, allocation and routing, which are expressed by the following design considerations: how many interconnection devices - consolidation points/concentrators should be used and where should they be located; how to allocate terminal nodes to concentrators; how should the voice, video or data traffic be routed and what transmission links (capacitated or not) should be built into the network. Including these three components of the decision into a single model generates a problem whose complexity makes it difficult to solve. A first method to address the overall problem is the sequential one, whereby the first step deals with the location-allocation problem and based on this solution the subsequent sub-problem (routing the network traffic) shall be solved. The issue of location and allocation in a telecommunications network, called "The capacitated concentrator location- allocation - CCLA problem" is based on one of the general location models on a network in which clients/demand nodes are the terminals and facilities are the concentrators. Like in a location model, each client node has a demand traffic, which must be served, and the facilities can serve these demands within their capacity limit. In this study, the CCLA problem is modeled as a single-source capacitated location-allocation model whose optimization objective is to determine the minimum network cost consisting of fixed costs for establishing the locations of concentrators, costs for operating concentrators and costs for allocating terminals to concentrators. The problem is known as a difficult combinatorial optimization problem for which powerful algorithms are required. Our approach proposes a Fuzzy Genetic Algorithm combined with a local search procedure to calculate the optimal values of the location and allocation variables. To confirm the efficiency of the proposed algorithm with respect to the quality of solutions, significant size test problems were considered: up to 100 terminal nodes and 50 concentrators on a 100 × 100 square grid. The performance of this hybrid intelligent algorithm was evaluated by measuring the quality of its solutions with respect to the following statistics: the standard deviation and the ratio of the best solution obtained.

Factors influencing resource allocation decisions and equity in the health system of Ghana.

PubMed

Asante, A D; Zwi, A B

2009-05-01

Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and diverse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.

Frontal cortex electrophysiology in reward- and punishment-related feedback processing during advice-guided decision making: An interleaved EEG-DC stimulation study.

PubMed

Wischnewski, Miles; Bekkering, Harold; Schutter, Dennis J L G

2018-04-01

During decision making, individuals are prone to rely on external cues such as expert advice when the outcome is not known. However, the electrophysiological correlates associated with outcome uncertainty and the use of expert advice are not completely understood. The feedback-related negativity (FRN), P3a, and P3b are event-related brain potentials (ERPs) linked to dissociable stages of feedback and attentional processing during decision making. Even though these ERPs are influenced by both reward- and punishment-related feedback, it remains unclear how extrinsic information during uncertainty modulates these brain potentials. In this study, the effects of advice cues on decision making were investigated in two separate experiments. In the first experiment, electroencephalography (EEG) was recorded in healthy volunteers during a decision-making task in which the participants received reward or punishment feedback preceded by novice, amateur, or expert advice. The results showed that the P3a component was significantly influenced by the subjective predictive value of an advice cue, whereas the FRN and P3b were unaffected by the advice cues. In the second, sham-controlled experiment, cathodal transcranial direct current stimulation (ctDCS) was administered in conjunction with EEG in order to explore the direct contributions of the frontal cortex to these brain potentials. Results showed no significant change in either advice-following behavior or decision times. However, ctDCS did decrease FRN amplitudes as compared to sham, with no effect on the P3a or P3b. Together, these findings suggest that advice information may act primarily on attention allocation during feedback processing, whereas the electrophysiological correlates of the detection and updating of internal prediction models are not affected.

Improved Acquisition for System Sustainment: Multiobjective Tradeoff Analysis for Condition-Based Decision-Making

DTIC Science & Technology

2013-10-21

depend on the quality of allocating resources. This work uses a reliability model of system and environmental covariates incorporating information at...state space. Further, the use of condition variables allows for the direct modeling of maintenance impact with the assumption that a nominal value ... value ), the model in the application of aviation maintenance can provide a useful estimation of reliability at multiple levels. Adjusted survival

Tailoring Configuration to User’s Tasks under Uncertainty

DTIC Science & Technology

2008-04-28

CARISMA is the problem being solved. CARISMA applies microeconom- ics and game theory to make runtime decisions about allocating scarce resources among...scarce resources, these applications are running on be- half of one user. Thus, our problem has no game theoretic aspects. 2.2 Task Oriented...prediction tool [15] is based on the RPS tool and allows prediction of bandwidth online . There is additional evidence (see, for example [49

NASA Seminar on Organization and Management

NASA Technical Reports Server (NTRS)

Crawley, R. W.; Kloman, E. H.

1972-01-01

The proceedings of a seminar series of current problems and organization of NASA are presented. The seminar was designed to provide a comparative basis for understanding such recurring problems as delegation of authority, resource allocation and decision making patterns, headquarters organization, systems of program control and evaluation, roles and relations of scientists, engineers, and administrators, headquarters-field center relationships, and the overall management philosophy of the headquarters and field centers.

The Need for Strategic Research and Study Centers (Think Tanks) in the Kingdom of Saudi Arabia

DTIC Science & Technology

2014-03-01

technology issues , or industrial or business policies.27 Evidence-based research has become an indispensable tool for political decision making and...can be used to judge public sentiment on given issues . Government as well as private business gives due consideration during policy or strategy...policy guidance on modern issues like economic growth, resource allocation, job creation, unemployment reduction, financial management, legislation

Using patient acuity data to manage patient care outcomes and patient care costs.

PubMed

Van Slyck, A; Johnson, K R

2001-01-01

This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

Methodological Variation in Economic Evaluations Conducted in Low- and Middle-Income Countries: Information for Reference Case Development

PubMed Central

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions. PMID:25950443

Delivering Value In A Global Aerospace Manufacturer Through The Effective Use Of Numerical Process Simulation

NASA Astrophysics Data System (ADS)

Ward, M. J.; Walløe, S. J.

2004-06-01

Numerical models are used extensively in the aerospace sector to identify appropriate manufacturing parameters, and to minimize the risk associated with new product introduction and manufacturing change. This usage is equally prevalent in original equipment manufacturers (OEMs), and in their supply chains. The wide range of manufacturing processes and production environments involved, coupled with the varying degrees of technology maturity associated with numerical models of different processes leads to a situation of significant complexity from the OEM perspective. In addition, the intended use of simulation technology can vary considerably between applications, from simple geometric assessment of die shape at one extreme, to full process design or development at the other. Consequently there is an increasing trend towards multi-scale modelling, i.e. the use of several different model types, with differing attributes in terms of accuracy and speed to support a range of different new product introduction decisions. This makes the allocation of appropriate levels of activity to the research and implementation of new capabilities a difficult problem. This paper uses a number of industrial cases studies to illustrate a framework for making such allocation decisions such that value to the OEM is maximized, and investigates how such a framework is likely to shift over the next few years based on technological developments.

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties.

PubMed

Keyonzo, Nelson; Korir, Julius; Abilla, Faith; Sirera, Morine; Nyakwara, Peter; Bazant, Eva; Waka, Charles; Koskei, Nancy; Kabue, Mark

2017-12-01

As international development partners reduce funding for family planning (FP) programs, the need to estimate the financial resources devoted to FP is becoming increasingly important both at all levels. This cross-sectional assessment examined the FP financing sources, agents, and expenditures in two counties of Kenya for fiscal years 2010/2011 and 2011/2012 to guide local decision-making on financial allocations. Data were collected through a participatory process. This involved stakeholder interviews, review of financial records and service statistics, and a survey of facilities offering FP services. Financing sources and agents were identified, and source amounts calculated. Types of FP provider organizations and the amounts spent by expenditure categories were identified. Overall, five financing sources and seven agents for FP were identified. Total two-year expenditures were KSh 307.8 M (US$ 3.62 M). The government's share of funding rose from 12% to 21% over the two years (p=0.029). In 2010/2011, the largest expense categories were administration, commodities, and labor; however, spending on commodities increased by 47% (p=0.042). This study provides local managers with FP financing and expenditure information for use in budget allocation decision-making. These analyses can be done routinely and replicated in other local counties or countries in a context of devolution.

Differences in fairness and trust between lean and corpulent men.

PubMed

Kubera, B; Klement, J; Wagner, C; Rädel, C; Eggeling, J; Füllbrunn, S; Kaczmarek, M C; Levinsky, R; Peters, A

2016-11-01

Employment disparities are known to exist between lean and corpulent people, for example, corpulent people are less likely to be hired and get lower wages. The reasons for these disparities between weight groups are not completely understood. We hypothesize (i) that economic decision making differs between lean and corpulent subjects, (ii) that these differences are influenced by peoples' blood glucose concentrations and (iii) by the body weight of their opponents. A total of 20 lean and 20 corpulent men were examined, who performed a large set of economic games (ultimatum game, trust game and risk game) under euglycemic and hypoglycemic conditions induced by the glucose clamp technique. In the ultimatum game, lean men made less fair decisions and offered 16% less money than corpulent men during euglycemia (P=0.042). During hypoglycemia, study participants of both weight groups accepted smaller amounts of money than during euglycemia (P=0.031), indicating that a lack of energy makes subjects to behave more like a Homo Economicus. In the trust game, lean men allocated twice as much money to lean than to corpulent trustees during hypoglycemia (P<0.001). Risk-seeking behavior did not differ between lean and corpulent men. Our data show that economic decision making is affected by both, the body weight of the participants and the body weight of their opponents, and that blood glucose concentrations should be taken into consideration when analyzing economic decision making. When relating these results to the working environment, the weight bias in economic decision making may be also relevant for employment disparities.

You Are the Danger: Attenuated Insula Response in Methamphetamine Users During Aversive Interoceptive Decision-Making*

PubMed Central

Stewart, Jennifer L.; May, April C.; Poppa, Tasha; Davenport, Paul W.; Tapert, Susan F.; Paulus, Martin P.

2014-01-01

Background Drug dependent individuals often make drug-taking decisions when they do not feel well. Yet, few studies have examined the influence of an aversive state on decision-making related neural processing. Methods We investigate brain activation to decision-making during an aversive interoceptive challenge in methamphetamine users using functional magnetic resonance imaging (fMRI). Recently abstinent inpatients with methamphetamine use disorder (METH; n=20) and healthy comparison subjects (CTL; n=22) performed a two-choice prediction task at three fixed error rates (ER; 20%=reward, 50%=uncertainty, 80%=punishment) while anticipating and experiencing episodes of inspiratory breathing load during fMRI. Results METH exhibited higher trait anxiety in conjunction with lower anterior insula (AI) and inferior frontal gyrus (IFG) activation than CTL across trials. METH also showed lower posterior insula (PI) and anterior cingulate cortex (ACC) activation than CTL during breathing load independent of ER. For the crucial ER by interoception interaction, METH displayed lower ACC activation to punishment/loss than CTL during breathing load. Within METH, lower trait anxiety was linked to bilateral AI/IFG attenuation across trials. Conclusions AI/IFG attenuations in METH are suggestive of an executive functioning deficit, particularly in users with low anxiety, reflecting reduced resources allocated to choice selection. In contrast, PI/ACC reductions in METH appear specific to impairments in registering and evaluating interoceptive experiences. Taken together, inadequate activation of brain areas that are important for regulating when one does not feel well may be the neural basis for poor decision-making by METH. PMID:24993186

Enhancing stakeholder involvement in environmental decision making: Active Response Geographic Information System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faber, B.G.; Thomas, V.L.; Thomas, M.R.

This paper describes a spatial decision support system that facilitates land-related negotiations and resolving conflicts. This system, called Active Response Geographic Information System (AR/GIS), uses a geographic information system to examine land resource management issues which involve multiple stakeholder groups. In this process, participants are given the opportunity and tools needed to share ideas in a facilitated land resource allocation negotiation session. Participants are able to assess current land status, develop objectives, propose alternative planning scenarios, and evaluate the effects or impacts of each alternative. AR/GIS is a unique tool that puts geographic information directly at the fingertips of non-technicalmore » policy analysts, decision makers, and representatives of stakeholder groups during the negotiation process. AR/GIS enhances individual comprehension and ownership of the decision making process and increasing the efficiency and effectiveness of group debate. It is most beneficial to planning tasks which are inherently geographic in nature, which require consideration of a large number of physical constraints and economic implications, and which involve publicly sensitive tradeoffs.« less

Future Water Management in the South Platte River Basin: Impacts of Hydraulic Fracturing, Population, Agriculture, and Climate Change in a Semi-Arid Region.

NASA Astrophysics Data System (ADS)

Walker, E. L.; Hogue, T. S.; Anderson, A. M.; Read, L.

2015-12-01

In semi-arid basins across the world, the gap between water supply and demand is growing due to climate change, population growth, and shifts in agriculture and unconventional energy development. Water conservation efforts among residential and industrial water users, recycling and reuse techniques and innovative regulatory frameworks for water management strive to mitigate this gap, however, the extent of these strategies are often difficult to quantify and not included in modeling water allocations. Decision support systems (DSS) are purposeful for supporting water managers in making informed decisions when competing demands create the need to optimize water allocation between sectors. One region of particular interest is the semi-arid region of the South Platte River basin in northeastern Colorado, where anthropogenic and climatic effects are expected to increase the gap between water supply and demand in the near future. Specifically, water use in the South Platte is impacted by several high-intensity activities, including unconventional energy development, i.e. hydraulic fracturing, and large withdrawals for agriculture; these demands are in addition to a projected population increase of 100% by 2050. The current work describes the development of a DSS for the South Platte River basin, using the Water Evaluation and Planning system software (WEAP) to explore scenarios of how variation in future water use in the energy, agriculture, and municipal sectors will impact water allocation decisions. Detailed data collected on oil and gas water use in the Niobrara shale play will be utilized to predict future sector use. We also employ downscaled climate projections for the region to quantify the potential range of water availability in the basin under each scenario, and observe whether or not, and to what extent, climate may impact management decisions at the basin level.

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

PubMed Central

2011-01-01

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

Equilibrium approach towards water resource management and pollution control in coal chemical industrial park.

PubMed

Xu, Jiuping; Hou, Shuhua; Xie, Heping; Lv, Chengwei; Yao, Liming

2018-08-01

In this study, an integrated water and waste load allocation model is proposed to assist decision makers in better understanding the trade-offs between economic growth, resource utilization, and environmental protection of coal chemical industries which characteristically have high water consumption and pollution. In the decision framework, decision makers in a same park, each of whom have different goals and preferences, work together to seek a collective benefit. Similar to a Stackelberg-Nash game, the proposed approach illuminates the decision making interrelationships and involves in the conflict coordination between the park authority and the individual coal chemical company stockholders. In the proposed method, to response to climate change and other uncertainties, a risk assessment tool, Conditional Value-at-Risk (CVaR) and uncertainties through reflecting parameters and coefficients using probability and fuzzy set theory are integrated in the modeling process. Then a case study from Yuheng coal chemical park is presented to demonstrate the practicality and efficiency of the optimization model. To reasonable search the potential consequences of different responses to water and waste load allocation strategies, a number of scenario results considering environmental uncertainty and decision maker' attitudes are examined to explore the tradeoffs between economic development and environmental protection and decision makers' objectives. The results are helpful for decision/police makers to adjust current strategies adapting for current changes. Based on the scenario analyses and discussion, some propositions and operational policies are given and sensitive adaptation strategies are presented to support the efficient, balanced and sustainable development of coal chemical industrial parks. Copyright © 2018 Elsevier Ltd. All rights reserved.

The SIMRAND methodology - Simulation of Research and Development Projects

NASA Technical Reports Server (NTRS)

Miles, R. F., Jr.

1984-01-01

In research and development projects, a commonly occurring management decision is concerned with the optimum allocation of resources to achieve the project goals. Because of resource constraints, management has to make a decision regarding the set of proposed systems or tasks which should be undertaken. SIMRAND (Simulation of Research and Development Projects) is a methodology which was developed for aiding management in this decision. Attention is given to a problem description, aspects of model formulation, the reduction phase of the model solution, the simulation phase, and the evaluation phase. The implementation of the considered approach is illustrated with the aid of an example which involves a simplified network of the type used to determine the price of silicon solar cells.

Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

PubMed

Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

2009-01-01

In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

How Green Water Flows structure be a decision indicator for ecological water allocation in arid Ejina Delta, China.

NASA Astrophysics Data System (ADS)

Yu, J.; Du, C.; Zhang, Y.; Liu, X.

2014-12-01

Green water flows, a key ecohydrological process, dominates the hydrological cycle in arid region. The structure of green water flows reflects the landscape water consumption characteristics and can be easily obtained by means of remote sensing approach. In arid region, limited fresh water and fragile environment resulted in sharp contradictions between economy and natural ecosystem concerning water demands. To rationally allocate economic and ecological water use, to maximize the regional freshwater use efficiency, is the route one must take for sustainable development in arid area. The pursuit of the most necessary ecological protection function and the maximum ecological water use efficiency is the key to ecological water allocation. However, we are short of simple and quick detectable variables or indexes to assess ecological water allocation decision. This paper introduced the green water flows structure as a decision variable, chose Heihe river flow allocation to downstream Ejina Delta for ecological protection as an example, put forward why and how green water flows structure could be used for ecological water allocation decision. The authors expect to provide reference for integrated fresh water resources management practice in arid region.

An Optimization Model for the Allocation of University Based Merit Aid

ERIC Educational Resources Information Center

Sugrue, Paul K.

2010-01-01

The allocation of merit-based financial aid during the college admissions process presents postsecondary institutions with complex and financially expensive decisions. This article describes the application of linear programming as a decision tool in merit based financial aid decisions at a medium size private university. The objective defined for…

Economic theory and nursing administration research--is this a good combination?

PubMed

Jones, Terry L; Yoder, Linda

2010-01-01

Economic theory is used to describe and explain decision making in the context of scarce resources. This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing.

Economic Theory and Nursing Administration Research—Is This a Good Combination?

PubMed Central

Jones, Terry L.; Yoder, Linda

2017-01-01

TOPIC Economic theory is used to describe and explain decision making in the context of scarce resources. PURPOSE This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. SOURCES OF INFORMATION The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. CONCLUSIONS While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing. PMID:20137023

Going All In: Unfavorable Sex Ratios Attenuate Choice Diversification.

PubMed

Ackerman, Joshua M; Maner, Jon K; Carpenter, Stephanie M

2016-06-01

When faced with risky decisions, people typically choose to diversify their choices by allocating resources across a variety of options and thus avoid putting "all their eggs in one basket." The current research revealed that this tendency is reversed when people face an important cue to mating-related risk: skew in the operational sex ratio, or the ratio of men to women in the local environment. Counter to the typical strategy of choice diversification, findings from four studies demonstrated that the presence of romantically unfavorable sex ratios (those featuring more same-sex than opposite-sex individuals) led heterosexual people to diversify financial resources less and instead concentrate investment in high-risk/high-return options when making lottery, stock-pool, retirement-account, and research-funding decisions. These studies shed light on a key process by which people manage risks to mating success implied by unfavorable interpersonal environments. These choice patterns have important implications for mating behavior as well as other everyday forms of decision making. © The Author(s) 2016.

The politics of end-of-life decision-making: computerised decision-support tools, physicians' jurisdiction and morality.

PubMed

Jennings, Beth

2006-04-01

With the increasing corporate and governmental rationalisation of medical care, the mandate of efficiency has caused many to fear that concern for the individual patient will be replaced with impersonal, rule-governed allocation of medical resources. Largely ignored is the role of moral principles in medical decision-making. This analysis comes from an ethnographic study conducted from 1999-2001 in three US Intensive Care Units, two of which were using the computerised decision-support tool, APACHE III (Acute Physiological and Chronic Health Evaluation III), which notably predicts the probability that a patient will die. It was found that the use of APACHE presents a paradox regarding concern for the individual patient. To maintain jurisdiction over the care of patients, physicians share the data with the payers and regulators of care to prove they are using resources effectively and efficiently, yet they use the system in conjunction with moral principles to justify treating each patient as unique. Thus, concern for the individual patient is not lessened with the use of this system. However, physicians do not share the data with patients or surrogate decision-makers because they fear they will be viewed as more interested in profits than patients.

The impacts of racial group membership on people's distributive justice: an event-related potential study.

PubMed

Wang, Yan; Tang, Yi-Yuan; Deng, Yuqin

2014-04-16

How individuals and societies distribute benefits has long been studied by psychologists and sociologists. Previous work has highlighted the importance of social identity on people's justice concerns. However, it is not entirely clear how racial in-group/out-group relationship affects the brain activity in distributive justice. In this study, event-related potentials were recorded while participants made their decisions about donation allocation. Behavioral results showed that racial in-group factor affected participants' decisions on justice consideration. Participants were more likely to make relatively equity decisions when racial in-group factor was congruent with equity compared with the corresponding incongruent condition. Moreover, this incongruent condition took longer response times than congruent condition. Meanwhile, less equity decisions were made when efficiency was larger in the opposite side to equity than it was equal between the two options. Scalp event-related potential analyses revealed that greater P300 and late positive potential amplitudes were elicited by the incongruent condition compared with the congruent condition. These findings suggest that the decision-making of distributive justice could be modulated by racial group membership, and greater attentional resources or cognitive efforts are required when racial in-group factor and equity conflict with each other.

Application of the environmental Gini coefficient in allocating water governance responsibilities: a case study in Taihu Lake Basin, China.

PubMed

Zhou, Shenbei; Du, Amin; Bai, Minghao

2015-01-01

The equitable allocation of water governance responsibilities is very important yet difficult to achieve, particularly for a basin which involves many stakeholders and policymakers. In this study, the environmental Gini coefficient model was applied to evaluate the inequality of water governance responsibility allocation, and an environmental Gini coefficient optimisation model was built to achieve an optimal adjustment. To illustrate the application of the environmental Gini coefficient, the heavily polluted transboundary Taihu Lake Basin in China, was chosen as a case study. The results show that the original environmental Gini coefficient of the chemical oxygen demand (COD) was greater than 0.2, indicating that the allocation of water governance responsibilities in Taihu Lake Basin was unequal. Of seven decision-making units, three were found to be inequality factors and were adjusted to reduce the water pollutant emissions and to increase the water governance inputs. After the adjustment, the environmental Gini coefficient of the COD was less than 0.2 and the reduction rate was 27.63%. The adjustment process provides clear guidance for policymakers to develop appropriate policies and improve the equality of water governance responsibility allocation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Hao; Garzoglio, Gabriele; Ren, Shangping

FermiCloud is a private cloud developed in Fermi National Accelerator Laboratory to provide elastic and on-demand resources for different scientific research experiments. The design goal of the FermiCloud is to automatically allocate resources for different scientific applications so that the QoS required by these applications is met and the operational cost of the FermiCloud is minimized. Our earlier research shows that VM launching overhead has large variations. If such variations are not taken into consideration when making resource allocation decisions, it may lead to poor performance and resource waste. In this paper, we show how we may use an VMmore » launching overhead reference model to minimize VM launching overhead. In particular, we first present a training algorithm that automatically tunes a given refer- ence model to accurately reflect FermiCloud environment. Based on the tuned reference model for virtual machine launching overhead, we develop an overhead-aware-best-fit resource allocation algorithm that decides where and when to allocate resources so that the average virtual machine launching overhead is minimized. The experimental results indicate that the developed overhead-aware-best-fit resource allocation algorithm can significantly improved the VM launching time when large number of VMs are simultaneously launched.« less

Tactical resource allocation and elective patient admission planning in care processes.

PubMed

Hulshof, Peter J H; Boucherie, Richard J; Hans, Erwin W; Hurink, Johann L

2013-06-01

Tactical planning of resources in hospitals concerns elective patient admission planning and the intermediate term allocation of resource capacities. Its main objectives are to achieve equitable access for patients, to meet production targets/to serve the strategically agreed number of patients, and to use resources efficiently. This paper proposes a method to develop a tactical resource allocation and elective patient admission plan. These tactical plans allocate available resources to various care processes and determine the selection of patients to be served that are at a particular stage of their care process. Our method is developed in a Mixed Integer Linear Programming (MILP) framework and copes with multiple resources, multiple time periods and multiple patient groups with various uncertain treatment paths through the hospital, thereby integrating decision making for a chain of hospital resources. Computational results indicate that our method leads to a more equitable distribution of resources and provides control of patient access times, the number of patients served and the fraction of allocated resource capacity. Our approach is generic, as the base MILP and the solution approach allow for including various extensions to both the objective criteria and the constraints. Consequently, the proposed method is applicable in various settings of tactical hospital management.

Activation of the cannabinoid system in the nucleus accumbens affects effort-based decision making.

PubMed

Fatahi, Zahra; Haghparast, Abbas

2018-02-01

Effort-based decision making addresses how we make an action choice based on an integration of action and goal values. The nucleus accumbens (NAc) is implicated in allowing an animal to overcome effort constraints to obtain greater benefits, and it has been previously shown that cannabis derivatives may affect such processes. Therefore, in this study, we intend to evaluate the involvement of the cannabinoid system in the entire NAc on effort-based decision making. Rats were trained in a T-maze cost-benefit decision making the task in which they could choose either to climb a barrier to obtain a large reward in one arm or run into the other arm without a barrier to obtaining a small reward. Following training, the animals were bilaterally implanted with guide cannulae in the NAc. On test day, rats received cannabinoid agonist (Win 55,212-2; 2, 10 and 50μM) and/or antagonist (AM251; 45μM), afterward percentage of large reward choice and latency of reward attainment were investigated. Results revealed that the administration of cannabinoid agonist led to decrease of large reward choice percentage such that the animals preferred to receive a small reward with low effort instead of receiving a large reward with high effort. The administration of antagonist solely did not affect effort-based decision making, but did attenuate the Win 55,212-2-induced impairments in effort allocation. In agonist-treated animals, the latency of reward collection increased. Moreover, when the effort was equated on both arms, the animals returned to choosing large reward showing that obtained results were not caused by spatial memory impairment. Our finding suggested that activation of the cannabinoid system in the NAc impaired effort-based decision making and led to rats were less willing to invest the physical effort to gain large reward. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards an equitable allocation of the cost of a global change adaptation plan at the river basin scale: going beyond the perfect cooperation assumption

NASA Astrophysics Data System (ADS)

Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velázquez, Manuel

2015-04-01

Adaptation to global change is a key issue in the planning of water resource systems in a changing world. Adaptation has to be efficient, but also equitable in the share of the costs of joint adaptation at the river basin scale. Least-cost hydro-economic optimization models have been helpful at defining efficient adaptation strategies. However, they often rely on the assumption of a "perfect cooperation" among the stakeholders, required for reaching the optimal solution. Nowadays, most adaptation decisions have to be agreed among the different actors in charge of their implementation, thus challenging the validity of a perfect command-and-control solution. As a first attempt to over-pass this limitation, our work presents a method to allocate the cost of an efficient adaptation programme of measures among the different stakeholders at the river basin scale. Principles of equity are used to define cost allocation scenarios from different perspectives, combining elements from cooperative game theory and axioms from social justice to bring some "food for thought" in the decision making process of adaptation. To illustrate the type of interactions between stakeholders in a river basin, the method has been applied in a French case study, the Orb river basin. Located on the northern rim of the Mediterranean Sea, this river basin is experiencing changes in demand patterns, and its water resources will be impacted by climate change, calling for the design of an adaptation plan. A least-cost river basin optimization model (LCRBOM) has been developed under GAMS to select the combination of demand- and supply-side adaptation measures that allows meeting quantitative water management targets at the river basin scale in a global change context. The optimal adaptation plan encompasses measures in both agricultural and urban sectors, up-stream and down-stream of the basin, disregarding the individual interests of the stakeholders. In order to ensure equity in the cost allocation of the adaptation plan, different allocation scenarios are considered. The LCRBOM allows defining a solution space based on economic rationality concepts from cooperative game theory (the core of the game), and then, to define equitable allocation of the cost of the programme of measures (the Shapley value and the nucleolus). Moreover, alternative allocation scenarios have been considered based on axiomatic principles of social justice, such as "utilitarian", "prior rights" or "strict equality", applied in the case study area. The comparison of the cost allocation scenarios brings insight to inform the decision making process at the river basin scale and potentially reap the efficiency gains from cooperation in the design of adaptation plan. The study has been partially supported by the IMPADAPT project /CGL2013-48424-C2-1-R) from the Spanish ministry MINECO (Ministerio de Economía y Competitividad) and European FEDER funds. Corentin Girard is supported by a grant from the University Lecturer Training Program (FPU12/03803) of the Ministry of Education, Culture and Sports of Spain.

Make or buy analysis model based on tolerance allocation to minimize manufacturing cost and fuzzy quality loss

NASA Astrophysics Data System (ADS)

Rosyidi, C. N.; Puspitoingrum, W.; Jauhari, W. A.; Suhardi, B.; Hamada, K.

2016-02-01

The specification of tolerances has a significant impact on the quality of product and final production cost. The company should carefully pay attention to the component or product tolerance so they can produce a good quality product at the lowest cost. Tolerance allocation has been widely used to solve problem in selecting particular process or supplier. But before merely getting into the selection process, the company must first make a plan to analyse whether the component must be made in house (make), to be purchased from a supplier (buy), or used the combination of both. This paper discusses an optimization model of process and supplier selection in order to minimize the manufacturing costs and the fuzzy quality loss. This model can also be used to determine the allocation of components to the selected processes or suppliers. Tolerance, process capability and production capacity are three important constraints that affect the decision. Fuzzy quality loss function is used in this paper to describe the semantic of the quality, in which the product quality level is divided into several grades. The implementation of the proposed model has been demonstrated by solving a numerical example problem that used a simple assembly product which consists of three components. The metaheuristic approach were implemented to OptQuest software from Oracle Crystal Ball in order to obtain the optimal solution of the numerical example.

Economic evaluations of point of care testing strategies for active tuberculosis.

PubMed

Zwerling, Alice; Dowdy, David

2013-06-01

Point of care (POC) diagnostics are often hailed as having the potential to transform tuberculosis (TB) control efforts. However, POC testing is better conceptualized as a system of diagnosis and treatment, not simply a test that can provide rapid, deployable results. Economic evaluations may help decision makers allocate scarce resources for TB control, but evaluations of POC testing face unique challenges that include evaluating the full diagnostic system, incorporating implementation costs, translating diagnostic results into health and accounting for downstream treatment costs. For economic evaluations to reach their full potential as decision-making tools for POC testing in TB, these challenges must be understood and addressed.

Resource allocation decisions in low-income rural households.

PubMed

Franklin, D L; Harrell, M W

1985-05-01

This paper is based on the theory that a society's nutritional well-being is both a cause and a consequence of the developmental process within that society. An approach to the choices made by poor rural households regarding food acquisition and nurturing behavior is emerging from recent research based on the new economic theory of household production. The central thesis of this approach is that household decisions related to the fulfillment of basic needs are strongly determined by decisions on the allocation of time to household production activities. Summarized are the results of the estimation of a model of household production and consumption behavior with data from a cross-sectional survey of 30 rural communities in Veraguas Province, Panama. The struture of the model consists of allocation of resources to nurturing activities and to production activities. The resources to be allocated are time and market goods, and in theory, these are allocated according to relative prices. The empirical results of this study are generally consistent with the predictions of the neoclassical economic model of household resource allocation. The major conclusions that time allocations and market price conditions matter in the determination of well-being in low-income rural households and, importantly, that nurturing decisions significantly affect the product and factor market behavior of these households form the basis for a discussion on implucations for agricultural and rural development. Programs and policies that seek nutritional improvement should be determined with explicit recognition of the value of time and the importance of timing in the decisions of the poor.

What factors influence physiotherapy service provision in rural communities? A pilot study.

PubMed

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

Dynamic equilibrium strategy for drought emergency temporary water transfer and allocation management

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Ma, Ning; Lv, Chengwei

2016-08-01

Efficient water transfer and allocation are critical for disaster mitigation in drought emergencies. This is especially important when the different interests of the multiple decision makers and the fluctuating water resource supply and demand simultaneously cause space and time conflicts. To achieve more effective and efficient water transfers and allocations, this paper proposes a novel optimization method with an integrated bi-level structure and a dynamic strategy, in which the bi-level structure works to deal with space dimension conflicts in drought emergencies, and the dynamic strategy is used to deal with time dimension conflicts. Combining these two optimization methods, however, makes calculation complex, so an integrated interactive fuzzy program and a PSO-POA are combined to develop a hybrid-heuristic algorithm. The successful application of the proposed model in a real world case region demonstrates its practicality and efficiency. Dynamic cooperation between multiple reservoirs under the coordination of a global regulator reflects the model's efficiency and effectiveness in drought emergency water transfer and allocation, especially in a fluctuating environment. On this basis, some corresponding management recommendations are proposed to improve practical operations.

The benefit of using additional hydrological information from earth observations and reanalysis data on water allocation decisions in irrigation districts

NASA Astrophysics Data System (ADS)

Kaune, Alexander; López, Patricia; Werner, Micha; de Fraiture, Charlotte

2017-04-01

Hydrological information on water availability and demand is vital for sound water allocation decisions in irrigation districts, particularly in times of water scarcity. However, sub-optimal water allocation decisions are often taken with incomplete hydrological information, which may lead to agricultural production loss. In this study we evaluate the benefit of additional hydrological information from earth observations and reanalysis data in supporting decisions in irrigation districts. Current water allocation decisions were emulated through heuristic operational rules for water scarce and water abundant conditions in the selected irrigation districts. The Dynamic Water Balance Model based on the Budyko framework was forced with precipitation datasets from interpolated ground measurements, remote sensing and reanalysis data, to determine the water availability for irrigation. Irrigation demands were estimated based on estimates of potential evapotranspiration and coefficient for crops grown, adjusted with the interpolated precipitation data. Decisions made using both current and additional hydrological information were evaluated through the rate at which sub-optimal decisions were made. The decisions made using an amended set of decision rules that benefit from additional information on demand in the districts were also evaluated. Results show that sub-optimal decisions can be reduced in the planning phase through improved estimates of water availability. Where there are reliable observations of water availability through gauging stations, the benefit of the improved precipitation data is found in the improved estimates of demand, equally leading to a reduction of sub-optimal decisions.

Portfolio evaluation of health programs: a reply to Sendi et al.

PubMed

Bridges, John F P; Terris, Darcey D

2004-05-01

Sendi et al. (Soc. Sci. Med. 57 (2003) 2207) extend previous research on cost-effectiveness analysis to the evaluation of a portfolio of interventions with risky outcomes using a "second best" approach that can identify improvements in efficiency in the allocation of resources. This method, however, cannot be used to directly identify the optimal solution to the resource allocation problem. Theoretically, a stricter adherence to the foundations of portfolio theory would permit direct optimization in portfolio selection, however, when we include uncertainty in our analysis in addition to the traditional concept of risk (which is often mislabelled uncertainty) complexities are introduced that create significant hurdles in the development of practical applications of portfolio theory for health care policy decision making.

Establishing politically feasible water markets: a multi-criteria approach.

PubMed

Ballestero, Enrique; Alarcón, Silverio; García-Bernabeu, Ana

2002-08-01

A multiple criteria decision-making (MCDM) model to simulate the establishment of water markets is developed. The environment is an irrigated area governed by a non-profit agency, which is responsible for water production, allocation, and pricing. There is a traditional situation of historical rights, average-cost pricing for water allocation, large quantities of water used, and inefficiency. A market-oriented policy could be implemented by accounting for ecological and political objectives such as saving groundwater and safeguarding historical rights while promoting economic efficiency. In this paper, a problem is solved by compromise programming, a multi-criteria technique based on the principles of Simonian logic. The model is theoretically developed and applied to the Lorca region in Spain near the Mediterranean Sea.

Improving Resource Allocation Decisions to Reduce the Risk of Terrorist Attacks on Passenger Rail Systems

DTIC Science & Technology

2016-12-01

theory, passenger rail bombing , attacker-defender methodology 15. NUMBER OF PAGES 103 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT...bombers carried out a successful coordinated attack against the London mass transit system in July 2005. Three suicide bombings occurred on trains and...iron rods to make shrapnel. The precise timing indicates the terrorists themselves detonated their own devices. In March 2016, a suicide bomb

Transforming the Air Traffic Management System -- Why Is It So Hard?

DTIC Science & Technology

2012-11-08

Aircraft Systems Integration The Equity Concept Chocolate Cake Problem: How can I distribute this cake equitably among each of the students sitting...net-centric system. – Timely, common information will be available to all (humans and machines ) to help them make their decisions. – While any change...prioritization done when scarce resources must be allocated? (Remember how hard it was to distribute the chocolate cake!) ADS-B In-Trail Procedures

Are economic evaluations and health technology assessments increasingly demanded in times of rationing health services? The case of the Argentine financial crisis.

PubMed

Rubinstein, Adolfo; Belizán, María; Discacciati, Vilda

2007-01-01

After 4 years of deepening recession, Argentina's economy plummeted after default in 2002. This crisis critically affected health expenditures and triggered acute rationing. Our objective was to explore health decision-makers' knowledge and attitudes about economic evaluations (EE) and whether health technology assessment (HTA) were increasingly used for decision making. A qualitative design based on semistructured interviews and focus groups was used to explore how decision makers belonging to different health sectors implement resource allocation decisions. Informants were mostly unaware of EE. The most important criteria mentioned to adopt a treatment were evidence of effectiveness, social/stakeholder demand, or resource availability. Despite general positive attitudes about EE, knowledge was rather limited. Although cost considerations were widely accepted by purchasers and managers, clinicians argued about these issues as interfering with the doctor-patient relationship. Other important perceived barriers to HTA use were lack of confidence in the transferability of studies conducted in developed countries and institutional fragmentation of the Argentine healthcare system. The new macroeconomic context was cited as a justification of implicit rationing measures. Although explicit priority setting was implemented by many purchasers and managers, HTA was not used to improve technical and/or allocative efficiency. The crisis seems to be a strong incentive to extend the use of HTA in Argentina, provided decision makers are aware as well as involved in the generation of local studies.

Development of water allocation Model Based on ET-Control and Its Application in Haihe River Basin

NASA Astrophysics Data System (ADS)

You, Jinjun; Gan, Hong; Gan, Zhiguo; Wang, Lin

2010-05-01

Traditionally, water allocation is to distribute water to different regions and sectors, without enough consideration on amount of water consumed after water distribution. Water allocation based on ET (evaporation and Transpiration) control changes this idea and emphasizes the absolute amount of evaporation and transpiration in specific area. With this ideology, the amount of ET involved the water allocation includes not only water consumed from the sectors, but the natural ET. Therefore, the water allocation consist of two steps, the first step is to estimate reasonable ET quantum in regions, then allocate water to more detailed regions and various sectors with the ET quantum according with the operational rules. To make qualified ET distribution and water allocation in various regions, a framework is put forward in this paper, in which two models are applied to analyze the different scenarios with predefined economic growth and ecological objective. The first model figures out rational ET objective with multi-objective analysis for compromised solution in economic growth and ecological maintenance. Food security and environmental protection are also taken as constraints in the optimization in the first model. The second one provides hydraulic simulation and water balance to allocate the ET objective to corresponding regions under operational rules. These two models are combined into an integrated ET-Control water allocation. Scenario analysis through the ET-Control Model could discover the relations between economy and ecology, farther to give suggestion on measures to control water use with condition of changing socio-economic growth and ecological objectives. To confirm the methodology, Haihe River is taken as a case to study. Rational water allocation is important branch of decision making on water planning and management in Haihe River Basin since water scarcity and deteriorating environment fights for water in this basin dramatically and reasonable water allocation between economy and ecology is a focus. Considering condition of water scarcity in Haihe River Basin, ET quota is taken as objective for water allocation in provinces to realize the requirement of water inflow into the Bohai Sea. Scenario analysis provides the results of water evaporation from natural water cycle and artificial use. A trade-off curve based on fulfilment of ecological and economic objectives in different scenarios discovers the competitive relation between human activities and nature.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Waller, Cara; Green, Sally; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-10

This is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in Melbourne Australia, sought to establish an organisation-wide systematic evidence-based program for disinvestment. In the absence of guidance from the literature, the Centre for Clinical Effectiveness, an in-house 'Evidence Based Practice Support Unit', was asked to explore concepts and practices related to disinvestment, consider the implications for a local health service and identify potential settings and methods for decision-making. Mixed methods were used to capture the relevant information. These included literature reviews; online questionnaire, interviews and structured workshops with a range of stakeholders; and consultation with experts in disinvestment, health economics and health program evaluation. Using the principles of evidence-based change, the project team worked with health service staff, consumers and external experts to synthesise the findings from published literature and local research and develop proposals, frameworks and plans. Multiple influencing factors were extracted from these findings. The implications were both positive and negative and addressed aspects of the internal and external environments, human factors, empirical decision-making, and practical applications. These factors were considered in establishment of the new program; decisions reached through consultation with stakeholders were used to define four program components, their aims and objectives, relationships between components, principles that underpin the program, implementation and evaluation plans, and preconditions for success and sustainability. The components were Systems and processes, Disinvestment projects, Support services, and Program evaluation and research. A model for a systematic approach to evidence-based resource allocation in a local health service was developed. A robust evidence-based investigation of the research literature and local knowledge with a range of stakeholders resulted in rich information with strong consistent messages. At the completion of Phase One, synthesis of the findings enabled development of frameworks and plans and all preconditions for exploration of the four main aims in Phase Two were met.

[Allocating resources for cancer control--resolving multicriteria decision-making using the analytic hierarchy process].

PubMed

Gróf, Agnes

2007-01-01

When competing programs ought to be financed simultaneously for the same purpose, an allocation problem occurs due to scarce resources, and different perspectives and preferences. Facing the problem needs determining criteria which the decision might be based on. Those criteria form the objectives (the scope) of the different participants, and are relevant for the achievement of the goal, providing a comprehensive resource allocation that bridges and integrates the different perspectives. In case of cancer control primary prevention, secondary prevention, therapy and tertiary prevention, education, basic sciences, and clinical trials form the alternatives. An analytic hierarchy process (AHP) is used for supporting decision-making in the resource allocation problem. AHP is a method for setting priorities, but can only work out the implications of what was declared through the pairwise-ranking process, namely the relative preferences, weighing the criteria and rating the alternatives two by two. In the first analysis the relative weights to criteria were 0.099 for 'distributive justice'; 0.120 for constitutional and human rights; 0.251 for lay opinion; 0.393 for EBM; 0.137 for cost-effectiveness. Ranking the alternatives using 'judgements' resulted in relative preference of 0.238 for therapy, 0.204 for primary prevention, 0.201 for secondary prevention, 0.135 for clinical trials, 0.111 for tertiary prevention, 0.066 for basic sciences and 0.045 for education. In the second analysis the relative importance of "cost-effectiveness" was doubled, thus resulting in 0.234 for therapy, 0.216 for secondary prevention, 0.183 for primary prevention, 0.145 for clinical trials, 0.113 for tertiary prevention, 0.063 for basic sciences and 0.046 for education. Sensitivity analysis has shown that increasing the relative weight of cost-effectiveness up to approximately 0.4 changes the rank of alternatives, and above 0.4 this criterion gives secondary prevention preferences. According to the relative rates computed in both of the models all criteria vote for therapy, but these preferences change at the high level of weights, in case of EBM, 'rights', and cost-effectiveness. Cost-effectiveness prefers secondary prevention to therapy; the criterion of constitutional and human rights and the criterion of evidence-based medicine vote for primary prevention.

Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules.

PubMed

O'Brien, B J; Sculpher, M J

2000-05-01

Current principles of cost-effectiveness analysis emphasize the rank ordering of programs by expected economic return (eg, quality-adjusted life-years gained per dollar expended). This criterion ignores the variance associated with the cost-effectiveness of a program, yet variance is a common measure of risk when financial investment options are appraised. Variation in health care program return is likely to be a criterion of program selection for health care managers with fixed budgets and outcome performance targets. Characterizing health care resource allocation as a risky investment problem, we show how concepts of portfolio analysis from financial economics can be adopted as a conceptual framework for presenting cost-effectiveness data from multiple programs as mean-variance data. Two specific propositions emerge: (1) the current convention of ranking programs by expected return is a special case of the portfolio selection problem in which the decision maker is assumed to be indifferent to risk, and (2) for risk-averse decision makers, the degree of joint risk or covariation in cost-effectiveness between programs will create incentives to diversify an investment portfolio. The conventional normative assumption of risk neutrality for social-level public investment decisions does not apply to a large number of health care resource allocation decisions in which health care managers seek to maximize returns subject to budget constraints and performance targets. Portfolio theory offers a useful framework for studying mean-variance tradeoffs in cost-effectiveness and offers some positive predictions (and explanations) of actual decision making in the health care sector.

Priority setting in the provincial health services authority: survey of key decision makers

PubMed Central

Teng, Flora; Mitton, Craig; MacKenzie, Jennifer

2007-01-01

Background In recent years, decision makers in Canada and elsewhere have expressed a desire for more explicit, evidence-based approaches to priority setting. To achieve this aim within health care organizations, knowledge of both the organizational context and stakeholder attitudes towards priority setting are required. The current work adds to a limited yet growing body of international literature describing priority setting practices in health organizations. Methods A qualitative study was conducted using in-depth, face-to-face interviews with 25 key decision makers of the Provincial Health Services Authority (PHSA) of British Columbia. Major themes and sub-themes were identified through content analysis. Results Priorities were described by decision makers as being set in an ad hoc manner, with resources generally allocated along historical lines. Participants identified the Strategic Plan and a strong research base as strengths of the organization. The main areas for improvement were a desire to have a more transparent process for priority setting, a need to develop a culture which supports explicit priority setting, and a focus on fairness in decision making. Barriers to an explicit allocation process included the challenge of providing specialized services for disparate patient groups, and a lack of formal training in priority setting amongst decision makers. Conclusion This study identified factors important to understanding organizational context and informed next steps for explicit priority setting for a provincial health authority. While the PHSA is unique in its organizational structure in Canada, lessons about priority setting should be transferable to other contexts. PMID:17565691

Adversarial reasoning and resource allocation: the LG approach

NASA Astrophysics Data System (ADS)

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

2005-05-01

Many existing automated tools purporting to model the intelligent enemy utilize a fixed battle plan for the enemy while using flexible decisions of human players for the friendly side. According to the Naval Studies Board, "It is an open secret and a point of distress ... that too much of the substantive content of such M&S has its origin in anecdote, ..., or a narrow construction tied to stereotypical current practices of 'doctrinally correct behavior.'" Clearly, such runs lack objectivity by being heavily skewed in favor of the friendly forces. Presently, the military branches employ a variety of game-based simulators and synthetic environments, with manual (i.e., user-based) decision-making, for training and other purposes. However, without an ability to automatically generate the best strategies, tactics, and COA, the games serve mostly to display the current situation rather than form a basis for automated decision-making and effective training. We solve the problem of adversarial reasoning as a gaming problem employing Linguistic Geometry (LG), a new type of game theory demonstrating significant increase in size in gaming problems solvable in real and near-real time. It appears to be a viable approach for solving such practical problems as mission planning and battle management. Essentially, LG may be structured into two layers: game construction and game solving. Game construction includes construction of a game called an LG hypergame based on a hierarchy of Abstract Board Games (ABG). Game solving includes resource allocation for constructing an advantageous initial game state and strategy generation to reach a desirable final game state in the course of the game.

Physicians' perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting.

PubMed

Giannini, A; Consonni, D

2006-01-01

Physicians' perceptions regarding intensive care unit (ICU) resource allocation and the problem of inappropriate admissions are unknown. We carried out an anonymous, self-administered questionnaire survey to assess the perceptions and attitudes of ICU physicians at all 20 ICUs in Milan, Italy, regarding inappropriate admissions and resource allocation. Eighty-seven percent (225/259) of physicians responded. Inappropriate admissions were acknowledged by 86% of respondents. The reasons given were clinical doubt (33%); limited decision time (32%); assessment error (25%); pressure from superiors (13%), referring clinician (11%) or family (5%); threat of legal action (5%); and an economically advantageous 'Diagnosis Related Group' (1%). Respondents reported being pressurized to make more 'productive' use of ICU beds by Unit heads (frequently 16%), hospital management (frequently 10%) and colleagues (frequently 4%). Five percent reported refusing appropriate admissions following 'indications' not to admit financially disadvantageous cases. Admissions after elective surgery prioritized patients from profitable surgical departments: frequently for 6% of respondents and occasionally for 15%. Sixty-seven percent said they frequently received requests for appropriate admissions when no beds were available. This was considered sufficient reason to withdraw treatment from patients with lower survival probability (sometimes 21%) or for whom nothing more could be done (sometimes 51%, frequently 11%). Inappropriate ICU admissions were perceived as a common event but were mainly attributed to difficulties in assessing suitability. Physicians were aware that their decisions were often influenced by factors other than medical necessity. Economic influences were perceived as limited but not negligible. Decisions to forgo treatment could be influenced by the need to admit other patients.

Expertise and age differences in pilot decision making.

PubMed

Morrow, Daniel G; Miller, Lisa M Soederberg; Ridolfo, Heather E; Magnor, Clifford; Fischer, Ute M; Kokayeff, Nina K; Stine-Morrow, Elizabeth A L

2009-01-01

We examined the influence of age and expertise on pilot decision making. Older and younger expert and novice pilots read at their own pace scenarios describing simpler or more complex flight situations. Then in a standard interview they discussed the scenario problem and how they would respond. Protocols were coded for identification of problem and solutions to this problem, and frequency of elaborations on problem and solution. Scenario comprehension was measured as differential reading time allocation to problem-critical information and scenario memory by the accuracy of answering questions about the scenarios after the interview. All groups accurately identified the problems, but experts elaborated problem descriptions more than novices did. Experts also spent more time reading critical information in the complex scenarios, which may reflect time needed to develop elaborate situation models of the problems. Expertise comprehension benefits were similar for older and younger pilots. Older experts were especially likely to elaborate the problem compared to younger experts, while older novices were less likely to elaborate the problem and to identify appropriate solutions compared to their younger counterparts. The findings suggest age invariance in knowledge-based comprehension relevant to pilot decision making.

Contrasting RCC, RVU, and ABC for managed care decisions. A case study compares three widely used costing methods and finds one superior.

PubMed

West, T D; Balas, E A; West, D A

1996-08-01

To obtain cost data needed to improve managed care decisions and negotiate profitable capitation contracts, most healthcare provider organizations use one of three costing methods: the ratio-of-costs-to-charges method, the relative value unit method, or the activity-based costing method. Although the ratio-of-costs to charges is used by a majority of provider organizations, a case study that applied these three methods in a renal dialysis clinic found that the activity-based costing method provided the most accurate cost data. By using this costing method, healthcare financial managers can obtain the data needed to make optimal decisions regarding resource allocation and cost containment, thus assuring the longterm financial viability of their organizations.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Development of an intervention to support patients and clinicians with advanced lung cancer when considering systematic anticancer therapy: protocol for the PACT study.

PubMed

Anagnostou, Despina; Sivell, Stephanie; Noble, Simon; Lester, Jason; Byrne, Anthony; Sampson, Catherine; Longo, Mirella; Nelson, Annmarie

2017-07-12

Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options. PACT is a five-stage, multimethod and multicentre study. Participants : Patients and health professionals will be recruited from three health boards. Methods : Non-participant observation of multidisciplinary team meetings (n=12) will be used to determine patients' allocation to treatment pathways (stage I). Non-participant observation of patient-clinician consultations (n=20-30) will be used to explore communication of treatment options and decision-making. Extent of participation in decision-making will be assessed using the Observing Patient Involvement in Shared Decision-Making tool. Interviews with patients (stage III) and their clinicians (stage IV) will explore the perception of treatment options and involvement in decision-making. Based on stages I-IV, an expert consensus meeting will finalise the content and format of the intervention. Cognitive interviews with patients will then determine the face validity of the intervention (stage V). Analysis : analysis will be according to data type and research question and will include mediated discourse analysis, thematic analysis, framework analysis and interpretative phenomenological analysis. Ethical approval has been granted. The study findings will contribute to and promote shared and informed decision-making in the best interest of patients and prudent healthcare. We therefore aim to disseminate results via relevant respiratory, oncology and palliative care journals and conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A decision-analytic approach to the optimal allocation of resources for endangered species consultation

USGS Publications Warehouse

Converse, Sarah J.; Shelley, Kevin J.; Morey, Steve; Chan, Jeffrey; LaTier, Andrea; Scafidi, Carolyn; Crouse, Deborah T.; Runge, Michael C.

2011-01-01

The resources available to support conservation work, whether time or money, are limited. Decision makers need methods to help them identify the optimal allocation of limited resources to meet conservation goals, and decision analysis is uniquely suited to assist with the development of such methods. In recent years, a number of case studies have been described that examine optimal conservation decisions under fiscal constraints; here we develop methods to look at other types of constraints, including limited staff and regulatory deadlines. In the US, Section Seven consultation, an important component of protection under the federal Endangered Species Act, requires that federal agencies overseeing projects consult with federal biologists to avoid jeopardizing species. A benefit of consultation is negotiation of project modifications that lessen impacts on species, so staff time allocated to consultation supports conservation. However, some offices have experienced declining staff, potentially reducing the efficacy of consultation. This is true of the US Fish and Wildlife Service's Washington Fish and Wildlife Office (WFWO) and its consultation work on federally-threatened bull trout (Salvelinus confluentus). To improve effectiveness, WFWO managers needed a tool to help allocate this work to maximize conservation benefits. We used a decision-analytic approach to score projects based on the value of staff time investment, and then identified an optimal decision rule for how scored projects would be allocated across bins, where projects in different bins received different time investments. We found that, given current staff, the optimal decision rule placed 80% of informal consultations (those where expected effects are beneficial, insignificant, or discountable) in a short bin where they would be completed without negotiating changes. The remaining 20% would be placed in a long bin, warranting an investment of seven days, including time for negotiation. For formal consultations (those where expected effects are significant), 82% of projects would be placed in a long bin, with an average time investment of 15. days. The WFWO is using this decision-support tool to help allocate staff time. Because workload allocation decisions are iterative, we describe a monitoring plan designed to increase the tool's efficacy over time. This work has general application beyond Section Seven consultation, in that it provides a framework for efficient investment of staff time in conservation when such time is limited and when regulatory deadlines prevent an unconstrained approach. ?? 2010.

Decision making in liver transplant selection committees: a multicenter study.

PubMed

Volk, Michael L; Biggins, Scott W; Huang, Mary Ann; Argo, Curtis K; Fontana, Robert J; Anspach, Renee R

2011-10-18

To receive a liver transplant, patients must first be placed on a waiting list-a decision made at most transplant centers by a multidisciplinary committee. The function of these committees has never been studied. To describe decision making in liver transplant committees and identify opportunities for process improvement. Observational multicenter study. 4 liver transplant centers in the United States. 68 members of liver transplant committees across the 4 centers. 63 meetings were observed, and 50 committee members were interviewed. Recorded transcripts and field notes were analyzed by using standard qualitative sociologic methods. Although the structure of the meetings varied by center, the process was uniform and primarily involved inductive reasoning to review possible reasons for patient exclusion. Patients were excluded if they were too well, too sick (in the setting of advanced liver disease), or too old or had nonhepatic comorbid conditions, substance abuse problems, or other psychosocial barriers. Dominant themes in the discussions included member angst over deciding who lived or died, a high correlation between psychosocial barriers to transplantation and the patient's socioeconomic status, and the influence of external forces on decision making. Unwritten center policies and confusion regarding advocacy versus stewardship roles were consistently identified as barriers to effective group decision making. The use of qualitative methods provides broad understanding but limits specific inferences. The 4 centers may not reflect the practices of every transplant center nationwide. The difficult decisions made by liver transplant committees are reasonably consistent and well-intentioned, but the process might be improved by having more explicit written policies and clarifying roles. This may inform resource allocation in other areas of medicine. The Greenwall Foundation and the National Institutes of Health.

Decision Making in Liver Transplant Selection Committees

PubMed Central

Volk, Michael L; Biggins, Scott W; Huang, Mary Ann; Argo, Curtis K; Fontana, Robert J; Anspach, Renee R

2011-01-01

Background In order to receive a liver transplant, patients must first be placed on the waiting list – a decision made in most transplant centers by a multidisciplinary committee. The function of these committees has never been studied. Objectives To describe decision making in liver transplant committees and identify opportunities for process improvement. Design Observational multi-center Setting We observed 63 meetings and interviewed 50 committee members at 4 liver transplant centers. Study Subjects Transplant committee members. Measurements Recorded transcripts and field notes were analyzed using standard qualitative sociological methods. Results While the structure of meetings varied by center, the process was uniform and involved reviewing possible reasons for patient exclusion using primarily inductive reasoning. Stated justifications for excluding patients were a) too well, b) non-hepatic comorbidities or advanced age, c) too sick in the setting of advanced liver disease, d) substance abuse, or e) other psychosocial barriers. Dominant themes identified included members’ angst over deciding who lives and dies, a high correlation between psychosocial barriers to transplant and patients’ socioeconomic status, and the influence of external forces on decision making. Consistently identified barriers to effective group decision making were: 1) unwritten center policies, and 2) confusion regarding advocacy versus stewardship roles. Limitations The use of qualitative methods provides broad understanding but limits specific inferences. These four centers may not be reflective of every transplant center nationwide. Conclusion The difficult decisions made by these committees are reasonably consistent and always well-intentioned, but might be improved by more explicit written policies and clarifying roles. This process may help inform resource allocation in other areas of medicine. Primary funding source The Greenwall Foundation. PMID:22007044

Psychosocial intervention in at-risk adolescents: using event-related potentials to assess changes in decision making and feedback processing.

PubMed

Pincham, H L; Bryce, D; Fonagy, P; Fearon, R M Pasco

2018-05-25

Decision making and feedback processing are two important cognitive processes that are impacted by social context, particularly during adolescence. The current study examined whether a psychosocial intervention could improve psychological wellbeing in at-risk adolescent boys, thereby improving their decision making and feedback processing skills. Two groups of at-risk adolescents were compared: those who were relatively new to a psychosocial intervention, and those who had engaged over a longer time period. Electroencephalography was recorded while the young people participated in a modified version of the Taylor Aggression Paradigm. The late positive potential (LPP) was measured during the decision phase of the task (where participants selected punishments for their opponents). The feedback-related negativity (FRN) and P3 components were measured during the task's outcome phase (where participants received 'win' or 'lose' feedback). Adolescents who were new to the intervention (the minimal-intervention group) were harsher in their punishment selections than those who had been engaged in the program for much longer. The minimal-intervention group also showed an enhanced LPP during the decision phase of the task, which may be indicative of immature decision making in that group. Analysis of the FRN and P3 amplitudes revealed that the minimal-intervention group was physiologically hypo-sensitive to feedback, compared with the extended-intervention group. Overall, these findings suggest that long-term community-based psychosocial intervention programs are beneficial for at-risk adolescents, and that event-related potentials can be employed as biomarkers of therapeutic change. However, because participants were not randomly allocated to treatment groups, alternative explanations cannot be excluded until further randomized controlled trials are undertaken.

Decentralisation of Health Services in Fiji: A Decision Space Analysis.

PubMed

Mohammed, Jalal; North, Nicola; Ashton, Toni

2015-11-15

Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Fiji's centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji's deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. © 2016 by Kerman University of Medical Sciences.

Tragic choices and moral compromise: the ethics of allocating kidneys for transplantation.

PubMed

Hoffmaster, Barry; Hooker, Cliff

2013-09-01

For almost a decade, the Kidney Transplantation Committee of the United Network for Organ Sharing has been striving to revise its approach to allocating kidneys from deceased donors for transplantation. Two fundamental values, equality and efficiency, are central to distributing this scarce resource. The prevailing approach gives primacy to equality in the temporal form of first-come, first-served, whereas the motivation for a new approach is to redeem efficiency by increasing the length of survival of transplanted kidneys and their recipients. But decision making about a better way of allocating kidneys flounders because it is constrained by the amorphous notion of "balancing" values. This article develops a more fitting, productive approach to resolving the conflict between equality and efficiency by embedding the notion of compromise in the analysis of a tragic choice provided by Guido Calabresi and Philip Bobbitt. For Calabresi and Bobbitt, the goals of public policy with respect to tragic choices are to limit tragedy and to deal with the irreducible minimum of tragedy in the least offensive way. Satisfying the value of efficiency limits tragedy, and satisfying the value of equality deals with the irreducible minimum of tragedy in the least offensive way. But both values cannot be completely satisfied simultaneously. Compromise is occasioned when not all the several obligations that exist in a situation can be met and when neglecting some obligations entirely in order to fulfill others entirely is improper. Compromise is amalgamated with the notion of a tragic choice and then used to assess proposals for revising the allocation of kidneys considered by the Kidney Transplantation Committee. Compromise takes two forms in allocating kidneys: it occurs within particular approaches to allocating kidneys because neither equality nor efficiency can be fully satisfied, and it occurs over the course of sequential approaches to allocating kidneys that cycle between preferring equality and efficiency. Ross and colleagues' Equal Opportunity Supplemented by Fair Innings proposal for allocating kidneys best exemplifies the rationality of compromise as a way of achieving the goals of making a tragic choice. The attempt to design a policy for allocating kidneys from deceased donors for transplantation by balancing the values of equality and efficiency is misguided and unhelpful. Instead policymaking should both incorporate compromise into discrete approaches to allocating kidneys and extend compromise over sequential approaches to allocating kidneys. © 2013 Milbank Memorial Fund.

Does the Use of a Decision Aid Improve Decision Making in Prosthetic Heart Valve Selection? A Multicenter Randomized Trial.

PubMed

Korteland, Nelleke M; Ahmed, Yunus; Koolbergen, David R; Brouwer, Marjan; de Heer, Frederiek; Kluin, Jolanda; Bruggemans, Eline F; Klautz, Robert J M; Stiggelbout, Anne M; Bucx, Jeroen J J; Roos-Hesselink, Jolien W; Polak, Peter; Markou, Thanasie; van den Broek, Inge; Ligthart, Rene; Bogers, Ad J J C; Takkenberg, Johanna J M

2017-02-01

A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group). Legally capable adult patients accepted for elective isolated or combined aortic and mitral valve replacement were included. Primary outcome was preoperative decisional conflict (Decisional Conflict Scale); secondary outcomes included patient knowledge, involvement in valve selection, anxiety and depression, (valve-specific) quality of life, and regret. Out of 306 eligible patients, 155 were randomized (78 control and 77 intervention). Preoperative decisional conflict did not differ between the groups (34% versus 33%; P =0.834). Intervention patients felt better informed (median Decisional Conflict Scale informed subscore: 8 versus 17; P =0.046) and had a better knowledge of prosthetic valves (85% versus 68%; P =0.004). Intervention patients experienced less anxiety and depression (median Hospital Anxiety and Depression Scale score: 6 versus 9; P =0.015) and better mental well-being (mean Short Form Health Survey score: 54 versus 50; P =0.032). Three months postoperatively, valve-specific quality of life and regret did not differ between the groups. A patient decision aid to support shared decision making in prosthetic heart valve selection does not lower decisional conflict. It does result in more knowledgeable, better informed, and less anxious and depressed patients, with a better mental well-being. http://www.trialregister.nl. Unique identifier: NTR4350. © 2017 American Heart Association, Inc.

Risk management of PPP project in the preparation stage based on Fault Tree Analysis

NASA Astrophysics Data System (ADS)

Xing, Yuanzhi; Guan, Qiuling

2017-03-01

The risk management of PPP(Public Private Partnership) project can improve the level of risk control between government departments and private investors, so as to make more beneficial decisions, reduce investment losses and achieve mutual benefit as well. Therefore, this paper takes the PPP project preparation stage venture as the research object to identify and confirm four types of risks. At the same time, fault tree analysis(FTA) is used to evaluate the risk factors that belong to different parts, and quantify the influencing degree of risk impact on the basis of risk identification. In addition, it determines the importance order of risk factors by calculating unit structure importance on PPP project preparation stage. The result shows that accuracy of government decision-making, rationality of private investors funds allocation and instability of market returns are the main factors to generate the shared risk on the project.

Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

PubMed

Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

2017-01-26

The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of economic evaluations include, amongst others, educating decision-makers and the general population about economic evaluations and presenting economic evaluation results in a clearer and more understandable way. This study demonstrated that the current use and impact of economic evaluations in Dutch healthcare decision-making is limited at best. Therefore, strategies are needed to overcome the barriers that currently prevent economic evaluations from being used extensively.

Results from a preliminary study to develop the quality adjustments for quality adjusted life year values for Trinidad and Tobago.

PubMed

Bailey, H

2013-07-01

No country can afford to provide all necessary healthcare for its citizens, so prioritization among interventions must feature in all health systems. Resources in health should be allocated among interventions/facilities/patients in such a way as to be in line with the objectives of the health system. To achieve this, resource allocation decisions must be informed by the relative contributions that prospective interventions will make to societal health and to costs. Internationally, the EQ-5D based quality adjusted life year (QALY) now dominates this kind of analysis. This paper reports on a pilot study to develop an EQ-5D-3L value set for Trinidad and Tobago based on a protocol that avoids some of the issues that are associated with other approaches to developing such value sets such as the complex elicitation tasks that respondents must carry out, and the large respondent samples required for collecting multiple valuation subset values using blocked designs. An orthogonal discrete choice experiment design was used to elicit a set of choices from a sample of respondents. The choice data were analysed using mixed multinomial logistic regression to produce an internally valid model that predicts well. This paper marks an important milestone in the development of health resource allocation in the Caribbean. It sets out the importance of incorporating the impact of health interventions to inform health resource allocation decisions, describes the elicitation and analysis methods used in the pilot and provides an illustration of the use of the EQ-5D value set.

United States Marine Corps 2012 Financial Report. Schedule of Budgetary Activity for Fiscal Year 2012 Appropriations

DTIC Science & Technology

2012-01-01

activity schedule for current year appropriations that is also compliant with Generally Accepted Accounting Principles ( GAAP ). The audit of this financial...are not only fighters, but also who can serve as trainers, mentors and advisers. Marine Corps Value to the Nation For a remarkably small investment ...who are interested in and could use the information in the statements to help them make resource allocation and other decisions and hold the entity

The 14th Annual Conference on Manual Control. [digital simulation of human operator dynamics

NASA Technical Reports Server (NTRS)

1978-01-01

Human operator dynamics during actual manual control or while monitoring the automatic control systems involved in air-to-air tracking, automobile driving, the operator of undersea vehicles, and remote handling are examined. Optimal control models and the use of mathematical theory in representing man behavior in complex man machine system tasks are discussed with emphasis on eye/head tracking and scanning; perception and attention allocation; decision making; and motion simulation and effects.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.

PubMed

Smith, Neale; Mitton, Craig; Bryan, Stirling; Davidson, Alan; Urquhart, Bonnie; Gibson, Jennifer L; Peacock, Stuart; Donaldson, Cam

2013-07-02

Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as 'good' or 'very good'. This paper explores these findings in greater detail and assesses them in context of the larger literature. Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada's health system leadership teams.

Do social utility judgments influence attentional processing?

PubMed

Shore, Danielle M; Heerey, Erin A

2013-10-01

Research shows that social judgments influence decision-making in social environments. For example, judgments about an interaction partners' trustworthiness affect a variety of social behaviors and decisions. One mechanism by which social judgments may influence social decisions is by biasing the automatic allocation of attention toward certain social partners, thereby shaping the information people acquire. Using an attentional blink paradigm, we investigate how trustworthiness judgments alter the allocation of attention to social stimuli in a set of two experiments. The first experiment investigates trustworthiness judgments based solely on a social partner's facial appearance. The second experiment examines the effect of trustworthiness judgments based on experienced behavior. In the first, strong appearance-based judgments (positive and negative) enhanced stimulus recognizability but did not alter the size of the attentional blink, suggesting that appearance-based social judgments enhance face memory but do not affect pre-attentive processing. However, in the second experiment, in which judgments were based on behavioral experience rather than appearance, positive judgments enhanced pre-attentive processing of trustworthy faces. This suggests that a stimulus's potential benefits, rather than its disadvantages, shape the automatic distribution of attentional resources. These results have implications for understanding how appearance- and behavior-based social cues shape attention distribution in social environments. Copyright © 2013 Elsevier B.V. All rights reserved.

Optimization of Land Use Suitability for Agriculture Using Integrated Geospatial Model and Genetic Algorithms

NASA Astrophysics Data System (ADS)

Mansor, S. B.; Pormanafi, S.; Mahmud, A. R. B.; Pirasteh, S.

2012-08-01

In this study, a geospatial model for land use allocation was developed from the view of simulating the biological autonomous adaptability to environment and the infrastructural preference. The model was developed based on multi-agent genetic algorithm. The model was customized to accommodate the constraint set for the study area, namely the resource saving and environmental-friendly. The model was then applied to solve the practical multi-objective spatial optimization allocation problems of land use in the core region of Menderjan Basin in Iran. The first task was to study the dominant crops and economic suitability evaluation of land. Second task was to determine the fitness function for the genetic algorithms. The third objective was to optimize the land use map using economical benefits. The results has indicated that the proposed model has much better performance for solving complex multi-objective spatial optimization allocation problems and it is a promising method for generating land use alternatives for further consideration in spatial decision-making.

Collaborative en-route and slot allocation algorithm based on fuzzy comprehensive evaluation

NASA Astrophysics Data System (ADS)

Yang, Shangwen; Guo, Baohua; Xiao, Xuefei; Gao, Haichao

2018-01-01

To allocate the en-routes and slots to the flights with collaborative decision making, a collaborative en-route and slot allocation algorithm based on fuzzy comprehensive evaluation was proposed. Evaluation indexes include flight delay costs, delay time and the number of turning points. Analytic hierarchy process is applied to determining index weights. Remark set for current two flights not yet obtained the en-route and slot in flight schedule is established. Then, fuzzy comprehensive evaluation is performed, and the en-route and slot for the current two flights are determined. Continue selecting the flight not yet obtained an en-route and a slot in flight schedule. Perform fuzzy comprehensive evaluation until all flights have obtained the en-routes and slots. MatlabR2007b was applied to numerical test based on the simulated data of a civil en-route. Test results show that, compared with the traditional strategy of first come first service, the algorithm gains better effect. The effectiveness of the algorithm was verified.

Desktop microsimulation: a tool to improve efficiency in the medical office practice.

PubMed

Montgomery, James B; Linville, Beth A; Slonim, Anthony D

2013-01-01

Because the economic crisis in the United States continues to have an impact on healthcare organizations, industry leaders must optimize their decision making. Discrete-event computer simulation is a quality tool with a demonstrated track record of improving the precision of analysis for process redesign. However, the use of simulation to consolidate practices and design efficiencies into an unfinished medical office building was a unique task. A discrete-event computer simulation package was used to model the operations and forecast future results for four orthopedic surgery practices. The scenarios were created to allow an evaluation of the impact of process change on the output variables of exam room utilization, patient queue size, and staff utilization. The model helped with decisions regarding space allocation and efficient exam room use by demonstrating the impact of process changes in patient queues at check-in/out, x-ray, and cast room locations when compared to the status quo model. The analysis impacted decisions on facility layout, patient flow, and staff functions in this newly consolidated practice. Simulation was found to be a useful tool for process redesign and decision making even prior to building occupancy. © 2011 National Association for Healthcare Quality.

Economics of Obesity — Learning from the Past to Contribute to a Better Future

PubMed Central

Ananthapavan, Jaithri; Sacks, Gary; Moodie, Marj; Carter, Rob

2014-01-01

The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process. PMID:24736685

An Agent-based Model for Groundwater Allocation and Management at the Bakken Shale in Western North Dakota

NASA Astrophysics Data System (ADS)

Lin, T.; Lin, Z.; Lim, S.

2017-12-01

We present an integrated modeling framework to simulate groundwater level change under the dramatic increase of hydraulic fracturing water use in the Bakken Shale oil production area. The framework combines the agent-based model (ABM) with the Fox Hills-Hell Creek (FH-HC) groundwater model. In development of the ABM, institution theory is used to model the regulation policies from the North Dakota State Water Commission, while evolutionary programming and cognitive maps are used to model the social structure that emerges from the behavior of competing individual water businesses. Evolutionary programming allows individuals to select an appropriate strategy when annually applying for potential water use permits; whereas cognitive maps endow agent's ability and willingness to compete for more water sales. All agents have their own influence boundaries that inhibit their competitive behavior toward their neighbors but not to non-neighbors. The decision-making process is constructed and parameterized with both quantitative and qualitative information, i.e., empirical water use data and knowledge gained from surveys with stakeholders. By linking institution theory, evolutionary programming, and cognitive maps, our approach addresses a higher complexity of the real decision making process. Furthermore, this approach is a new exploration for modeling the dynamics of Coupled Human and Natural System. After integrating ABM with the FH-HC model, drought and limited water accessibility scenarios are simulated to predict FH-HC ground water level changes in the future. The integrated modeling framework of ABM and FH-HC model can be used to support making scientifically sound policies in water allocation and management.

Male-female differences in households' resource allocation and decision to seek healthcare in south-eastern Nigeria: Results from a mixed methods study.

PubMed

Onah, Michael Nnachebe; Horton, Susan

2018-05-01

Ability to influence household decision-making has been shown to increase with improved social capital and power and is linked to better access to household financial resources and other services outside the household including healthcare. To examine the male-female differences in household custody of financial resources, decision-making, and type of healthcare utilised, we used a mixed methods approach of cross-sectional household surveys and focus-group discussions (FGDs). Data was collected between 10 January-28 February 2011. We analyzed a sample of 411 households and a sub-sample of 223 households with a currently married head. We conducted six single-sex FGDs in 3 communities (1 urban, 2 rural) among a random sub-sample of participants in the survey. We performed univariate, bivariate, and logistic regression analyses with a 95% confidence interval. For the qualitative data, we performed thematic analysis where broad themes relevant to the research objective were abstracted. In all households and in those with a married head, sick male members were less likely to forgo healthcare (aOR all 0.87, 95% CI 0.80-0.90; aOR married 0.52, 95% CI 0.18-0.83) and more likely to utilise formal healthcare relative to female sick members (aOR all 3.36, 95% CI 3.20-3.87; aOR married 19.50, 95% CI 9.62-39.52). Formal healthcare providers are medically trained while informal providers are untrained vendors that dispense medications for profit. There were more reports of sole custody of household resources among men within households with married heads. Joint decision-making on healthcare expenditure improved women's access to healthcare but is not reflective of unhindered access to household financial resources. Qualitatively, women spoke of seeking permission from male household head before expenditure was incurred, while male heads spoke of concealing household financial resources from their spouse. Gender constructs and male-female differences have important effects on household resource allocation and healthcare utilisation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

A decision-theoretic approach to identifying future high-cost patients.

PubMed

Pietz, Kenneth; Byrne, Margaret M; Petersen, Laura A

2006-09-01

The objective of this study was to develop and evaluate a method of allocating funding for very-high-cost (VHC) patients among hospitals. Diagnostic cost groups (DCGs) were used for risk adjustment. The patient population consisted of 253,013 veterans who used Department of Veterans Affairs (VA) medical care services in fiscal year (FY) 2003 (October 1, 2002-September 30, 2003) in a network of 8 VA hospitals. We defined VHC as greater than 75,000 dollars (0.81%). The upper fifth percentile was also used for comparison. A Bayesian decision rule for classifying patients as VHC/not VHC using DCGs was developed and evaluated. The method uses FY 2003 DCGs to allocate VHC funds for FY 2004. We also used FY 2002 DCGs to allocate VHC funds for FY 2003 for comparison. The resulting allocation was compared with using the allocation of VHC patients among the hospitals in the previous year. The decision rule identified DCG 17 as the optimal cutoff for identifying VHC patients for the next year. The previous year's allocation came closest to the actual distribution of VHC patients. The decision-theoretic approach may provide insight into the economic consequences of classifying a patient as VHC or not VHC. More research is needed into methods of identifying future VHC patients so that capitation plans can fairly reimburse healthcare systems for appropriately treating these patients.

Application of decentralized cooperative problem solving in dynamic flexible scheduling

NASA Astrophysics Data System (ADS)

Guan, Zai-Lin; Lei, Ming; Wu, Bo; Wu, Ya; Yang, Shuzi

1995-08-01

The object of this study is to discuss an intelligent solution to the problem of task-allocation in shop floor scheduling. For this purpose, the technique of distributed artificial intelligence (DAI) is applied. Intelligent agents (IAs) are used to realize decentralized cooperation, and negotiation is realized by using message passing based on the contract net model. Multiple agents, such as manager agents, workcell agents, and workstation agents, make game-like decisions based on multiple criteria evaluations. This procedure of decentralized cooperative problem solving makes local scheduling possible. And by integrating such multiple local schedules, dynamic flexible scheduling for the whole shop floor production can be realized.

Resource allocation in road infrastructure using ANP priorities with ZOGP formulation-A case study

NASA Astrophysics Data System (ADS)

Alias, Suriana; Adna, Norfarziah; Soid, Siti Khuzaimah; Kardri, Mahani

2013-09-01

Road Infrastructure (RI) project evaluation and selection is concern with the allocation of scarce organizational resources. In this paper, it is suggest an improved RI project selection methodology which reflects interdependencies among evaluation criteria and candidate projects. Fuzzy Delphi Method (FDM) is use to evoking expert group opinion and also to determine a degree of interdependences relationship between the alternative projects. In order to provide a systematic approach to set priorities among multi-criteria and trade-off among objectives, Analytic Network Process (ANP) is suggested to be applied prior to Zero-One Goal Programming (ZOGP) formulation. Specifically, this paper demonstrated how to combined FDM and ANP with ZOGP through a real-world RI empirical example on an ongoing decision-making project in Johor, Malaysia.

Automated Pollution Control

NASA Technical Reports Server (NTRS)

1997-01-01

Patterned after the Cassini Resource Exchange (CRE), Sholtz and Associates established the Automated Credit Exchange (ACE), an Internet-based concept that automates the auctioning of "pollution credits" in Southern California. An early challenge of the Jet Propulsion Laboratory's Cassini mission was allocating the spacecraft's resources. To support the decision-making process, the CRE was developed. The system removes the need for the science instrument manager to know the individual instruments' requirements for the spacecraft resources. Instead, by utilizing principles of exchange, the CRE induces the instrument teams to reveal their requirements. In doing so, they arrive at an efficient allocation of spacecraft resources by trading among themselves. A Southern California RECLAIM air pollution credit trading market has been set up using same bartering methods utilized in the Cassini mission in order to help companies keep pollution and costs down.

Social-economical decision making in current and remitted major depression.

PubMed

Pulcu, E; Thomas, E J; Trotter, P D; McFarquhar, M; Juhasz, G; Sahakian, B J; Deakin, J F W; Anderson, I M; Zahn, R; Elliott, R

2015-04-01

Prosocial emotions related to self-blame are important in guiding human altruistic decisions. These emotions are elevated in major depressive disorder (MDD), such that MDD has been associated with guilt-driven pathological hyper-altruism. However, the impact of such emotional impairments in MDD on different types of social decision-making is unknown. In order to address this issue, we investigated different kinds of altruistic behaviour (interpersonal cooperation and fund allocation, altruistic punishment and charitable donation) in 33 healthy subjects, 35 patients in full remission (unmedicated) and 24 currently depressed patients (11 on medication) using behavioural-economical paradigms. We show a significant main effect of clinical status on altruistic decisions (p = 0.04) and a significant interaction between clinical status and type of altruistic decisions (p = 0.03). More specifically, symptomatic patients defected significantly more in the Prisoner's Dilemma game (p < 0.05) and made significantly lower charitable donations, whether or not these incurred a personal cost (p < 0.05 and p < 0.01, respectively). Currently depressed patients also reported significantly higher guilt elicited by receiving unfair financial offers in the Ultimatum Game (p < 0.05). Currently depressed individuals were less altruistic in both a charitable donation and an interpersonal cooperation task. Taken together, our results challenge the guilt-driven pathological hyper-altruism hypothesis in depression. There were also differences in both current and remitted patients in the relationship between altruistic behaviour and pathological self-blaming, suggesting an important role for these emotions in moral and social decision-making abnormalities in depression.

Drug pricing and reimbursement decision making systems in Mongolia.

PubMed

Dorj, Gereltuya; Sunderland, Bruce; Sanjjav, Tsetsegmaa; Dorj, Gantuya; Gendenragchaa, Byambatsogt

2017-01-01

It is essential to allocate available resources equitably in order to ensure accessibility and affordability of essential medicines, especially in less fortunate nations with limited health funding. Currently, transparent and evidence based research is required to evaluate decision making regarding drug registration, drug pricing and reimbursement processes in Mongolia. To assess the drug reimbursement system and discuss challenges faced by policy-makers and stakeholders. The study has examined Mongolian administrative documents and directives for stakeholders and analysed published statistics. Experts and decision-makers were interviewed about the drug pricing and reimbursement processes in Mongolia. Decisions regarding Mongolian drug registration were based on commonly used criteria of quality, safety, efficacy plus some economic considerations. A total of 11.32 billion Mongolian National Tugrugs (MNT) [5.6 million United States Dollars (USD)] or 12.1% of total health expenditure was spent on patient reimbursement of essential drugs. The highest reimbursed drugs with respect to cost in 2014 were the cardiovascular drug group. Health insurance is compulsory for all citizens; in addition all insured patients have access to reimbursed drugs. However, the decision making process, in particular the level of reimbursement was limited by various barriers, including lack of evidence based data regarding efficacy and comparative cost-effectiveness analysis of drugs and decisions regarding reimbursement. Drug registration, pricing and reimbursement process in Mongolia show an increasing trend of drug registration and reimbursement rates, along with lack of transparency. Limited available data indicate that more evidence-based research studies are required in Mongolia to evaluate and improve the effectiveness of drug pricing and reimbursement policies.

Thinking strategies used by Registered Nurses during emergency department triage.

PubMed

Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna

2008-01-01

This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.

Intrahousehold resource allocation and child growth in Mozambique: an ethnographic case-control study.

PubMed

Pfeiffer, J; Gloyd, S; Ramirez Li, L

2001-07-01

This study examines the effect of intrahousehold cash income control and decision-making patterns on child growth in the rural town of Sussundenga in Manica Province, Mozambique. A case-control study design was used to examine the influence of men's and women's disaggregated cash incomes on child growth. The research tested whether greater maternal share of household cash income was associated with (1) increased maternal decision-making and bargaining power in the household, and (2) better child growth. Fifty case households, with children 1-4 years old exhibiting poor growth, were matched with 50 control households of similar socioeconomic status in which all children under five demonstrated healthy growth. Data were gathered on gender-specific income generation and expenditure, specific intrahousehold allocation processes, diet, and sociodemographic variables using a formal survey. Key informant interviews, focus groups, and observation over one year provided ethnographic context for the case-control findings. Case-control differences were analyzed using McNemar's test, paired t-test, and conditional logistic regression. In spite of matching households for socioeconomic status, control household incomes were still slightly greater than cases. Male spouse income was also higher among controls while maternal income, and maternal proportion of household income, were not significantly different. Household meat, fish and poultry consumption, and maternal education were significantly greater among control households than cases. Greater maternal share of household income was not associated with greater maternal decision-making around cash. However, mothers must spend what little cash they earn on daily food supplies and usually request additional cash from spouses to cover these costs. There is evidence that if mothers earn enough to cover these socially prescribed costs, they can spend cash for other needs. Above this threshold, women's earnings may confer more bargaining power. The research also revealed a nuclearization of households, attenuation of community bonds of mutual aid, and increasing importance of cash for survival.

Trade-offs, fairness, and funding for cancer drugs: key findings from a deliberative public engagement event in British Columbia, Canada.

PubMed

Bentley, Colene; Costa, Sarah; Burgess, Michael M; Regier, Dean; McTaggart-Cowan, Helen; Peacock, Stuart J

2018-05-08

Spending on cancer drugs has risen dramatically in recent years compared to other areas of health care, due in part to higher prices associated with newly approved drugs and increased demand for these drugs. Addressing this situation requires making difficult trade-offs between cost, harms, and ability to benefit when using public resources, making it important for policy makers to have input from many people affected by the issue, including citizens. In September 2014, a deliberative public engagement event was conducted in Vancouver, British Columbia (BC), on the topic of priority setting and costly cancer drugs. The aim of the study was to gain citizens' input on the topic and have them generate recommendations that could inform cancer drug funding decisions in BC. A market research company was engaged to recruit members of the BC general public to deliberate over two weekends (four days) on how best to allocate resources for expensive cancer treatments. Participants were stratified based on the 2006 census data for BC. Participants were asked to discuss disinvestment, intravenous versus oral chemotherapy delivery, and decision governance. All sessions were audio recorded and transcribed. Transcripts were analyzed using NVivo 11 software. Twenty-four individuals participated in the event and generated 30 recommendations. Participants accepted the principle of resource scarcity and the need of governments to make difficult trade-offs when allocating health-care resources. They supported the view that cost-benefit thresholds must be set for high-cost drugs. They also expected reasonable health benefits in return for large expenditures, and supported the view that some drugs do not merit funding. Participants also wanted drug funding decisions to be made in a non-partisan and transparent way. The recommendations from the Vancouver deliberation can provide guidance to policy makers in BC and may be useful in challenging pricing by pharmaceutical companies.

Forecasting of Seasonal Rainfall using ENSO and IOD teleconnection with Classification Models

NASA Astrophysics Data System (ADS)

De Silva, T.; Hornberger, G. M.

2017-12-01

Seasonal to annual forecasts of precipitation patterns are very important for water infrastructure management. In particular, such forecasts can be used to inform decisions about the operation of multipurpose reservoir systems in the face of changing climate conditions. Success in making useful forecasts often is achieved by considering climate teleconnections such as the El-Nino-Southern Oscillation (ENSO), Indian Ocean Dipole (IOD) as related to sea surface temperature variations. We present an analysis to explore the utility of using rainfall relationships in Sri Lanka with ENSO and IOD to predict rainfall to the Mahaweli, river basin. Forecasting of rainfall as classes - above normal, normal, and below normal - can be useful for water resource management decision making. Quadratic discrimination analysis (QDA) and random forest models are used to identify the patterns of rainfall classes with respect to ENSO and IOD indices. These models can be used to forecast the likelihood of areal rainfall anomalies using predicted climate indices. Results can be used for decisions regarding allocation of water for agriculture and electricity generation within the Mahaweli project of Sri Lanka.

Assessment of spatial variation of risks in small populations.

PubMed Central

Riggan, W B; Manton, K G; Creason, J P; Woodbury, M A; Stallard, E

1991-01-01

Often environmental hazards are assessed by examining the spatial variation of disease-specific mortality or morbidity rates. These rates, when estimated for small local populations, can have a high degree of random variation or uncertainty associated with them. If those rate estimates are used to prioritize environmental clean-up actions or to allocate resources, then those decisions may be influenced by this high degree of uncertainty. Unfortunately, the effect of this uncertainty is not to add "random noise" into the decision-making process, but to systematically bias action toward the smallest populations where uncertainty is greatest and where extreme high and low rate deviations are most likely to be manifest by chance. We present a statistical procedure for adjusting rate estimates for differences in variability due to differentials in local area population sizes. Such adjustments produce rate estimates for areas that have better properties than the unadjusted rates for use in making statistically based decisions about the entire set of areas. Examples are provided for county variation in bladder, stomach, and lung cancer mortality rates for U.S. white males for the period 1970 to 1979. PMID:1820268

Will the Conscious-Subconscious Pacing Quagmire Help Elucidate the Mechanisms of Self-Paced Exercise? New Opportunities in Dual Process Theory and Process Tracing Methods.

PubMed

Micklewright, Dominic; Kegerreis, Sue; Raglin, John; Hettinga, Florentina

2017-07-01

The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious-subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments. The paper provides clarity about key conscious, preconscious, subconscious and unconscious concepts, terms that have previously been used in conflicting and confusing ways. The potential of dual process theory in articulating multidimensional aspects of intuitive and deliberative decision-making processes is discussed in the context of athletic pacing along with associated process-tracing research methods. In attempting to refine pacing models and improve training strategies and psychological skills for athletes, the dual-process framework could be used to gain a clearer understanding of (1) the situational conditions for which either intuitive or deliberative decisions are optimal; (2) how intuitive and deliberative decisions are biased by things such as perception, emotion and experience; and (3) the underlying cognitive mechanisms such as memory, attention allocation, problem solving and hypothetical thought.

Does improved decision-making ability reduce the physiological demands of game-based activities in field sport athletes?

PubMed

Gabbett, Tim J; Carius, Josh; Mulvey, Mike

2008-11-01

This study investigated the effects of video-based perceptual training on pattern recognition and pattern prediction ability in elite field sport athletes and determined whether enhanced perceptual skills influenced the physiological demands of game-based activities. Sixteen elite women soccer players (mean +/- SD age, 18.3 +/- 2.8 years) were allocated to either a video-based perceptual training group (N = 8) or a control group (N = 8). The video-based perceptual training group watched video footage of international women's soccer matches. Twelve training sessions, each 15 minutes in duration, were conducted during a 4-week period. Players performed assessments of speed (5-, 10-, and 20-m sprint), repeated-sprint ability (6 x 20-m sprints, with active recovery on a 15-second cycle), estimated maximal aerobic power (V O2 max, multistage fitness test), and a game-specific video-based perceptual test of pattern recognition and pattern prediction before and after the 4 weeks of video-based perceptual training. The on-field assessments included time-motion analysis completed on all players during a standardized 45-minute small-sided training game, and assessments of passing, shooting, and dribbling decision-making ability. No significant changes were detected in speed, repeated-sprint ability, or estimated V O2 max during the training period. However, video-based perceptual training improved decision accuracy and reduced the number of recall errors, indicating improved game awareness and decision-making ability. Importantly, the improvements in pattern recognition and prediction ability transferred to on-field improvements in passing, shooting, and dribbling decision-making skills. No differences were detected between groups for the time spent standing, walking, jogging, striding, and sprinting during the small-sided training game. These findings demonstrate that video-based perceptual training can be used effectively to enhance the decision-making ability of field sport athletes; however, it has no effect on the physiological demands of game-based activities.

Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

PubMed

Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

2012-09-01

The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial opportunity to refine decision making and group dynamics. Making the best possible decisions concerning therapeutics selection for trial testing is a cornerstone of the Network's function.

Study protocol: Improving patient choice in treating low back pain (IMPACT - LBP): A randomised controlled trial of a decision support package for use in physical therapy

PubMed Central

2011-01-01

Background Low back pain is a common and costly condition. There are several treatment options for people suffering from back pain, but there are few data on how to improve patients' treatment choices. This study will test the effects of a decision support package (DSP), designed to help patients seeking care for back pain to make better, more informed choices about their treatment within a physiotherapy department. The package will be designed to assist both therapist and patient. Methods/Design Firstly, in collaboration with physiotherapists, patients and experts in the field of decision support and decision aids, we will develop the DSP. The work will include: a literature and evidence review; secondary analysis of existing qualitative data; exploration of patients' perspectives through focus groups and exploration of experts' perspectives using a nominal group technique and a Delphi study. Secondly, we will carry out a pilot single centre randomised controlled trial within NHS Coventry Community Physiotherapy. We will randomise physiotherapists to receive either training for the DSP or not. We will randomly allocate patients seeking treatment for non specific low back pain to either a physiotherapist trained in decision support or to receive usual care. Our primary outcome measure will be patient satisfaction with treatment at three month follow-up. We will also estimate the cost-effectiveness of the intervention, and assess the value of conducting further research. Discussion Informed shared decision-making should be an important part of any clinical consultation, particularly when there are several treatments, which potentially have moderate effects. The results of this pilot will help us determine the benefits of improving the decision-making process in clinical practice on patient satisfaction. Trial registration Current Controlled Trials ISRCTN46035546 PMID:21352528

GIS and Game Theory for Water Resource Management

NASA Astrophysics Data System (ADS)

Ganjali, N.; Guney, C.

2017-11-01

In this study, aspects of Game theory and its application on water resources management combined with GIS techniques are detailed. First, each term is explained and the advantages and limitations of its aspect is discussed. Then, the nature of combinations between each pair and literature on the previous studies are given. Several cases were investigated and results were magnified in order to conclude with the applicability and combination of GIS- Game Theory- Water Resources Management. It is concluded that the game theory is used relatively in limited studies of water management fields such as cost/benefit allocation among users, water allocation among trans-boundary users in water resources, water quality management, groundwater management, analysis of water policies, fair allocation of water resources development cost and some other narrow fields. Also, Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Most of the literature on water allocation and conflict problems uses traditional optimization models to identify the most efficient scheme while the Game Theory, as an optimization method, combined GIS are beneficial platforms for agent based models to be used in solving Water Resources Management problems in the further studies.

Decision-Making under Risk of Loss in Children

PubMed Central

Steelandt, Sophie; Broihanne, Marie-Hélène; Romain, Amélie; Thierry, Bernard; Dufour, Valérie

2013-01-01

In human adults, judgment errors are known to often lead to irrational decision-making in risky contexts. While these errors can affect the accuracy of profit evaluation, they may have once enhanced survival in dangerous contexts following a “better be safe than sorry” rule of thumb. Such a rule can be critical for children, and it could develop early on. Here, we investigated the rationality of choices and the possible occurrence of judgment errors in children aged 3 to 9 years when exposed to a risky trade. Children were allocated with a piece of cookie that they could either keep or risk in exchange of the content of one cup among 6, visible in front of them. In the cups, cookies could be of larger, equal or smaller sizes than the initial allocation. Chances of losing or winning were manipulated by presenting different combinations of cookie sizes in the cups (for example 3 large, 2 equal and 1 small cookie). We investigated the rationality of children's response using the theoretical models of Expected Utility Theory (EUT) and Cumulative Prospect Theory. Children aged 3 to 4 years old were unable to discriminate the profitability of exchanging in the different combinations. From 5 years, children were better at maximizing their benefit in each combination, their decisions were negatively induced by the probability of losing, and they exhibited a framing effect, a judgment error found in adults. Confronting data to the EUT indicated that children aged over 5 were risk-seekers but also revealed inconsistencies in their choices. According to a complementary model, the Cumulative Prospect Theory (CPT), they exhibited loss aversion, a pattern also found in adults. These findings confirm that adult-like judgment errors occur in children, which suggests that they possess a survival value. PMID:23349682

Decision-making under risk of loss in children.

PubMed

Steelandt, Sophie; Broihanne, Marie-Hélène; Romain, Amélie; Thierry, Bernard; Dufour, Valérie

2013-01-01

In human adults, judgment errors are known to often lead to irrational decision-making in risky contexts. While these errors can affect the accuracy of profit evaluation, they may have once enhanced survival in dangerous contexts following a "better be safe than sorry" rule of thumb. Such a rule can be critical for children, and it could develop early on. Here, we investigated the rationality of choices and the possible occurrence of judgment errors in children aged 3 to 9 years when exposed to a risky trade. Children were allocated with a piece of cookie that they could either keep or risk in exchange of the content of one cup among 6, visible in front of them. In the cups, cookies could be of larger, equal or smaller sizes than the initial allocation. Chances of losing or winning were manipulated by presenting different combinations of cookie sizes in the cups (for example 3 large, 2 equal and 1 small cookie). We investigated the rationality of children's response using the theoretical models of Expected Utility Theory (EUT) and Cumulative Prospect Theory. Children aged 3 to 4 years old were unable to discriminate the profitability of exchanging in the different combinations. From 5 years, children were better at maximizing their benefit in each combination, their decisions were negatively induced by the probability of losing, and they exhibited a framing effect, a judgment error found in adults. Confronting data to the EUT indicated that children aged over 5 were risk-seekers but also revealed inconsistencies in their choices. According to a complementary model, the Cumulative Prospect Theory (CPT), they exhibited loss aversion, a pattern also found in adults. These findings confirm that adult-like judgment errors occur in children, which suggests that they possess a survival value.

A system dynamics model of a large R&D program

NASA Astrophysics Data System (ADS)

Ahn, Namsung

Organizations with large R&D activities must deal with a hierarchy of decision regarding resource allocation. At the highest level of allocation, the decision is related to the total allocation to R&D as some portion of revenue. The middle level of allocation deals with the allocation among phases of the R&D process. The lowest level of decisions relates to the resource allocation to specific projects within a specific phase. This study focuses on developing an R&D model to deal with the middle level of allocation, i.e., the allocation among phases of research such as basic research, development, and demonstration. The methodology used to develop the R&D model is System Dynamics. Our modeling concept is innovative in representing each phase of R&D as consisting of two parts: projects under way, and an inventory of successful but not-yet- exploited projects. In a simple world, this concept can yield an exact analytical solution for allocation of resources among phases. But in a real world, the concept should be improved by adding more complex structures with nonlinear behaviors. Two particular nonlinear feedbacks are incorporated into the R&D model. The probability of success for any specific project is assumed partly dependent upon resources allocated to the project. Further, the time required to reach a conclusion regarding the success or failure of a project is also assumed dependent upon the level of resources allocated. In addition, the number of successful projects partly depends on the inventory of potential ideas in the previous stage that can be exploited. This model can provide R&D management with insights into the effect of changing allocations to phases whether those changes are internally or externally driven. With this model, it is possible to study the effectiveness of management decisions in a continuous fashion. Managers can predict payoffs for a host of different policies. In addition, as new research results accumulate, a re- assessment of program goals can be implemented easily and allocations adjusted to enhance continuously the likelihood of success, and to optimize payoffs. Finally, this model can give managers a quantitative rationale for program evaluation and permit the quantitative assessment of various externally imposed changes. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)

Multi-Objective, Auto-Optimization Modeling for Resource Allocation Decision Making in the Military Health System

DTIC Science & Technology

2014-01-22

FTEs would need to be reduced by 12.16, expenses reduced by $184.63K, and the number of interns adjusted by 7.67. The reference set for DMU D includes...efficiency: concept, measurement techniques and review of hospital efficiency studies. Malaysian Journal of Public Health Medicine, 10(2), 35-43...REPORT DOCUMENTATION PAGE Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 Form Approved OMB No. 0704-0188 The public reporting burden

Pre-Milestone I Program Development Process Guide (ASC/YX).

DTIC Science & Technology

1993-11-01

the PMD tasking to a particular Center. In the case of ASC, the task is entered into the ASC New Work Review process for internal allocation. AFMC/XP...0 Prooect Team to support decisions they make in response to external and - - internal requirements. Data base inputs 1 I"" 11. 12 0EVEFJ.O RA" DW...other international capabilities (COD). Although these are considered during the pre-MS 0 tasks (Task 0.2), they are examined once again during the

Costing evidence for health care decision-making in Austria: A systematic review.

PubMed

Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata; Simon, Judit

2017-01-01

With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. A systematic literature review of English and German language peer-reviewed as well as grey literature (2004-2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods.