Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

PubMed

Parker, Lisa

2017-07-01

Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Conclusion Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools’ application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice. PMID:25034534

Tools to support evidence-informed public health decision making.

PubMed

Yost, Jennifer; Dobbins, Maureen; Traynor, Robyn; DeCorby, Kara; Workentine, Stephanie; Greco, Lori

2014-07-18

Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the 'actionable message(s)' from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools' application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice.

Technical Assistance Needs Assessments (TANAs)

EPA Pesticide Factsheets

The Technical Assistance Needs Assessment (TANA) is a process to identify whether a community requires additional support from EPA in order to understand technical information and have meaningful participation in the Superfund decision-making process.

From Resource-Adaptive Navigation Assistance to Augmented Cognition

NASA Astrophysics Data System (ADS)

Zimmer, Hubert D.; Münzer, Stefan; Baus, Jörg

In an assistance scenario, a computer provides purposive information supporting a human user in an everyday situation. Wayfinding with navigation assistance is a prototypical assistance scenario. The present chapter analyzes the interplay of the resources of the assistance system and the resources of the user. The navigation assistance system provides geographic knowledge, positioning information, route planning, spatial overview information, and route commands at decision points. The user's resources encompass spatial knowledge, spatial abilities and visuo-spatial working memory, orientation strategies, and cultural habit. Flexible adaptations of the assistance system to available resources of the user are described, taking different wayfinding goals, situational constraints, and individual differences into account. Throughout the chapter, the idea is pursued that the available resources of the user should be kept active.

A decision support system for technology R&D planning: connecting the dots from information to innovation

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.; Wertz, Julie; Weisbin, Charles

2004-01-01

This paper describes an information technology innovation developed to assist decision makers faced with complex R&D tasks. The decision support system (DSS) was developed and applied to the analysis of a 10-year, 700 million dollar technology program for the exploration of Mars. The technologies were to enable a 4.8 billion dollar portfolio of exploration flight missions to Mars.

Developing Decision-Making Skills for Socio-Scientific Issues

ERIC Educational Resources Information Center

Lee, Yeung Chung

2007-01-01

The ability to make informed decisions on science-related social issues is considered an important attribute of scientific literacy. Literature to inform science educators how to bridge the gap between rhetoric and practice--and to assist them in developing this attribute in their students--burgeons. In view of the great diversity of…

What is the impact of the Internet on decision-making in pregnancy? A global study.

PubMed

Lagan, Briege M; Sinclair, Marlene; Kernohan, W George

2011-12-01

  Women need access to evidence-based information to make informed choices in pregnancy. A search for health information is one of the major reasons that people worldwide access the Internet. Recent years have witnessed an increase in Internet usage by women seeking pregnancy-related information. The aim of this study was to build on previous quantitative studies to explore women's experiences and perceptions of using the Internet for retrieving pregnancy-related information, and its influence on their decision-making processes.   This global study drew on the interpretive qualitative traditions together with a theoretical model on information seeking, adapted to understand Internet use in pregnancy and its role in relation to decision-making. Thirteen asynchronous online focus groups across five countries were conducted with 92 women who had accessed the Internet for pregnancy-related information over a 3-month period. Data were readily transferred and analyzed deductively.   The overall analysis indicates that the Internet is having a visible impact on women's decision making in regards to all aspects of their pregnancy. The key emergent theme was the great need for information. Four broad themes also emerged: "validate information,"empowerment,"share experiences," and "assisted decision-making." Women also reported how the Internet provided support, its negative and positive aspects, and as a source of accurate, timely information.   Health professionals have a responsibility to acknowledge that women access the Internet for support and pregnancy-related information to assist in their decision-making. Health professionals must learn to work in partnership with women to guide them toward evidence-based websites and be prepared to discuss the ensuing information. © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

Palliative Medicine and Decision Science: The Critical Need for a Shared Agenda To Foster Informed Patient Choice in Serious Illness

PubMed Central

Kryworuchko, Jennifer; Matlock, Dan D.; Volandes, Angelo E.

2011-01-01

Abstract Assisting patients and their families in complex decision making is a foundational skill in palliative care; however, palliative care clinicians and scientists have just begun to establish an evidence base for best practice in assisting patients and families in complex decision making. Decision scientists aim to understand and clarify the concepts and techniques of shared decision making (SDM), decision support, and informed patient choice in order to ensure that patient and family perspectives shape their health care experience. Patients with serious illness and their families are faced with myriad complex decisions over the course of illness and as death approaches. If patients lose capacity, then surrogate decision makers are cast into the decision-making role. The fields of palliative care and decision science have grown in parallel. There is much to be gained in advancing the practices of complex decision making in serious illness through increased collaboration. The purpose of this article is to use a case study to highlight the broad range of difficult decisions, issues, and opportunities imposed by a life-limiting illness in order to illustrate how collaboration and a joint research agenda between palliative care and decision science researchers, theorists, and clinicians might guide best practices for patients and their families. PMID:21895453

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.

40 CFR 35.4005 - What is a Technical Assistance Grant?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Technical Assistance Grant? A Technical Assistance Grant (TAG) provides money for your group to obtain... technical advisors to help you interpret and comment on site-related information and decisions. Examples of how a technical advisor can help your group include, but are not limited to: (a) Reviewing preliminary...

40 CFR 35.4005 - What is a Technical Assistance Grant?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Technical Assistance Grant? A Technical Assistance Grant (TAG) provides money for your group to obtain... technical advisors to help you interpret and comment on site-related information and decisions. Examples of how a technical advisor can help your group include, but are not limited to: (a) Reviewing preliminary...

40 CFR 35.4005 - What is a Technical Assistance Grant?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Technical Assistance Grant? A Technical Assistance Grant (TAG) provides money for your group to obtain... technical advisors to help you interpret and comment on site-related information and decisions. Examples of how a technical advisor can help your group include, but are not limited to: (a) Reviewing preliminary...

40 CFR 35.4005 - What is a Technical Assistance Grant?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Technical Assistance Grant? A Technical Assistance Grant (TAG) provides money for your group to obtain... technical advisors to help you interpret and comment on site-related information and decisions. Examples of how a technical advisor can help your group include, but are not limited to: (a) Reviewing preliminary...

Leveraging certified nursing assistant documentation and knowledge to improve clinical decision making: the on-time quality improvement program to prevent pressure ulcers.

PubMed

Sharkey, Siobhan; Hudak, Sandra; Horn, Susan D; Spector, William

2011-04-01

The goal of this article was to enhance understanding of the On-Time Quality Improvement for Long-term Care Program, a practical approach to embed health information technology into quality improvement in nursing homes that leverages certified nursing assistant documentation and knowledge, supports frontline clinical decision making, and establishes proactive intervention for pressure ulcer prevention.

[Experience assisting an AIDS-infected homosexual patient and his same-sex partner make a do-not-resuscitate decision].

PubMed

Wang, Shu-Jang; Lai, Pei-Yu; Liou, Siao-Ying; Ko, Wen-Chien; Ko, Nai-Ying

2012-10-01

Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.

Discovering Decision Knowledge from Web Log Portfolio for Managing Classroom Processes by Applying Decision Tree and Data Cube Technology.

ERIC Educational Resources Information Center

Chen, Gwo-Dong; Liu, Chen-Chung; Ou, Kuo-Liang; Liu, Baw-Jhiune

2000-01-01

Discusses the use of Web logs to record student behavior that can assist teachers in assessing performance and making curriculum decisions for distance learning students who are using Web-based learning systems. Adopts decision tree and data cube information processing methodologies for developing more effective pedagogical strategies. (LRW)

Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: Implications for informed consent and shared decision-making.

PubMed

Blumenthal-Barby, Jennifer S; Kostick, Kristin M; Delgado, Estevan D; Volk, Robert J; Kaplan, Holland M; Wilhelms, L A; McCurdy, Sheryl A; Estep, Jerry D; Loebe, Matthias; Bruce, Courtenay R

2015-09-01

Several organizations have underscored the crucial need for patient-centered decision tools to enhance shared decision-making in advanced heart failure. The purpose of this study was to investigate the decision-making process and informational and decisional needs of patients and their caregivers regarding left ventricular assist device (LVAD) placement. In-depth, structured interviews with LVAD patients, candidates and caregivers (spouse, family members) (n = 45) were conducted. We also administered a Decisional Regret Scale. Participants reported LVAD decision-making to be quick and reflexive (n = 30), and deferred heavily to clinicians (n = 22). They did not perceive themselves as having a real choice (n = 28). The 2 most prevalent informational domains that participants identified were lifestyle issues (23 items), followed by technical (drive-line, battery) issues (14 items). Participants easily and clearly identified their values: life extension; family; and mobility. Participants reported the need to meet other patients and caregivers before device placement (n = 31), and to have an involved caregiver (n = 28) to synthesize information. Some participants demonstrated a lack of clarity regarding transplant probability: 9 of 15 patients described themselves as on a transplant trajectory, yet 7 of these were destination therapy patients. Finally, we found that decisional regret scores were low (1.307). Informed consent and shared-decision making should: (a) help patients offered highly invasive technologies for life-threatening disease get past the initial "anything to avoid thinking about death" reaction and make a more informed decision; (b) clarify transplant status; and (c) focus on lifestyle and technical issues, as patients have the most informational needs in these domains. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

PubMed

Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

2011-06-01

Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

SADA: Ecological Risk Based Decision Support System for Selective Remediation

EPA Science Inventory

Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

Information Handling is the Problem

NASA Technical Reports Server (NTRS)

Malin, Jane T.

2001-01-01

This slide presentation reviews the concerns surrounding the automation of information handling. There are two types of decision support software that supports most Space Station Flight Controllers. one is very simple, and the other is very complex. A middle ground is sought. This is the reason for the Human Centered Autonomous and Assistant Systems Testbed (HCAAST) Project. The aim is to study flight controllers at work, and in the bigger picture, with particular attention to how they handle information and how coordination of multiple teams is performed. The focus of the project is on intelligent assistants to assist in handling information for the flight controllers.

78 FR 53375 - Partner Vetting in USAID Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... information used for screening. The calculation takes into the account the additional pieces of information... majority of information used for screening. The calculations take into account the additional information...'s additional information merits a revised decision. (3) The Agency's determination of whether...

7 CFR 1260.124 - Consumer information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Promotion and Research Order Definitions § 1260.124 Consumer information. Consumer information means nutritional data and other information that will assist consumers and other persons in making evaluations and decisions regarding the purchasing, preparing, and use of beef and beef products. ...

Solar Technical Assistance Team (STAT) (Fact Sheet)

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

Not Available

The Solar Technical Assistance Team (STAT) is a team of solar technology and deployment experts who ensure that the best information on policies, regulations, financing, and other issues is getting into the hands of state government decision makers when they need it.

Improved decision making in construction using virtual site visits.

DOT National Transportation Integrated Search

2003-01-01

This study explored the dynamics of information exchange involving field issues relating to construction and the assistance that a virtual site visit can provide to the field decision-making process. Such a process can be used for inspection and surv...

Human-Assisted Machine Information Exploitation: a crowdsourced investigation of information-based problem solving

NASA Astrophysics Data System (ADS)

Kase, Sue E.; Vanni, Michelle; Caylor, Justine; Hoye, Jeff

2017-05-01

The Human-Assisted Machine Information Exploitation (HAMIE) investigation utilizes large-scale online data collection for developing models of information-based problem solving (IBPS) behavior in a simulated time-critical operational environment. These types of environments are characteristic of intelligence workflow processes conducted during human-geo-political unrest situations when the ability to make the best decision at the right time ensures strategic overmatch. The project takes a systems approach to Human Information Interaction (HII) by harnessing the expertise of crowds to model the interaction of the information consumer and the information required to solve a problem at different levels of system restrictiveness and decisional guidance. The design variables derived from Decision Support Systems (DSS) research represent the experimental conditions in this online single-player against-the-clock game where the player, acting in the role of an intelligence analyst, is tasked with a Commander's Critical Information Requirement (CCIR) in an information overload scenario. The player performs a sequence of three information processing tasks (annotation, relation identification, and link diagram formation) with the assistance of `HAMIE the robot' who offers varying levels of information understanding dependent on question complexity. We provide preliminary results from a pilot study conducted with Amazon Mechanical Turk (AMT) participants on the Volunteer Science scientific research platform.

Concepts of mental capacity for patients requesting assisted suicide: a qualitative analysis of expert evidence presented to the Commission on Assisted Dying

PubMed Central

2014-01-01

Background In May 2013 a new Assisted Dying Bill was tabled in the House of Lords and is currently scheduled for a second reading in May 2014. The Bill was informed by the report of the Commission on Assisted Dying which itself was informed by evidence presented by invited experts. This study aims to explore how the experts presenting evidence to the Commission on Assisted Dying conceptualised mental capacity for patients requesting assisted suicide and examine these concepts particularly in relation to the principles of the Mental Capacity Act 2005. Methods This study was a secondary qualitative analysis of 36 transcripts of oral evidence and 12 pieces of written evidence submitted by invited experts to the Commission on Assisted Dying using a framework approach. Results There was agreement on the importance of mental capacity as a central safeguard in proposed assisted dying legislation. Concepts of mental capacity, however, were inconsistent. There was a tendency towards a conceptual and clinical shift toward a presumption of incapacity. This appeared to be based on the belief that assisted suicide should only be open to those with a high degree of mental capacity to make the decision. The ‘boundaries’ around the definition of mental capacity appeared to be on a continuum between a circumscribed legal ‘cognitive’ definition of capacity (in which most applicants would be found to have capacity unless significantly cognitively impaired) and a more inclusive definition which would take into account wider concepts such as autonomy, rationality, voluntariness and decision specific factors such as motivation for decision making. Conclusion Ideas presented to the Commission on Assisted Dying about mental capacity as it relates to assisted suicide were inconsistent and in a number of cases at variance with the principles of the Mental Capacity Act 2005. Further work needs to be done to establish a consensus as to what constitutes capacity for this decision and whether current legal frameworks are able to support clinicians in determining capacity for this group. PMID:24755362

Concepts of mental capacity for patients requesting assisted suicide: a qualitative analysis of expert evidence presented to the Commission on Assisted Dying.

PubMed

Price, Annabel; McCormack, Ruaidhri; Wiseman, Theresa; Hotopf, Matthew

2014-04-22

In May 2013 a new Assisted Dying Bill was tabled in the House of Lords and is currently scheduled for a second reading in May 2014. The Bill was informed by the report of the Commission on Assisted Dying which itself was informed by evidence presented by invited experts.This study aims to explore how the experts presenting evidence to the Commission on Assisted Dying conceptualised mental capacity for patients requesting assisted suicide and examine these concepts particularly in relation to the principles of the Mental Capacity Act 2005. This study was a secondary qualitative analysis of 36 transcripts of oral evidence and 12 pieces of written evidence submitted by invited experts to the Commission on Assisted Dying using a framework approach. There was agreement on the importance of mental capacity as a central safeguard in proposed assisted dying legislation. Concepts of mental capacity, however, were inconsistent. There was a tendency towards a conceptual and clinical shift toward a presumption of incapacity. This appeared to be based on the belief that assisted suicide should only be open to those with a high degree of mental capacity to make the decision.The 'boundaries' around the definition of mental capacity appeared to be on a continuum between a circumscribed legal 'cognitive' definition of capacity (in which most applicants would be found to have capacity unless significantly cognitively impaired) and a more inclusive definition which would take into account wider concepts such as autonomy, rationality, voluntariness and decision specific factors such as motivation for decision making. Ideas presented to the Commission on Assisted Dying about mental capacity as it relates to assisted suicide were inconsistent and in a number of cases at variance with the principles of the Mental Capacity Act 2005. Further work needs to be done to establish a consensus as to what constitutes capacity for this decision and whether current legal frameworks are able to support clinicians in determining capacity for this group.

WWC Quick Review of the Report "The Role of Simplification and Information in College Decisions: Results from the H&R Block FAFSA Experiment" Revised

ERIC Educational Resources Information Center

What Works Clearinghouse, 2010

2010-01-01

This paper presents an updated WWC (What Works Clearinghouse) Quick Review of the report "The Role of Simplification and Information in College Decisions: Results from the H&R Block FAFSA Experiment". The study examined whether assistance in filling out the Free Application for Federal Student Aid (FAFSA) increases the likelihood of…

WWC Quick Review of the Report "The Role of Simplification and Information in College Decisions: Results from the H&R Block FAFSA Experiment"

ERIC Educational Resources Information Center

What Works Clearinghouse, 2010

2010-01-01

This paper presents a WWC (What Works Clearinghouse) Quick Review of the report "The Role of Simplification and Information in College Decisions: Results from the H&R Block FAFSA Experiment". The study examined whether assistance in filling out the Free Application for Federal Student Aid (FAFSA) increases the likelihood of filing…

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

Methods to assess landscape-scale risk of bark beetle infestation to support forest management decisions

Treesearch

T. L. Shore; A. Fall; W. G. Riel; J. Hughes; M. Eng

2010-01-01

The objective of our paper is to provide practitioners with suggestions on how to select appropriate methods for risk assessment of bark beetle infestations at the landscape scale in order to support their particular management decisions and to motivate researchers to refine novel risk assessment methods. Methods developed to assist and inform management decisions for...

Teamwork, communication, and anaesthetic assistance in Scotland.

PubMed

Rutherford, J S; Flin, R; Mitchell, L

2012-07-01

Teamwork involves supporting others, solving conflicts, exchanging information, and co-ordinating activities. This article describes the results of interviews with anaesthetic assistants (n=22) and consultant anaesthetists (n=11), investigating the non-technical skills involved in the effective teamwork of the anaesthetic assistants in the operating theatre. Anaesthetic assistants most commonly saw themselves as either being part of a theatre team or an anaesthetic subgroup and most commonly described the senior theatre nurse as their team leader. Examples of supporting others included the following: checking equipment, providing equipment, being a second pair of eyes, providing emotional and decision support, and supporting trainee anaesthetists. Of the 19 anaesthetic assistants who were asked if they would speak up if they disagreed with a decision in theatre, only 14 said that they would voice their concerns, and the most common approach was to ask for the logic behind the decision. The WHO checklist was described as prompting some anaesthetists to describe their anaesthetic plan to the anaesthetic assistant, when previously the anaesthetist would have failed to communicate their intentions in time for equipment to be prepared. The prioritization of activities to achieve co-ordination and the anaesthetic assistants becoming familiar with the idiosyncrasies of their regular anaesthetists were also described by anaesthetic assistants.

29 CFR 1902.20 - Decision following informal proceeding.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 1902.20 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... been presented, if the Assistant Secretary approves a plan he shall issue a decision to that effect... Secretary proposes to disapprove a plan, or the disposition of a subject or issue permits the possible...

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT, ENVIRONMENTAL DECISION SUPPORT SOFTWARE, UNIVERSITY OF TENNESSEE RESEARCH CORPORATION, SPATIAL ANALYSIS AND DECISION ASSISTANCE (SADA)

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) has created the Environmental Technology Verification Program (ETV) to facilitate the deployment of innovative or improved environmental technologies through performance verification and dissemination of information. The goal of the...

Comprehensible knowledge model creation for cancer treatment decision making.

PubMed

Afzal, Muhammad; Hussain, Maqbool; Ali Khan, Wajahat; Ali, Taqdir; Lee, Sungyoung; Huh, Eui-Nam; Farooq Ahmad, Hafiz; Jamshed, Arif; Iqbal, Hassan; Irfan, Muhammad; Abbas Hydari, Manzar

2017-03-01

A wealth of clinical data exists in clinical documents in the form of electronic health records (EHRs). This data can be used for developing knowledge-based recommendation systems that can assist clinicians in clinical decision making and education. One of the big hurdles in developing such systems is the lack of automated mechanisms for knowledge acquisition to enable and educate clinicians in informed decision making. An automated knowledge acquisition methodology with a comprehensible knowledge model for cancer treatment (CKM-CT) is proposed. With the CKM-CT, clinical data are acquired automatically from documents. Quality of data is ensured by correcting errors and transforming various formats into a standard data format. Data preprocessing involves dimensionality reduction and missing value imputation. Predictive algorithm selection is performed on the basis of the ranking score of the weighted sum model. The knowledge builder prepares knowledge for knowledge-based services: clinical decisions and education support. Data is acquired from 13,788 head and neck cancer (HNC) documents for 3447 patients, including 1526 patients of the oral cavity site. In the data quality task, 160 staging values are corrected. In the preprocessing task, 20 attributes and 106 records are eliminated from the dataset. The Classification and Regression Trees (CRT) algorithm is selected and provides 69.0% classification accuracy in predicting HNC treatment plans, consisting of 11 decision paths that yield 11 decision rules. Our proposed methodology, CKM-CT, is helpful to find hidden knowledge in clinical documents. In CKM-CT, the prediction models are developed to assist and educate clinicians for informed decision making. The proposed methodology is generalizable to apply to data of other domains such as breast cancer with a similar objective to assist clinicians in decision making and education. Copyright © 2017 Elsevier Ltd. All rights reserved.

Combination of uncertainty theories and decision-aiding methods for natural risk management in a context of imperfect information

NASA Astrophysics Data System (ADS)

Tacnet, Jean-Marc; Dupouy, Guillaume; Carladous, Simon; Dezert, Jean; Batton-Hubert, Mireille

2017-04-01

In mountain areas, natural phenomena such as snow avalanches, debris-flows and rock-falls, put people and objects at risk with sometimes dramatic consequences. Risk is classically considered as a combination of hazard, the combination of the intensity and frequency of the phenomenon, and vulnerability which corresponds to the consequences of the phenomenon on exposed people and material assets. Risk management consists in identifying the risk level as well as choosing the best strategies for risk prevention, i.e. mitigation. In the context of natural phenomena in mountainous areas, technical and scientific knowledge is often lacking. Risk management decisions are therefore based on imperfect information. This information comes from more or less reliable sources ranging from historical data, expert assessments, numerical simulations etc. Finally, risk management decisions are the result of complex knowledge management and reasoning processes. Tracing the information and propagating information quality from data acquisition to decisions are therefore important steps in the decision-making process. One major goal today is therefore to assist decision-making while considering the availability, quality and reliability of information content and sources. A global integrated framework is proposed to improve the risk management process in a context of information imperfection provided by more or less reliable sources: uncertainty as well as imprecision, inconsistency and incompleteness are considered. Several methods are used and associated in an original way: sequential decision context description, development of specific multi-criteria decision-making methods, imperfection propagation in numerical modeling and information fusion. This framework not only assists in decision-making but also traces the process and evaluates the impact of information quality on decision-making. We focus and present two main developments. The first one relates to uncertainty and imprecision propagation in numerical modeling using both classical Monte-Carlo probabilistic approach and also so-called Hybrid approach using possibility theory. Second approach deals with new multi-criteria decision-making methods which consider information imperfection, source reliability, importance and conflict, using fuzzy sets as well as possibility and belief function theories. Implemented methods consider information imperfection propagation and information fusion in total aggregation methods such as AHP (Saaty, 1980) or partial aggregation methods such as the Electre outranking method (see Soft Electre Tri ) or decisions in certain but also risky or uncertain contexts (see new COWA-ER and FOWA-ER- Cautious and Fuzzy Ordered Weighted Averaging-Evidential Reasoning). For example, the ER-MCDA methodology considers expert assessment as a multi-criteria decision process based on imperfect information provided by more or less heterogeneous, reliable and conflicting sources: it mixes AHP, fuzzy sets theory, possibility theory and belief function theory using DSmT (Dezert-Smarandache Theory) framework which provides powerful fusion rules.

Adaptation of a Knowledge-Based Decision-Support System in the Tactical Environment.

DTIC Science & Technology

1981-12-01

002-04-6411S1CURITY CL All PICATION OF 1,416 PAGE (00HIR Onto ea0aOW .L10 *GU9WVC 4bGSI.CAYON S. Voss 10466lVka t... OftesoE ’ making decisons . The...noe..aaw Ad tdlalttt’ IV 680011 MMib) Artificial Intelligence; Decision-Support Systems; Tactical Decision- making ; Knowledge-based Decision-support...tactical information to assist tactical commanders in making decisions. The system, TAC*, for "Tactical Adaptable Consultant," incorporates a database

Overview of USEPA's ORD Technical Outreach and Support Activities on Vapor Intrusion Impacts - 03/2008

EPA Science Inventory

The science of determining, characterizing and managing vapor intrusion risks is constantly evolving. Much remains to be done in assisting regulators, consultants and other decision-makers to make informed decisions in mitigating the problem and reducing these risks. ORD has been...

Computer-Assisted Community Planning and Decision Making.

ERIC Educational Resources Information Center

College of the Atlantic, Bar Harbor, ME.

The College of the Atlantic (COA) developed a broad-based, interdisciplinary curriculum in ecological policy and community planning and decision-making that incorporates two primary computer-based tools: ARC/INFO Geographic Information System (GIS) and STELLA, a systems-dynamics modeling tool. Students learn how to use and apply these tools…

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

Use of Cognitive Therapy and the Balance Sheet Procedure to Assist Career Decision Making.

ERIC Educational Resources Information Center

O'Hare, Marianne M.

1989-01-01

A balance sheet technique enables counselors to help clients identify and overcome anxiety associated with career decision making. Steps include describing the problem, brainstorming alternatives, listing expected positive and negative outcomes in terms of self and others, seeking information, and choosing alternatives. (SK)

7 CFR 1709.214 - Administrator's review and selection of grant awards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... pertinent information before making a decision about which, if any, applications to approve, the amount of... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Bulk Fuel Revolving... decision to make a grant award is at the discretion of the Administrator. The Administrator shall consider...

System Accountability Report 2013-14. Revised

ERIC Educational Resources Information Center

Board of Governors, State University System of Florida, 2015

2015-01-01

Information Resource Management - State University System of Florida (IRM-SUS) is the primary collector and provider of data concerning state universities that is used to make sound education policy decisions. The office provides technical assistance to those using the information, state and federal reporting support, those supplying information,…

5 CFR 1302.5 - Request for review.

Code of Federal Regulations, 2010 CFR

2010-01-01

....5 Request for review. (a) Individuals wishing to request a review of the decision by OMB with regard..., include the information specified in § 1302.5(b), below. Individuals desiring assistance in the... disputed information amended. The request for review should make reference to the information furnished by...

48 CFR 7.403 - General Services Administration assistance.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; and (4) Industry or market trends. (b) Agencies may request information from the following GSA offices: (1) Center for Strategic IT Analysis (MKS), Washington, DC 20405, for information on acquisition of... in lease or purchase decisions by providing information such as— (1) Pending price adjustments to...

The current status of mHealth for diabetes: will it be the next big thing?

PubMed

Klonoff, David C

2013-05-01

mHealth is an emerging concept in health care and uses mobile communications devices for health services and information. Mobile phones, patient monitoring devices, tablets, personal digital assistants, and other wireless devices can be part of mHealth systems. With mHealth systems, glucose data can now be automatically collected, transmitted, aggregated with other physiologic data, analyzed, stored, and presented as actionable information. mHealth systems use mobile decision support software applications (or apps) to assist or direct health care professionals to make decisions, or they can assist or direct patients to make decisions without waiting for input from a clinician. With real-time decision support for patients, appropriate actions can be taken in real time without waiting to see a clinician. Decisions can be personalized if individual treatment goals and personal preferences for treatment are inputted into an app. Few mHealth apps for diabetes have been rigorously tested. Outcome studies of the use of mHealth for diabetes from the literature have shown the potential for benefits, but higher-quality studies are needed. Regulatory approval of mHealth products will require demonstration of safety and effectiveness, especially where information and trends are not just presented to patients, but used to make treatment recommendations. Three additional hurdles must be overcome to facilitate widespread adoption of this technology, including demonstration of the following: (1) privacy to satisfy regulators, (2) clinical benefit to satisfy clinicians, and (3) economic benefit to satisfy payers. mHealth for diabetes is making rapid strides and is expected to be a transforming technology that will be the next big thing. © 2013 Diabetes Technology Society.

The Current Status of mHealth for Diabetes: Will It Be the Next Big Thing?

PubMed Central

Klonoff, David C.

2013-01-01

mHealth is an emerging concept in health care and uses mobile communications devices for health services and information. Mobile phones, patient monitoring devices, tablets, personal digital assistants, and other wireless devices can be part of mHealth systems. With mHealth systems, glucose data can now be automatically collected, transmitted, aggregated with other physiologic data, analyzed, stored, and presented as actionable information. mHealth systems use mobile decision support software applications (or apps) to assist or direct health care professionals to make decisions, or they can assist or direct patients to make decisions without waiting for input from a clinician. With real-time decision support for patients, appropriate actions can be taken in real time without waiting to see a clinician. Decisions can be personalized if individual treatment goals and personal preferences for treatment are inputted into an app. Few mHealth apps for diabetes have been rigorously tested. Outcome studies of the use of mHealth for diabetes from the literature have shown the potential for benefits, but higher-quality studies are needed. Regulatory approval of mHealth products will require demonstration of safety and effectiveness, especially where information and trends are not just presented to patients, but used to make treatment recommendations. Three additional hurdles must be overcome to facilitate widespread adoption of this technology, including demonstration of the following: (1) privacy to satisfy regulators, (2) clinical benefit to satisfy clinicians, and (3) economic benefit to satisfy payers. mHealth for diabetes is making rapid strides and is expected to be a transforming technology that will be the next big thing. PMID:23759409

Proposal and Justification for Establishing Strategic Technology Information Analysis Center.

DTIC Science & Technology

1981-12-04

decision to establish a Strategic Technology Information Analysis Center (STIAC). This Center would provide a mission-oriented focus for Strategic Technology...SECTION 1. INTRODUCTION This proposal provides the Defense Logistic Agency with the following critical data to assist them in making the decision on...time consuming for the strategic BID community to acquire. 1.2 EVOLVING NEED FOR STIAC The need for a STIAC has been surfacing along multiple paths

The impact of consumer involvement on satisfaction with and use of assistive technology.

PubMed

Martin, Jay K; Martin, Liam G; Stumbo, Norma J; Morrill, Joshua H

2011-01-01

This exploratory study examined the relationships between consumers' involvement in the pre-purchase decision-making process, their perceptions of feeling informed, and their degree of being satisfied with and use of assistive technology (AT). Does consumer information and participation in decision-making process lead to improved satisfaction and use of AT? A link to an project-specific web-based survey, sent to several online disability forums and independent living centres, resulted in a sample of 145 individuals with a range of disabilities, who used a range of AT and were geographically dispersed. There is a significant relationship between being feeling informed and being satisfied with an AT device (F(13,278) = 27.79, p = 0.000). Feeling that personal needs were not assessed led to lower satisfaction (β = -0.15, p < 0.07), while feeling informed resulted from a number of different factors. Lack of consumer involvement in the pre-purchase decision-making process led to somewhat greater rates of abandonment in some categories of AT (some with small n's). Talking with other users, auditioning the device and searching the Internet are important ways for consumers to gather information. When consumers feel informed, they are more likely to be satisfied with the AT and retain it.

Prostate Cancer Patient Perspectives on the Use of Information in Treatment Decision-Making: A Systematic Review and Qualitative Meta-synthesis

PubMed Central

Kandasamy, Sujane; Khalid, Ahmad Firas; Majid, Umair; Vanstone, Meredith

2017-01-01

Background Men with low- to intermediate-risk prostate cancer are typically asked to choose from a variety of treatment options, including active surveillance, radical prostatectomy, or brachytherapy. The Prolaris cell cycle progression test is intended to provide additional information on personal risk status to assist men with prostate cancer in their choice of treatment. To assist with assessing that new technology, this report synthesizes qualitative research on how men with prostate cancer use information to make decisions about treatment options. Methods We performed a systematic review and qualitative meta-synthesis to retrieve and synthesize findings across primary qualitative studies that report on patient perspectives during prostate cancer treatment decision-making. Results Of 8,610 titles and abstracts reviewed, 29 studies are included in this report. Most men diagnosed with prostate cancer express that their information-seeking pathway extends beyond the medical information received from their health care provider. They access other social resources to attain additional medical information, lived-experience information, and medical administrative information to help support their final treatment decision. Men value privacy, trust, honesty, control, power, organization, and open communication during interactions with their health care providers. They also emphasize the importance of gaining comfort with their treatment choice, having a chance to confirm their health care provider's recommendations (validation of treatment plan), and exercising their preferred level of independence in the treatment decision-making process. Conclusions Although each prostate cancer patient is unique, studies suggest that most patients seek extensive information to help inform their treatment decisions. This may happen before, during, and after the treatment choice is made. Given the amount of information patients may access, it is important that they also establish the trustworthiness of the various types and sources of information. When information conflicts, patients may be unsure about how to proceed. Open collaboration between patients and their health care providers can help patients manage and navigate their concerns so that their values and perspectives are captured in their treatment choices. PMID:28572868

Computer-assisted navigation in orthopedic surgery.

PubMed

Mavrogenis, Andreas F; Savvidou, Olga D; Mimidis, George; Papanastasiou, John; Koulalis, Dimitrios; Demertzis, Nikolaos; Papagelopoulos, Panayiotis J

2013-08-01

Computer-assisted navigation has a role in some orthopedic procedures. It allows the surgeons to obtain real-time feedback and offers the potential to decrease intra-operative errors and optimize the surgical result. Computer-assisted navigation systems can be active or passive. Active navigation systems can either perform surgical tasks or prohibit the surgeon from moving past a predefined zone. Passive navigation systems provide intraoperative information, which is displayed on a monitor, but the surgeon is free to make any decisions he or she deems necessary. This article reviews the available types of computer-assisted navigation, summarizes the clinical applications and reviews the results of related series using navigation, and informs surgeons of the disadvantages and pitfalls of computer-assisted navigation in orthopedic surgery. Copyright 2013, SLACK Incorporated.

20 CFR 668.340 - What are INA grantee allowable activities?

Code of Federal Regulations, 2011 CFR

2011-04-01

... national Labor Market Information; (9) Provision of information about filing of Unemployment Insurance... successful completion of training; and (10) Educational and tuition assistance. (e) Allowable activities... for leadership development, decision-making, citizenship and community service; (7) Preparation for...

78 FR 16486 - Commission Information Collection Activities (FERC-606); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

...-time employment). \\4\\ Average salary plus benefits per full-time equivalent employee. Comments... Requests for Further Information), to the Office of Management and Budget (OMB) for review of the... intended to allow agencies to assist the Commission to make better informed decisions in establishing due...

System Accountability Report 2013-14. Appendix: Data Tables

ERIC Educational Resources Information Center

Board of Governors, State University System of Florida, 2013

2013-01-01

Information Resource Management-State University System of Florida (IRM-SUS) is the primary collector and provider of data concerning state universities that is used to make sound education policy decisions. The office provides technical assistance to those using the information, state and federal reporting support, those supplying information,…

Successful Principles for Collaboration: Formation of the IAIMS Consortium.

ERIC Educational Resources Information Center

Stead, William W.; And Others

1991-01-01

Six universities collaborated in developing an integrated academic information management system (IAIMS) to manage data and information as a shared resource and to bring together resources for timely decision making. The program assists institutions in linking their library systems and other information systems to support education, research,…

2014 Higher Education Summit/SUS Data Workshop Proceedings

ERIC Educational Resources Information Center

Board of Governors, State University System of Florida, 2014

2014-01-01

Information Resource Management--State University System of Florida (IRM-SUS) is the primary collector and provider of data concerning state universities that is used to make sound education policy decisions. The office provides technical assistance to those using the information, state and federal reporting support, those supplying information,…

76 FR 78286 - Collection of Information Under Review by Office of Management and Budget

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

..., between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. OIRA posts its decisions on.... Coast Guard, Acting Assistant Commandant for Command, Control, Communications, Computers and Information... DEPARTMENT OF HOMELAND SECURITY Coast Guard [USCG-2011-0902] Collection of Information Under...

78 FR 56758 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... intended to assist shareholders in making an informed voting decision with regards to any nominee or... whether the information will have practical utility; (b) the accuracy of the agency's estimate of the burden imposed by the collection of information; (c) ways to enhance the quality, utility, and clarity of...

Shared decision making in mental health: the importance for current clinical practice.

PubMed

Alguera-Lara, Victoria; Dowsey, Michelle M; Ride, Jemimah; Kinder, Skye; Castle, David

2017-12-01

We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. Narrative review of published English-language articles. After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers. There is a paucity of published studies specifically related to antipsychotic medications. Shared decision making is a central part of the recovery paradigm and is of increasing importance in mental health service delivery. The field needs to better understand the basis on which decisions are reached regarding psychiatric treatments. Discrete choice experiments might be useful to inform the development of tools to assist shared decision making in psychiatry.

Promoting Decision-Making Skills by Youth with Disabilities: Health, Education, and Vocational Choices. CYDLINE Reviews.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. National Center for Youth with Disabilities.

The annotated bibliography is intended to assist professionals working to develop decision making skills in disabled youth. The 40 bibliographic citations date from 1981 to 1989 and are grouped into the following categories: health issues, psychosocial issues, and education and career issues. Fourteen training materials with information given…

15 CFR 2005.6 - Request for review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... person making the request in writing of the decision on the request for review within 30 days (excluding... wishing to request a review of the decision by STR with regard to an initial request to amend a record in... extent possible, include the information specified in § 2005.5(a). Individuals desiring assistance in the...

Online Course Selection: Using Course Dashboards to Inform Student Enrollment Decisions

ERIC Educational Resources Information Center

Marshall, James

2016-01-01

This article explores the potential of course dashboards as a front-end strategy for decreasing online course dropout rates. Scholarship has addressed course attrition once students are enrolled in online courses. However, supporting academic success by assisting students in the making of effective decisions about which online courses to take has…

Administration and Organizational Influences on AFDC Case Decision Errors: An Empirical Analysis.

ERIC Educational Resources Information Center

Piliavin, Irving; And Others

The quality of effort among public assistance personnel has been criticized virtually since the inception of welfare programs for the poor. However, until recently, empirical information on the performance of these workers has been nonexistent. The present study, concerned with Aid to Families with Dependent Children (AFDC) case decision errors,…

Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.

PubMed

Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K

2018-01-17

Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices varied from passive decision-making to shared decision-making. All women have the right to be informed of alternative birthing options. Routine provision of explanations by obstetricians regarding risks associated with alternative birth options, in addition to financial coverage for RCS from National Health Insurance, would assist women's decision-making. Establishment of a website to provide women with reliable information about birthing options may also assist women's decision-making.

Semantic bifurcated importance field visualization

NASA Astrophysics Data System (ADS)

Lindahl, Eric; Petrov, Plamen

2007-04-01

While there are many good ways to map sensual reality to two dimensional displays, mapping non-physical and possibilistic information can be challenging. The advent of faster-than-real-time systems allow the predictive and possibilistic exploration of important factors that can affect the decision maker. Visualizing a compressed picture of the past and possible factors can assist the decision maker summarizing information in a cognitive based model thereby reducing clutter and perhaps related decision times. Our proposed semantic bifurcated importance field visualization uses saccadic eye motion models to partition the display into a possibilistic and sensed data vertically and spatial and semantic data horizontally. Saccadic eye movement precedes and prepares decision makers before nearly every directed action. Cognitive models for saccadic eye movement show that people prefer lateral to vertical saccadic movement. Studies have suggested that saccades may be coupled to momentary problem solving strategies. Also, the central 1.5 degrees of the visual field represents 100 times greater resolution that then peripheral field so concentrating factors can reduce unnecessary saccades. By packing information according to saccadic models, we can relate important decision factors reduce factor dimensionality and present the dense summary dimensions of semantic and importance. Inter and intra ballistics of the SBIFV provide important clues on how semantic packing assists in decision making. Future directions of SBIFV are to make the visualization reactive and conformal to saccades specializing targets to ballistics, such as dynamically filtering and highlighting verbal targets for left saccades and spatial targets for right saccades.

Naturalistic decision making in forensic science: toward a better understanding of decision making by forensic team leaders.

PubMed

Helsloot, Ira; Groenendaal, Jelle

2011-07-01

This study uses the naturalistic decision-making (NDM) perspective to examine how Dutch forensic team leaders (i.e., the officers in charge of criminal forensic research from the crime scene until the use of laboratory assistance) make decisions in real-life settings and identifies the contextual factors that might influence those decisions. First, a focus group interview was conducted to identify four NDM mechanisms in day-to-day forensic decision making. Second, a serious game was conducted to examine the influence of three of these contextual mechanisms. The results uncovered that forensic team leaders (i) were attracted to obtain further information when more information was initially made available, (ii) were likely to devote more attention to emotionally charged cases, and (iii) used not only forensic evidence in the decision making but also tactical, unverified information of the police inquiry. Interestingly, the measured contextual influences did not deviate significantly from a control group of laypeople. © 2011 American Academy of Forensic Sciences.

[Treatment Decision-Making Process of Cancer Patients].

PubMed

Lee, Shiu-Yu C Katie

2016-10-01

The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one's own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision-making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.

Development of a support tool for complex decision-making in the provision of rural maternity care.

PubMed

Hearns, Glen; Klein, Michael C; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

2010-02-01

Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology.

Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care

PubMed Central

Hearns, Glen; Klein, Michael C.; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

2010-01-01

Context: Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. Objective: To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Design: Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Setting: Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Participants: Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). Results: We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Conclusions: Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology. PMID:21286270

Geospatial Thinking of Information Professionals

ERIC Educational Resources Information Center

Bishop, Bradley Wade; Johnston, Melissa P.

2013-01-01

Geospatial thinking skills inform a host of library decisions including planning and managing facilities, analyzing service area populations, facility site location, library outlet and service point closures, as well as assisting users with their own geospatial needs. Geospatial thinking includes spatial cognition, spatial reasoning, and knowledge…

78 FR 37598 - Missing Participants in Individual Account Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

... PENSION BENEFIT GUARANTY CORPORATION Missing Participants in Individual Account Plans AGENCY: Pension Benefit Guaranty Corporation. ACTION: Request for information. SUMMARY: PBGC is soliciting information from the public to assist it in making decisions about implementing a new program to deal with...

Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

PubMed

Power, Tara E; Swartzman, Leora C; Robinson, John W

2011-05-01

Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Integrating Agriculture and Conservation

USGS Publications Warehouse

Vandever, Mark W.

2010-01-01

The USGS produces the needed science-based information to guide management actions and policy decisions that support wildlife habitat and other environmental services compatible with USDA conservation goals and farm operations. The Policy Analysis and Science Assistance Branch of the Fort Collins Science Center (FORT) has conducted research involving a national landowner survey and numerous short- and long-term evaluations regarding vegetation responses to land management practices. This research helps land and resource managers to make informed decisions and resolve resource management conflicts.

Big data, smart homes and ambient assisted living.

PubMed

Vimarlund, V; Wass, S

2014-08-15

To discuss how current research in the area of smart homes and ambient assisted living will be influenced by the use of big data. A scoping review of literature published in scientific journals and conference proceedings was performed, focusing on smart homes, ambient assisted living and big data over the years 2011-2014. The health and social care market has lagged behind other markets when it comes to the introduction of innovative IT solutions and the market faces a number of challenges as the use of big data will increase. First, there is a need for a sustainable and trustful information chain where the needed information can be transferred from all producers to all consumers in a structured way. Second, there is a need for big data strategies and policies to manage the new situation where information is handled and transferred independently of the place of the expertise. Finally, there is a possibility to develop new and innovative business models for a market that supports cloud computing, social media, crowdsourcing etc. The interdisciplinary area of big data, smart homes and ambient assisted living is no longer only of interest for IT developers, it is also of interest for decision makers as customers make more informed choices among today's services. In the future it will be of importance to make information usable for managers and improve decision making, tailor smart home services based on big data, develop new business models, increase competition and identify policies to ensure privacy, security and liability.

Treatment decision-making in ductal carcinoma in situ: A mixed methods systematic review of women's experiences and information needs.

PubMed

Rutherford, Claudia; Mercieca-Bebber, Rebecca; Butow, Phyllis; Wu, Jenny Liang; King, Madeleine T

2017-09-01

Decision-making in ductal carcinoma in situ (DCIS) is complex due to the heterogeneity of the disease. This study aimed to understand women's experience of making treatment decisions for DCIS, their information and support needs, and factors that influenced decisions. We searched six electronic databases, conference proceedings, and key authors. Two reviewers independently applied inclusion and quality criteria, and extracted findings. Thematic analysis was used to combine and summarise findings. We identified six themes and 28 subthemes from 18 studies. Women with DCIS have knowledge deficits about DCIS, experience anxiety related to information given at diagnosis and the complexity of decision-making, and have misconceptions regarding risks and outcomes of treatment. Women's decisions are influenced by their understanding of risk, the clinical features of their DCIS, and the benefits and harms of treatment options. Women are dissatisfied with the decisional support available. Informed and shared decision-making in this complex decision setting requires clear communication of information specific to DCIS and individual's, as well as decision support for patients and clinicians. This approach would educate patients and clinicians, and assist clinicians in supporting patients to an evidence-based treatment plan that aligns with individual values and pReferences. Copyright © 2017 Elsevier B.V. All rights reserved.

Smart homes and ambient assisted living applications: from data to knowledge-empowering or overwhelming older adults? Contribution of the IMIA Smart Homes and Ambiant Assisted Living Working Group.

PubMed

Demiris, G; Thompson, H

2011-01-01

As health care systems face limited resources and workforce shortages to address the complex needs of older adult populations, innovative approaches utilizing information technology can support aging. Smart Home and Ambient Assisted Living (SHAAL) systems utilize advanced and ubiquitous technologies including sensors and other devices that are integrated in the residential infrastructure or wearable, to capture data describing activities of daily living and health related events. This paper highlights how data from SHAAL systems can lead to information and knowledge that ultimately improves clinical outcomes and quality of life for older adults as well as quality of health care services. We conducted a review of personal health record applications specifically for older adults and approaches to using information to improve elder care. We present a framework that showcases how data captured from SHAAL systems can be processed to provide meaningful information that becomes part of a personal health record. Synthesis and visualization of information resulting from SHAAL systems can lead to knowledge and support education, delivery of tailored interventions and if needed, transitions in care. Such actions can involve multiple stakeholders as part of shared decision making. SHAAL systems have the potential to support aging and improve quality of life and decision making for older adults and their families. The framework presented in this paper demonstrates how emphasis needs to be placed into extracting meaningful information from new innovative systems that will support decision making. The challenge for informatics designers and researchers is to facilitate an evolution of SHAAL systems expanding beyond demonstration projects to actual interventions that will improve health care for older adults.

Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

PubMed

Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

2015-12-01

The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.

7 CFR 614.3 - Decisions subject to informal appeal procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Program; and (x) Conservation Innovation Grants. (2) Non-Title XII conservation programs or provisions, including: (i) Agriculture Management Assistance Program; (ii) Emergency Watershed Protection Program; (iii...

48 CFR 7.403 - General Services Administration assistance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in lease or purchase decisions by providing information such as— (1) Pending price adjustments to... REGULATION ACQUISITION PLANNING ACQUISITION PLANNING Equipment Lease or Purchase 7.403 General Services...

78 FR 76289 - Request for Information To Gather Technical Expertise Pertaining to Data Elements, Metrics, Data...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... information. To assist us in making a determination on your request, we encourage you to identify any specific... consumer decision-making. Organizations that have developed, or are developing, ratings systems for.... The Department is interested in a PIRS that takes into account information important to the Federal...

2013 Higher Education Summit/SUS Data Workshop Proceedings. Session: IRM Data Workshop

ERIC Educational Resources Information Center

Board of Governors, State University System of Florida, 2013

2013-01-01

Information Resource Management--State University System of Florida (IRM-SUS) is the primary collector and provider of data concerning state universities that is used to make sound education policy decisions. The office provides technical assistance to those using the information, state and federal reporting support, those supplying information,…

Analysis of Search on Clinical Narrative within the EHR

ERIC Educational Resources Information Center

Natarajan, Karthik

2012-01-01

Electronic Health Records (EHRs) are used increasingly in the hospital and outpatient settings, and patients are amassing digitized clinical information. On one hand, aggregating all the patient's clinical information can greatly assist health care workers in making sound decisions. On the other hand, it can result in information overload,…

The design of aircraft using the decision support problem technique

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Marinopoulos, Stergios; Jackson, David M.; Shupe, Jon A.

1988-01-01

The Decision Support Problem Technique for unified design, manufacturing and maintenance is being developed at the Systems Design Laboratory at the University of Houston. This involves the development of a domain-independent method (and the associated software) that can be used to process domain-dependent information and thereby provide support for human judgment. In a computer assisted environment, this support is provided in the form of optimal solutions to Decision Support Problems.

Formal analysis of the surgical pathway and development of a new software tool to assist surgeons in the decision making in primary breast surgery.

PubMed

Catanuto, Giuseppe; Pappalardo, Francesco; Rocco, Nicola; Leotta, Marco; Ursino, Venera; Chiodini, Paolo; Buggi, Federico; Folli, Secondo; Catalano, Francesca; Nava, Maurizio B

2016-10-01

The increased complexity of the decisional process in breast cancer surgery is well documented. With this study we aimed to create a software tool able to assist patients and surgeons in taking proper decisions. We hypothesized that the endpoints of breast cancer surgery could be addressed combining a set of decisional drivers. We created a decision support system software tool (DSS) and an interactive decision tree. A formal analysis estimated the information gain derived from each feature in the process. We tested the DSS on 52 patients and we analyzed the concordance of decisions obtained by different users and between the DSS suggestions and the actual surgery. We also tested the ability of the system to prevent post breast conservation deformities. The information gain revealed that patients preferences are the root of our decision tree. An observed concordance respectively of 0.98 and 0.88 was reported when the DSS was used twice by an expert operator or by a newly trained operator vs. an expert one. The observed concordance between the DSS suggestion and the actual decision was 0.69. A significantly higher incidence of post breast conservation defects was reported among patients who did not follow the DSS decision (Type III of Fitoussi, N = 4; 33.3%, p = 0.004). The DSS decisions can be reproduced by operators with different experience. The concordance between suggestions and actual decision is quite low, however the DSS is able to prevent post- breast conservation deformities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clarification process: Resolution of decision-problem conditions

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A model of a general process which occurs in both decisionmaking and problem-solving tasks is presented. It is called the clarification model and is highly dependent on information flow. The model addresses the possible constraints of individual indifferences and experience in achieving success in resolving decision-problem conditions. As indicated, the application of the clarification process model is only necessary for certain classes of the basic decision-problem condition. With less complex decision problem conditions, certain phases of the model may be omitted. The model may be applied across a wide range of decision problem conditions. The model consists of two major components: (1) the five-phase prescriptive sequence (based on previous approaches to both concepts) and (2) the information manipulation function (which draws upon current ideas in the areas of information processing, computer programming, memory, and thinking). The two components are linked together to provide a structure that assists in understanding the process of resolving problems and making decisions.

44 CFR 351.21 - The Nuclear Regulatory Commission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... account the overall state of emergency preparedness in making decisions to issue operating licenses or... public information and education programs. (k) Assist FEMA with other Federal agencies in the development...

Intelligent Work Process Engineering System

NASA Technical Reports Server (NTRS)

Williams, Kent E.

2003-01-01

Optimizing performance on work activities and processes requires metrics of performance for management to monitor and analyze in order to support further improvements in efficiency, effectiveness, safety, reliability and cost. Information systems are therefore required to assist management in making timely, informed decisions regarding these work processes and activities. Currently information systems regarding Space Shuttle maintenance and servicing do not exist to make such timely decisions. The work to be presented details a system which incorporates various automated and intelligent processes and analysis tools to capture organize and analyze work process related data, to make the necessary decisions to meet KSC organizational goals. The advantages and disadvantages of design alternatives to the development of such a system will be discussed including technologies, which would need to bedesigned, prototyped and evaluated.

A decision support system for map projections of small scale data

USGS Publications Warehouse

Finn, Michael P.; Usery, E. Lynn; Posch, Stephan T.; Seong, Jeong Chang

2004-01-01

The use of commercial geographic information system software to process large raster datasets of terrain elevation, population, land cover, vegetation, soils, temperature, and rainfall requires both projection from spherical coordinates to plane coordinate systems and transformation from one plane system to another. Decision support systems deliver information resulting in knowledge that assists in policies, priorities, or processes. This paper presents an approach to handling the problems of raster dataset projection and transformation through the development of a Web-enabled decision support system to aid users of transformation processes with the selection of appropriate map projections based on data type, areal extent, location, and preservation properties.

Prostatectomy: information provision and education for patients.

PubMed

Simpson, Paula

Following the diagnosis of prostate cancer, information should be imparted to ensure an informed decision regarding treatment can be made. The impact of a cancer diagnosis could lead men to opt for surgical intervention without fully understanding the consequences of treatment. Effective communication of evidence-based information can assist men to fully understand the consequences of treatment. Radical prostatectomy, whether robotically assisted laparoscopic or retropubic, will lead to quality-of-life issues with functional outcomes such as erectile dysfunction and urinary incontinence being at the forefront. Issues should be discussed and communicated in depth so that frustration and regret following treatment are avoided. A cautious approach to information provision should be considered so the patient does not feel in a position of information overload. Advanced communication skills are of utmost importance to ensure information is tailored to suit individual needs, as no one model of information giving suits all. This article is a rapid literature search relating to post-prostatectomy functional outcomes and how communication and information giving before treatment assists with acceptance of treatment outcomes.

An aquatic multiscale assessment and planning framework approach—forest plan revision case study

Treesearch

Kerry Overton; Ann D. Carlson; Cynthia Tait

2010-01-01

The Aquatic Multiscale Assessment and Planning Framework is a Web-based decision-support tool developed to assist aquatic practitioners in managing fisheries and watershed information. This tool, or framework, was designed to assist resource assessments and planning efforts from the broad scale to the fine scale, to document procedures, and to link directly to relevant...

A new decision sciences for complex systems.

PubMed

Lempert, Robert J

2002-05-14

Models of complex systems can capture much useful information but can be difficult to apply to real-world decision-making because the type of information they contain is often inconsistent with that required for traditional decision analysis. New approaches, which use inductive reasoning over large ensembles of computational experiments, now make possible systematic comparison of alternative policy options using models of complex systems. This article describes Computer-Assisted Reasoning, an approach to decision-making under conditions of deep uncertainty that is ideally suited to applying complex systems to policy analysis. The article demonstrates the approach on the policy problem of global climate change, with a particular focus on the role of technology policies in a robust, adaptive strategy for greenhouse gas abatement.

Governing therapy choices: power/knowledge in the treatment of progressive renal failure.

PubMed

Holmes, Dave; Perron, Amélie M; Savoie, Marc

2006-12-04

This article outlines the struggle between the power of the health care professional and the rights of the individual to choose freely a modality of treatment. Nurses are instrumental in assisting patients in making the best decision for a therapy they will have to assume for the rest of their lives. In guiding patients' decision, nurses must take into account these unavoidable contingencies: changes in lifestyle, nutritional restrictions, level of acceptance, compliance issues, ease of training and availability of support/facilities. Ensuring that the patient makes an informed decision is therefore an ongoing challenge for nurses as they are taking part in a delicate balancing act between not directly influencing the patient's decision while making sure the patient is accurately informed.

Governing therapy choices: Power/Knowledge in the treatment of progressive renal failure

PubMed Central

Holmes, Dave; Perron, Amélie M; Savoie, Marc

2006-01-01

This article outlines the struggle between the power of the health care professional and the rights of the individual to choose freely a modality of treatment. Nurses are instrumental in assisting patients in making the best decision for a therapy they will have to assume for the rest of their lives. In guiding patients' decision, nurses must take into account these unavoidable contingencies: changes in lifestyle, nutritional restrictions, level of acceptance, compliance issues, ease of training and availability of support/facilities. Ensuring that the patient makes an informed decision is therefore an ongoing challenge for nurses as they are taking part in a delicate balancing act between not directly influencing the patient's decision while making sure the patient is accurately informed. PMID:17144913

Personal data assistants: using new technology to enhance nursing practice.

PubMed

Lewis, Judith A; Sommers, Catherine O

2003-01-01

This article explains how the new technology of personal data assistants can be used to enhance and augment comprehensive nursing care. Nurses are constantly challenged in their need for current, reliable, and accurate information at the point of patient care. Professional books and journals, by the very nature of their print format, have been prepared long before they can be actually used in practice. More current information is available from the World Wide Web, but it is often impractical for a nurse to access a computer during a patient encounter. Personal data assistants [PDAs] allow clinicians to access and document absolutely current information at the moment the patient is being seen. There are many general applications for PDAs that nurses might use such as keeping electronic calendars, address books, and reminder lists. In addition, however, there are even more actual healthcare applications, including patient tracking systems, access to pharmacologic databases, and a variety of clinical decision-making support tools. This article describes the wide variety of PDAs, along with the factors a nurse should consider in the decision of whether to purchase a PDA, and which type of device is best suited for which application.

The Development and Validation of a Special Education Intelligent Administration Support Program. Final Report.

ERIC Educational Resources Information Center

Utah State Univ., Logan. Center for Persons with Disabilities.

This project studied the effects of implementing a computerized management information system developed for special education administrators. The Intelligent Administration Support Program (IASP), an expert system and database program, assisted in information acquisition and analysis pertaining to the district's quality of decisions and procedures…

32 CFR 1665.5 - Request for review.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROCEDURES § 1665.5 Request for review. (a) Individuals wishing to request a review of the decision by SSS... the information specified in § 1665.5(b). Individuals desiring assistance in the preparation of their... requester believes that access should be granted or the disputed information amended. The request for review...

LEA Basic Data Systems. A Manual of Developmental Activities.

ERIC Educational Resources Information Center

Powers, Roderick W.

Intended to assist school administrators in developing both student information systems and total information systems, this guide contains suggestions which, when considered in terms of local characteristics and concerns, can be used to create such systems to support administrative decision making, state and federal reporting, guidance, research,…

Guidelines for the Development of Computerized Student Information Systems.

ERIC Educational Resources Information Center

Armes, Nancy, Ed.; And Others

Designed to provide guidelines for the development of computerized student information systems, this report raises policy issues and questions to be resolved at the campus level and describes a variety of computer-generated reports and records that can assist in educational decision making and planning. Introductory material discusses the…

Adaptation to climate variability: The role of the USDA Southern Plains Climate Hub

USDA-ARS?s Scientific Manuscript database

The Southern Plains USDA Climate Hub was established in 2014 in El Reno, Oklahoma to develop and deliver science-based, information and technologies to agricultural and natural resource land managers that enable climate-informed decision-making, and to provide access to assistance to implement those...

Policy Dimensions of Analytics in Higher Education

ERIC Educational Resources Information Center

Petersen, Rodney J.

2012-01-01

The current higher education landscape is replete with demands for improving accountability, increasing efficiency, and controlling costs. At the same time, information technologies make it easier to collect and analyze information to measure outcomes or to assist in decision making. Consequently, there is a higher demand for better information…

20 CFR 667.262 - Are employment generating activities, or similar activities, allowable under WIA title I?

Code of Federal Regulations, 2011 CFR

2011-04-01

... as chambers of commerce); joint labor management committees, labor associations, and resource centers... development agencies, to: (i) Provide information about WIA programs, (ii) Assist in making informed decisions... enterprise zone vouchering services, (4) Active participation in local business resource centers (incubators...

Ongoing Data Collection for Measuring Child Progress.

ERIC Educational Resources Information Center

Stevens-Dominquez, Meave, Ed.; Stremel-Campbell, Kathleen, Ed.

Practical information is supplied that can be directly applied to early childhood projects and used for staff inservice in data collection procedures. This information assists in documenting the overall effectiveness of an approach and aids in making the frequent educational decisions to ensure the child is benefiting from instruction. Separate…

The Current Status Of The United States Foreign Military Sales (FMS) Program

DTIC Science & Technology

2004-06-01

changing domestic and global security environment. Strengths, Weaknesses, Opportunities and Threats ( SWOT ) analysis was used to analyze: the information...gathered from the literature review; the importance of various players (domestic and international competitors, interests groups , decision makers...Foreign military assistance, Gulf Wars, the September 11 incidents, Market share, Decision Makers, Interest Groups , Major West European suppliers group

Medical sieve: a cognitive assistant for radiologists and cardiologists

NASA Astrophysics Data System (ADS)

Syeda-Mahmood, T.; Walach, E.; Beymer, D.; Gilboa-Solomon, F.; Moradi, M.; Kisilev, P.; Kakrania, D.; Compas, C.; Wang, H.; Negahdar, R.; Cao, Y.; Baldwin, T.; Guo, Y.; Gur, Y.; Rajan, D.; Zlotnick, A.; Rabinovici-Cohen, S.; Ben-Ari, R.; Guy, Amit; Prasanna, P.; Morey, J.; Boyko, O.; Hashoul, S.

2016-03-01

Radiologists and cardiologists today have to view large amounts of imaging data relatively quickly leading to eye fatigue. Further, they have only limited access to clinical information relying mostly on their visual interpretation of imaging studies for their diagnostic decisions. In this paper, we present Medical Sieve, an automated cognitive assistant for radiologists and cardiologists designed to help in their clinical decision-making. The sieve is a clinical informatics system that collects clinical, textual and imaging data of patients from electronic health records systems. It then analyzes multimodal content to detect anomalies if any, and summarizes the patient record collecting all relevant information pertinent to a chief complaint. The results of anomaly detection are then fed into a reasoning engine which uses evidence from both patient-independent clinical knowledge and large-scale patient-driven similar patient statistics to arrive at potential differential diagnosis to help in clinical decision making. In compactly summarizing all relevant information to the clinician per chief complaint, the system still retains links to the raw data for detailed review providing holistic summaries of patient conditions. Results of clinical studies in the domains of cardiology and breast radiology have already shown the promise of the system in differential diagnosis and imaging studies summarization.

Big Data, Smart Homes and Ambient Assisted Living

PubMed Central

Wass, S.

2014-01-01

Summary Objectives To discuss how current research in the area of smart homes and ambient assisted living will be influenced by the use of big data. Methods A scoping review of literature published in scientific journals and conference proceedings was performed, focusing on smart homes, ambient assisted living and big data over the years 2011-2014. Results The health and social care market has lagged behind other markets when it comes to the introduction of innovative IT solutions and the market faces a number of challenges as the use of big data will increase. First, there is a need for a sustainable and trustful information chain where the needed information can be transferred from all producers to all consumers in a structured way. Second, there is a need for big data strategies and policies to manage the new situation where information is handled and transferred independently of the place of the expertise. Finally, there is a possibility to develop new and innovative business models for a market that supports cloud computing, social media, crowdsourcing etc. Conclusions The interdisciplinary area of big data, smart homes and ambient assisted living is no longer only of interest for IT developers, it is also of interest for decision makers as customers make more informed choices among today’s services. In the future it will be of importance to make information usable for managers and improve decision making, tailor smart home services based on big data, develop new business models, increase competition and identify policies to ensure privacy, security and liability. PMID:25123734

Helping patients make better decisions: how to apply behavioral economics in clinical practice

PubMed Central

Courtney, Maureen Reni; Spivey, Christy; Daniel, Kathy M

2014-01-01

Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE) is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients. PMID:25378915

36 CFR 230.37 - State priority plan-educational assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sessions; (8) Web site construction and maintenance; or (9) Similar activities designed to bring landowners to an informed decision point and accelerate adoption of sustainable forest practices in a State. (b...

36 CFR 230.37 - State priority plan-educational assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sessions; (8) Web site construction and maintenance; or (9) Similar activities designed to bring landowners to an informed decision point and accelerate adoption of sustainable forest practices in a State. (b...

36 CFR 230.37 - State priority plan-educational assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sessions; (8) Web site construction and maintenance; or (9) Similar activities designed to bring landowners to an informed decision point and accelerate adoption of sustainable forest practices in a State. (b...

7 CFR 1944.266 - Other Federal requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

24 CFR 700.175 - Other Federal requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

24 CFR 700.175 - Other Federal requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

7 CFR 1944.266 - Other Federal requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

24 CFR 700.175 - Other Federal requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

7 CFR 1944.266 - Other Federal requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

7 CFR 1944.266 - Other Federal requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... exercised any function or responsibilities with respect to activities assisted with CHSP grant funds, or who is in a position to participate in a decision-making process or gain inside information with regard...

Development of a Common User Interface for the Launch Decision Support System

NASA Technical Reports Server (NTRS)

Scholtz, Jean C.

1991-01-01

The Launch Decision Support System (LDSS) is software to be used by the NASA Test Director (NTD) in the firing room during countdown. This software is designed to assist the NTD with time management, that is, when to resume from a hold condition. This software will assist the NTD in making and evaluating alternate plans and will keep him advised of the existing situation. As such, the interface to this software must be designed to provide the maximum amount of information in the clearest fashion and in a timely manner. This research involves applying user interface guidelines to a mature prototype of LDSS and developing displays that will enable the users to easily and efficiently obtain information from the LDSS displays. This research also extends previous work on organizing and prioritizing human-computer interaction knowledge.

Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support.

PubMed

Xia, Eryu; Liu, Haifeng; Li, Jing; Mei, Jing; Li, Xuejun; Xu, Enliang; Li, Xiang; Hu, Gang; Xie, Guotong; Xu, Meilin

2017-01-01

Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.

Exploration of how women make treatment decisions after a breast cancer diagnosis.

PubMed

Spittler, Cheryl A; Pallikathayil, Leonie; Bott, Marjorie

2012-09-01

To examine the information needs of women after receiving a diagnosis of breast cancer, investigate how decisions about treatment options are made, and assess personal responses to the decisions made. Mixed-methods approach using quantitative and qualitative data. The University of Kansas Medical Center and Quinn Plastic Surgery Center, both in the midwestern United States. 102 breast cancer survivors who had completed all forms of treatment for at least three months and less than five years. Phase I participants completed five questionnaires about informational needs, confidence and satisfaction with the decision, decisional regret, and conflict. In phase II, 15 participants were purposively sampled from the 102 survivors to participate in a focus group session. Data analysis included frequencies and multiple regression for phase I and qualitative content analysis for phase II. Informational needs, confidence and satisfaction with the decision, and decisional regret and conflict. The variables (widowed, confidence and satisfaction with decision, and decisional conflict and regret) significantly (p = 0.01) accounted for 14% of the variance in informational needs. Two themes emerged from the study: (a) feelings, thoughts, and essential factors that impact treatment considerations, and (b) tips for enhancing treatment consideration options. The study's results show that women viewed informational needs as very important in making treatment decisions after being diagnosed with breast cancer. The treatment team should provide the information, with consideration of the patient's personal preferences, that will assist women to make informed, confident, and satisfied decisions about treatment choices.

Peer referencing in adolescent decision making as a function of perceived parenting style.

PubMed

Bednar, Dell Elaine; Fisher, Terri D

2003-01-01

This study examined the relationship between parenting style and adolescent decision making. Two hundred sixty-two college students completed a decision-making scale as well as a parenting scale in an effort to determine if the child-rearing style of their parents was related to the tendency of these late adolescents to reference peers rather than parents or other adults in decision making. The results indicated that adolescents raised by authoritative parents tended to refer to their parents for moral and informational decisions, while adolescents raised by authoritarian, permissive, or neglecting-rejecting parents more often referenced their peers for moral and informational decisions. Adolescents referred to their peers for social decisions regardless of how they were raised. Parental responsiveness was a significant factor in determining the source of adolescent decision-making assistance, but parental demandingness was not. It was concluded that less orientation toward peers during late adolescence seems to be another advantage of authoritative parenting.

Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

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

Feldman, D.L.; Dobson, J.E.

1990-08-01

This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

Computer modeling of human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

Models of human decision making are reviewed. Models which treat just the cognitive aspects of human behavior are included as well as models which include motivation. Both models which have associated computer programs, and those that do not, are considered. Since flow diagrams, that assist in constructing computer simulation of such models, were not generally available, such diagrams were constructed and are presented. The result provides a rich source of information, which can aid in construction of more realistic future simulations of human decision making.

Impact of a decision aid on surrogate decision-makers' perceptions of feeding options for patients with dementia.

PubMed

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

2013-02-01

In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates' perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Semistructured interview with prestudy and poststudy design for surrogates in the intervention group. Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Two hundred and fifty-five surrogate decision makers for nursing home residents with advanced dementia and feeding problems, in control (n = 129) and intervention (n = 126) groups. For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options, and the role of surrogates in making these decisions. The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true/false items and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the decisional conflict scale. Before the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical, and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs 16.8; P < .001), decreased expectation of benefits from tube feeding (2.73 vs 2.32; P = .001), and reduced decisional conflict (2.24 vs 1.91; P < .001). Surrogates preferred assisted oral feeding initially and reported more certainty about this choice after the decision aid. A structured decision aid can be used to improve decision making about feeding options in dementia care. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2012-01-01

Objective In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions feeding options, and to determine if a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Design Semi-structured interview with pre-post study design for surrogates in the intervention group. Setting Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Participants Two hundred fifty-five surrogate decision-makers for nursing home residents with advanced dementia and feeding problems, in control (n=129) and intervention (n=126) groups. Intervention For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options and the role of surrogates in making these decisions. Measurements The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true-false items, and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the Decisional Conflict Scale. Results Prior to the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs. 16.8; p<0.001), decreased expectation of benefits from tube feeding (2.73 vs. 2.32; p = 0.001) and reduced decisional conflict (2.24 vs. 1.91, p<0.001). Surrogates preferred assisted oral feeding initially, and reported more certainty about this choice after the decision aid. Conclusion A structured decision aid can be used to improve decision-making about feeding options in dementia care. PMID:23273855

Strategic analytics: towards fully embedding evidence in healthcare decision-making.

PubMed

Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

2015-01-01

Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

SOUTHWEST REGIONAL GAP ANALYSIS PROJECT: THE SECOND GENERATION

EPA Science Inventory

The project goal of providing useful information to the regional, state, and community stakeholders to assist them in understanding the environment, setting priorities, and making important decisions relative to conservation and sustainable resource management.

Effects of automation of information-processing functions on teamwork.

PubMed

Wright, Melanie C; Kaber, David B

2005-01-01

We investigated the effects of automation as applied to different stages of information processing on team performance in a complex decision-making task. Forty teams of 2 individuals performed a simulated Theater Defense Task. Four automation conditions were simulated with computer assistance applied to realistic combinations of information acquisition, information analysis, and decision selection functions across two levels of task difficulty. Multiple measures of team effectiveness and team coordination were used. Results indicated different forms of automation have different effects on teamwork. Compared with a baseline condition, an increase in automation of information acquisition led to an increase in the ratio of information transferred to information requested; an increase in automation of information analysis resulted in higher team coordination ratings; and automation of decision selection led to better team effectiveness under low levels of task difficulty but at the cost of higher workload. The results support the use of early and intermediate forms of automation related to acquisition and analysis of information in the design of team tasks. Decision-making automation may provide benefits in more limited contexts. Applications of this research include the design and evaluation of automation in team environments.

Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff.

PubMed

Del Río, M I; Shand, B; Bonati, P; Palma, A; Maldonado, A; Taboada, P; Nervi, F

2012-09-01

Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff. The present literature review examines the emotional impact of reduced oral intake as well as perceptions and attitudes toward assisted nutrition and hydration for terminally ill patients(1) at the end of life, among patients, family, and health care staff. We have identified the ways in which emotional and cultural factors influence decision-making about assisted nutrition and hydration. Lack of information and misperceptions of medically assisted nutrition and hydration can play a predominant role in the decision to begin or suspend nutritional or hydration support. Our literature review reveals that these social, emotional, and clinical misperception elements should be considered in the decision-making processes to help the triad develop functional forms of care at this final stage of life. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Computer-assisted abdominal surgery: new technologies.

PubMed

Kenngott, H G; Wagner, M; Nickel, F; Wekerle, A L; Preukschas, A; Apitz, M; Schulte, T; Rempel, R; Mietkowski, P; Wagner, F; Termer, A; Müller-Stich, Beat P

2015-04-01

Computer-assisted surgery is a wide field of technologies with the potential to enable the surgeon to improve efficiency and efficacy of diagnosis, treatment, and clinical management. This review provides an overview of the most important new technologies and their applications. A MEDLINE database search was performed revealing a total of 1702 references. All references were considered for information on six main topics, namely image guidance and navigation, robot-assisted surgery, human-machine interface, surgical processes and clinical pathways, computer-assisted surgical training, and clinical decision support. Further references were obtained through cross-referencing the bibliography cited in each work. Based on their respective field of expertise, the authors chose 64 publications relevant for the purpose of this review. Computer-assisted systems are increasingly used not only in experimental studies but also in clinical studies. Although computer-assisted abdominal surgery is still in its infancy, the number of studies is constantly increasing, and clinical studies start showing the benefits of computers used not only as tools of documentation and accounting but also for directly assisting surgeons during diagnosis and treatment of patients. Further developments in the field of clinical decision support even have the potential of causing a paradigm shift in how patients are diagnosed and treated.

Data to DecisionsTerminate, Tolerate, Transfer, or Treat

DTIC Science & Technology

2016-07-25

and patching, a risk-based cyber - security decision model that enables a pre- dictive capability to respond to impending cyber -attacks is needed...States. This sensitive data includes business proprietary information on key programs of record and infrastructure, including government documents at...leverage nationally. The Institute for Defense Analyses (IDA) assisted the DoD CIO in formalizing a proof of concept for cyber initiatives and

78 FR 3317 - Removal of Persons From the Entity List Based on Removal Request; Implementation of Entity List...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... the Entity List. The ERC's decision to remove these two persons took into account their cooperation... INFORMATION CONTACT: Karen Nies-Vogel, Chair, End-User Review Committee, Office of the Assistant Secretary..., Fax: (202) 482-3911, Email: [email protected] . SUPPLEMENTARY INFORMATION: Background The Entity List...

Great gulf wilderness use estimation: comparisons from 1976, 1989, and 1999

Treesearch

Chad P. Dawson; Mark Simon; Rebecca Oreskes; Gary Davis

2001-01-01

Wilderness visitor monitoring techniques can provide important baseline information on recreational use and assist managers in making recreation use management decisions. A demonstration project was conducted in the Great Gulf Wilderness using active infra-red beam type trail counters and brief on-site interviews to obtain information about visitor travel patterns,...

Designing Evaluations. 2012 Revision. Applied Research and Methods. GAO-12-208G

ERIC Educational Resources Information Center

US Government Accountability Office, 2012

2012-01-01

GAO assists congressional decision makers in their deliberations by furnishing them with analytical information on issues and options. Many diverse methodologies are needed to develop sound and timely answers to the questions the Congress asks. To provide GAO evaluators with basic information about the more commonly used methodologies, GAO's…

The duty of care: an update. Current legal principles.

PubMed

Fullbrook, Suzanne

2005-02-01

The author had a twofold purpose in writing this article: firstly to inform readers of the current legal principles that inform the duty of care, and secondly to discuss these principles with reference to two recent cases. Practitioners giving consideration to these issues will be assisted in their professional decision-making processes.

Annual Research Highlights, 1979-80. Alberta Education, September 1980.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Planning and Research Branch.

The Planning and Research Branch is a service branch of Alberta Education which provides information to planning and policy makers within Alberta Education to assist in making realistic decisions about educational directions and programs. This guide presents information about the operation of the Branch and reports in capsule form on a selection…

Aeronautical Satellite-Assisted Process for Information Exchange Through Network Technologies (Aero-SAPIENT) Conducted

NASA Technical Reports Server (NTRS)

Zernic, Michael J.

2002-01-01

Broadband satellite communications for aeronautics marries communication and network technologies to address NASA's goals in information technology base research and development, thereby serving the safety and capacity needs of the National Airspace System. This marriage of technology increases the interactivity between airborne vehicles and ground systems. It improves decision-making and efficiency, reduces operation costs, and improves the safety and capacity of the National Airspace System. To this end, a collaborative project called the Aeronautical Satellite Assisted Process for Information Exchange through Network Technologies, or Aero-SAPIENT, was conducted out of Tinker AFB, Oklahoma, during November and December 2000.

Resurfacing the care in nursing by telephone: lessons from ambulatory oncology.

PubMed

Wilson, Rosemary; Hubert, John

2002-01-01

The practice of providing telephone mediated advice and assistance is often described as "telephone triage" in relevant literature. The decision-making processes required for priority-setting and the provision of advice have been found to be complex and multifaceted. Conceptualization of this valuable patient care activity as a linear "triage" function serves to make invisible the nursing care provided. This article explores the current practice of providing telephone mediated advice and assistance in the following 2 distinct nursing care settings: emergency departments and ambulatory oncology centers. Examination of this activity in these 2 settings provides a forum to discuss and critique legally and fiscally driven prescriptive protocol use to inform decision-making. The effectiveness of experiential knowledge coupled with the strengths of nurse-patient relationships suggests that a need exists to highlight the caring aspects of telephone mediated assistance.

An ethical perspective on euthanasia and assisted suicide in The Netherlands from a nursing point of view.

PubMed

van der Arend, A J

1998-07-01

In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia or assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the 'slippery slope'.

Group Augmentation in Realistic Visual-Search Decisions via a Hybrid Brain-Computer Interface.

PubMed

Valeriani, Davide; Cinel, Caterina; Poli, Riccardo

2017-08-10

Groups have increased sensing and cognition capabilities that typically allow them to make better decisions. However, factors such as communication biases and time constraints can lead to less-than-optimal group decisions. In this study, we use a hybrid Brain-Computer Interface (hBCI) to improve the performance of groups undertaking a realistic visual-search task. Our hBCI extracts neural information from EEG signals and combines it with response times to build an estimate of the decision confidence. This is used to weigh individual responses, resulting in improved group decisions. We compare the performance of hBCI-assisted groups with the performance of non-BCI groups using standard majority voting, and non-BCI groups using weighted voting based on reported decision confidence. We also investigate the impact on group performance of a computer-mediated form of communication between members. Results across three experiments suggest that the hBCI provides significant advantages over non-BCI decision methods in all cases. We also found that our form of communication increases individual error rates by almost 50% compared to non-communicating observers, which also results in worse group performance. Communication also makes reported confidence uncorrelated with the decision correctness, thereby nullifying its value in weighing votes. In summary, best decisions are achieved by hBCI-assisted, non-communicating groups.

“The problem often is that we do not have a family spokesperson but a spokesgroup”: Family Member Informal Roles in End-of-Life Decision-Making in Adult ICUs

PubMed Central

Quinn, Jill R.; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A.; Dombeck, Mary T.; Sellers, Craig R.

2013-01-01

Background To support the process of effective family decision-making, it is important to recognize and understand informal roles various family members may play in the end-of-life decision-making process. Objective The purpose of this study was to describe some informal roles consistently enacted by family members involved in the process of end-of-life decision-making in intensive care units (ICUs). Methods Ethnographic study. Data were collected via participant observation with field notes and semi-structured interviews on four ICUs in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical ICU, a surgical ICU, a burn and trauma ICU, and a cardiovascular ICU. Participants Participants included health care clinicians, patients, and family members. Results Informal roles for family members consistently observed were:, Primary Caregiver, Primary Decision Maker, Family Spokesperson, Out-of-Towner, Patient Wishes Expert, Protector, Vulnerable Member, and Health Care Expert. The identified informal roles were part of family decision making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision-making within the family system, and between the family and health care domains. Conclusions These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these family member informal roles can assist clinicians to recognize and understand the functions of these roles in family decision making at the end-of-life, and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes. PMID:22210699

7 CFR 3430.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial assistance that provides support or stimulation to accomplish a public purpose. Awards may be..., curriculum development, instructional materials and equipment, and innovative teaching methodologies... knowledge and informal educational programs to people, enabling them to make practical decisions. Food and...

78 FR 44136 - Agency Information Collection Activities: Office of Biometric Identity Management (OBIM...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

..., state, and local law enforcement agencies; and the Intelligence Community to assist in the decisions..., US-VISIT expanded the collection of fingerprints from two prints to ten. The new collection time of...

Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

PubMed

Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

2018-04-20

Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

Automating Information Assurance for Cyber Situational Awareness within a Smart Cloud System of Systems

DTIC Science & Technology

2014-03-01

Humanitarian Assistance and Disaster Relief HTML HyperText Markup Language IA Information Assurance IAI Israel Aerospace Industries IASA Information ...decision maker at the Command and Control “mini cloud” was of upmost interest . This discussion not only confirmed the need to have information ...2) monitoring for specific cyber attacks on a specified system, (3) alerting information of interest to an operator, and finally (4) allowing the

Content Analysis of Social Media Related to Left Ventricular Assist Devices.

PubMed

Kostick, Kristin M; Blumenthal-Barby, Jennifer S; Wilhelms, Lidija A; Delgado, Estevan D; Bruce, Courtenay R

2015-09-01

Social media have the potential to offer important benefits for patient education, support, and shared decision making. Despite the proliferation of social media use during the past decade, little is known about the scope and quality of available information, or the purposes that social media sites serve for patient decisional and support needs. We conducted a mixed method study, including content analysis of social media and principal components analysis analysis of data sites discussing left ventricular assist device treatment for heart failure. This study explored aspects of interactivity, user-friendliness, appeal, medium, purpose, audience, and accuracy of information. Higher levels of interactivity (eg, posting comments) seem to enhance the appeal and usability of available information but also introduce greater potential for inaccuracy and inconsistency. The current lack of oversight into the content and quality of available information constitute a challenge for the reliable use of social media as forums for information-seeking and social network-based support. We conclude that social media outlets constitute a promising source of informational and psychosocial support for patients, caregivers, and candidates, and if used in conjunction with patient-provider dialog, can contribute to informed decision making by facilitating reflection and discussion of personal concerns, values, and informational needs. © 2015 American Heart Association, Inc.

Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance.

PubMed

Hall, Jennifer D; Harding, Rose L; DeVoe, Jennifer E; Gold, Rachel; Angier, Heather; Sumic, Aleksandra; Nelson, Christine A; Likumahuwa-Ackman, Sonja; Cohen, Deborah J

2017-06-23

Changes in health insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to insurance gaps. Electronic health records (EHRs) can automate processes for assisting patients with health insurance enrollment and re-enrollment. We describe community health centers' (CHC) workflow, documentation, and tracking needs for assisting families with insurance application processes, and the health information technology (IT) tool components that were developed to meet those needs. We conducted a qualitative study using semi-structured interviews and observation of clinic operations and insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Four steps to the insurance assistance workflow were common among CHCs: 1) Identifying patients for public health insurance application assistance; 2) Completing and submitting the public health insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking public health insurance approval to monitor for decisions; and 4) assisting with annual health insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. CHCs are uniquely positioned to help patients and families with public health insurance applications. CHCs have invested in staff to assist patients with insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based insurance tools need comprehensive, timely, and accurate health insurance information.

Shared decision-making in epilepsy management.

PubMed

Pickrell, W O; Elwyn, G; Smith, P E M

2015-06-01

Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

Many-objective Groundwater Monitoring Network Design Using Bias-Aware Ensemble Kalman Filtering and Evolutionary Optimization

NASA Astrophysics Data System (ADS)

Kollat, J. B.; Reed, P. M.

2009-12-01

This study contributes the ASSIST (Adaptive Strategies for Sampling in Space and Time) framework for improving long-term groundwater monitoring decisions across space and time while accounting for the influences of systematic model errors (or predictive bias). The ASSIST framework combines contaminant flow-and-transport modeling, bias-aware ensemble Kalman filtering (EnKF) and many-objective evolutionary optimization. Our goal in this work is to provide decision makers with a fuller understanding of the information tradeoffs they must confront when performing long-term groundwater monitoring network design. Our many-objective analysis considers up to 6 design objectives simultaneously and consequently synthesizes prior monitoring network design methodologies into a single, flexible framework. This study demonstrates the ASSIST framework using a tracer study conducted within a physical aquifer transport experimental tank located at the University of Vermont. The tank tracer experiment was extensively sampled to provide high resolution estimates of tracer plume behavior. The simulation component of the ASSIST framework consists of stochastic ensemble flow-and-transport predictions using ParFlow coupled with the Lagrangian SLIM transport model. The ParFlow and SLIM ensemble predictions are conditioned with tracer observations using a bias-aware EnKF. The EnKF allows decision makers to enhance plume transport predictions in space and time in the presence of uncertain and biased model predictions by conditioning them on uncertain measurement data. In this initial demonstration, the position and frequency of sampling were optimized to: (i) minimize monitoring cost, (ii) maximize information provided to the EnKF, (iii) minimize failure to detect the tracer, (iv) maximize the detection of tracer flux, (v) minimize error in quantifying tracer mass, and (vi) minimize error in quantifying the moment of the tracer plume. The results demonstrate that the many-objective problem formulation provides a tremendous amount of information for decision makers. Specifically our many-objective analysis highlights the limitations and potentially negative design consequences of traditional single and two-objective problem formulations. These consequences become apparent through visual exploration of high-dimensional tradeoffs and the identification of regions with interesting compromise solutions. The prediction characteristics of these compromise designs are explored in detail, as well as their implications for subsequent design decisions in both space and time.

The search and selection of assisted living facilities by elders and family.

PubMed

Castle, Nicholas G; Sonon, Kristen E

2007-08-01

In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living. Data were collected from 375 residents of 25 assisted living facilities matched with 375 family members. We conducted face-to-face interviews with the residents to determine: (1) the principal decision maker; (2) the process of searching for a facility; (3) the factors crucial to facility selection; (4) the time frame from the relocation decision to relocation; and (5) satisfaction with selection. Similar questions were asked of family members, using a mail survey. Residents described themselves as extremely influential in 39% of cases when searching for a facility, and in 27% of cases when selecting a facility. Quality, cost, and location were the most influential factors for both residents and family members in selecting a facility. Almost all residents and family would use different search and selection processes if they had to select a facility again, and almost all were dissatisfied with the sources of information available. Consumers and policy makers both favor the use of assisted living settings; but, the information available to choose a setting is far from ideal, and may represent a barrier to both consumer and policy makers' agendas.

Superfund Site Information

EPA Pesticide Factsheets

This asset includes a number of individual data sets related to site-specific information for Superfund, which is governed under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) of 1980, which was amended by the Superfund Amendments and Reauthorization Act (SARA) in 1986. The Superfund Enterprise Management System (SEMS) contains basic site description, location, schedule of activities, enforcement and settlement data, contaminants and selected remedy and much more, as well as the records that clearly document site decisions. This asset also includes sampling data and lab results (CLPSS, EDDs), redevelopment and technical assistance case studies, site reuse and land revitalization information, EPAOSC.net information, Superfund Technical Assistance Grants information, site management information records (RODs, Remediation plans, cleanup directives), contract management information, and more.Superfund site management information can also be found in agency wide systems such as EAS and COMPASS.

Operational Plan Ontology Model for Interconnection and Interoperability

NASA Astrophysics Data System (ADS)

Long, F.; Sun, Y. K.; Shi, H. Q.

2017-03-01

Aiming at the assistant decision-making system’s bottleneck of processing the operational plan data and information, this paper starts from the analysis of the problem of traditional expression and the technical advantage of ontology, and then it defines the elements of the operational plan ontology model and determines the basis of construction. Later, it builds up a semi-knowledge-level operational plan ontology model. Finally, it probes into the operational plan expression based on the operational plan ontology model and the usage of the application software. Thus, this paper has the theoretical significance and application value in the improvement of interconnection and interoperability of the operational plan among assistant decision-making systems.

Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

PubMed

Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

2005-10-01

The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

CAESAR : an expert system for evaluation of scour and stream stability

DOT National Transportation Integrated Search

1999-01-01

This report documents the development and testing of a field-deployable, knowledge-based decision support system that assists bridge inspectors by acquiring, cataloging, storing, and retrieving information necessary for the evaluation of a bridge for...

Computer-Assisted Pregnancy Management

PubMed Central

Haug, Peter J.; Hebertson, Richard M.; Heywood, Reed E.; Larkin, Ronald; Swapp, Craig; Waterfall, Brian; Warner, Homer R.

1987-01-01

A computer system under development for the management of pregnancy is described. This system exploits expert systems tools in the HELP Hospital Information System to direct the collection of clinical data and to generate medical decisions aimed at enhancing and standardizing prenatal care.

Towards a Framework for Making Effective Computational Choices: A "Very Big Idea" of Mathematics

ERIC Educational Resources Information Center

Hurst, Chris

2016-01-01

It is important for students to make informed decisions about computation. This article highlights this importance and develops a framework which may assist teachers to help students to make effective computational choices.

76 FR 27172 - Notice of Request for the Reinstatement of an Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... the bus the grantee is purchasing has been tested at the Center. Also, grantees about to purchase a bus use this report to assist them in making their purchasing decisions. PTI maintains a reference...

Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions

PubMed Central

Jibaja‐Weiss, Maria L.; Volk, Robert J.; Friedman, Lois C.; Granchi, Thomas S.; Neff, Nancy E.; Spann, Stephen J.; Robinson, Emily K.; Aoki, Noriaki; Robert Beck, J.

2006-01-01

Abstract Objective  To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design  Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample  Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention  A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes  Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results  Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions  A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. PMID:16911136

Models for Information Assurance Education and Outreach: A Report on Year 1 Implementation

ERIC Educational Resources Information Center

Wang, Jianjun

2013-01-01

On September 22, 2012, NSF announced its decision to fund a three-year project, "Models for Information Assurance Education and Outreach" (MIAEO). In the first year of grant operation, MIAEO has invited 18 high school students, two K-12 teachers, and two CSUB student assistants to conduct research explorations in the fields of…

Asset Management Plans, Appraisal Guidance for 2003-04.

ERIC Educational Resources Information Center

Department for Education and Skills, London (England).

This document is one in a series which aims to assist Local Authorities in Britain with asset management planning (AMPs) for schools. AMPs set out the information needed, and the criteria used, to make decisions about spending on school premises. The document provides guidance on the appraisal of school AMPs in 2002 to inform 3-year formulaic…

Transforming Higher Education and Student Engagement through Collaborative Review to Inform Educational Design

ERIC Educational Resources Information Center

von Konsky, Brian R.; Martin, Romana; Bolt, Susan; Broadley, Tania; Ostashewski, Nathaniel

2014-01-01

This paper reports on staff perceptions arising from a review process designed to assist staff in making informed decisions regarding educational design, approaches to engage students in learning, and the technology to support engagement in the classroom and across multiple locations and delivery modes. The aim of the review process was to…

Navy Information Dominance, the Battle of Midway, and the Joint Force Commander: It Worked Then, It Needs to Work Now

DTIC Science & Technology

2013-05-19

cyberspace, is putting increased emphasis on the need for the Joint Force Commander to employ his force to achieve Information Dominance . The information... Information Dominance is to assist in achieving Decision Superiority, Assured Command and Control, Battlespace Awareness, and Integrated Fires. Navy... Information Dominance aims to use information in cyberspace as a way and means in warfare -- as a battery in the Joint Force Commander’s arsenal. The

Parenting through genetic uncertainty: themes in the disclosure of breast cancer risk information to children.

PubMed

Sharff, McKane E; DeMarco, Tiffani A; Mays, Darren; Peshkin, Beth N; Valdimarsdottir, Heiddis B; Garber, Judy E; Schneider, Katherine A; Patenaude, Andrea F; Tercyak, Kenneth P

2012-05-01

Among mothers undergoing BRCA1/2 testing and their spouses/partners, this study sought to examine decision support needs and motivations for family communication of genetic risk information to asymptomatic children. This study gathered data from 213 tested mothers and 104 of their untested parenting partners 1 month after maternal receipt of genetic test results and upon making a decision about communicating genetic information to their child (ages 8-21 years). Data include parents' perceived needs for family communication decision support, decision motivations, and parent-child communication. Parents reported high decision support needs (e.g., educational materials, professional counseling, peer assistance). Motivations for disclosure to children among mothers and partners focused on promoting the parent-child bond and maintaining family health (55.3% and 75%, respectively) and promoting positive child affect (44.7% and 25.5%, respectively). Motivations for nondisclosure to children among mothers and partners focused on the lack of appropriateness (69.6% and 51.3%, respectively) and relative importance of genetic test results (30.4% and 48.7%, respectively). Significant discrepancies in parental motivation for family communication were observed. Decision support needs were highest among disclosing mothers with affect-related motivations [t (129)=2.47; p=0.01]. Parent-child communication was poorest among nondisclosing mothers concerned about the appropriateness of genetic information for their child [t (77)=-3.29; p=.002]. Parents receiving information about hereditary cancer predisposition have unmet needs when making decisions about disclosing genetic risk information to their asymptomatic children. These data can guide the development of cancer risk communication decision support interventions for parents undergoing such testing.

Modelling and Decision Support of Clinical Pathways

NASA Astrophysics Data System (ADS)

Gabriel, Roland; Lux, Thomas

The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

PubMed

Andrea Sullivan, E

2012-11-01

Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Providing Transparent Information to Empower Students' Decision Making and Develop Institutional Capacity

ERIC Educational Resources Information Center

Rodwell, Gary

2014-01-01

This chapter describes the University of Hawaii's work to develop an online navigational tool that helps students develop and execute their educational plans, and assists colleges with ensuring that they have the capacity to meet students' needs.

78 FR 22274 - Agency Information Collection Activities: Office of Biometric Identity Management (OBIM...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... intelligence community to assist in the decisions they make related to, and in support of, the homeland... prints to ten. The new collection time of 35 seconds, an increase from the previous 15 seconds, is a...

Clinical decision support tools: performance of personal digital assistant versus online drug information databases.

PubMed

Clauson, Kevin A; Polen, Hyla H; Marsh, Wallace A

2007-12-01

To evaluate personal digital assistant (PDA) drug information databases used to support clinical decision-making, and to compare the performance of PDA databases with their online versions. Prospective evaluation with descriptive analysis. Five drug information databases available for PDAs and online were evaluated according to their scope (inclusion of correct answers), completeness (on a 3-point scale), and ease of use; 158 question-answer pairs across 15 weighted categories of drug information essential to health care professionals were used to evaluate these databases. An overall composite score integrating these three measures was then calculated. Scores for the PDA databases and for each PDA-online pair were compared. Among the PDA databases, composite rankings, from highest to lowest, were as follows: Lexi-Drugs, Clinical Pharmacology OnHand, Epocrates Rx Pro, mobileMicromedex (now called Thomson Clinical Xpert), and Epocrates Rx free version. When we compared database pairs, online databases that had greater scope than their PDA counterparts were Clinical Pharmacology (137 vs 100 answers, p<0.001), Micromedex (132 vs 96 answers, p<0.001), Lexi-Comp Online (131 vs 119 answers, p<0.001), and Epocrates Online Premium (103 vs 98 answers, p=0.001). Only Micromedex online was more complete than its PDA version (p=0.008). Regarding ease of use, the Lexi-Drugs PDA database was superior to Lexi-Comp Online (p<0.001); however, Epocrates Online Premium, Epocrates Online Free, and Micromedex online were easier to use than their PDA counterparts (p<0.001). In terms of composite scores, only the online versions of Clinical Pharmacology and Micromedex demonstrated superiority over their PDA versions (p>0.01). Online and PDA drug information databases assist practitioners in improving their clinical decision-making. Lexi-Drugs performed significantly better than all of the other PDA databases evaluated. No PDA database demonstrated superiority to its online counterpart; however, the online versions of Clinical Pharmacology and Micromedex were superior to their PDA versions in answering questions.

WWC Review of the Report "The Role of Application Assistance and Information in College Decisions: Results from the H&R Block FAFSA Experiment." What Works Clearinghouse Single Study Review

ERIC Educational Resources Information Center

What Works Clearinghouse, 2013

2013-01-01

In this study, the authors examined the impact of two interventions related to the Free Application for Federal Student Aid (FAFSA) on postsecondary outcomes of low- to moderate-income individuals. The two interventions were included: (1) providing an estimate of need-based aid compared against tuition costs for nearby colleges and assistance in…

The online community based decision making support system for mitigating biased decision making

NASA Astrophysics Data System (ADS)

Kang, Sunghyun; Seo, Jiwan; Choi, Seungjin; Kim, Junho; Han, Sangyong

2016-10-01

As the Internet technology and social media advance, various information and opinions are shared and distributed through the online communities. However, the existence of implicit and explicit bias of opinions may have a potential influence on the outcomes. Compared to the importance of mitigating biased information, the study in this field is relatively young and does not address many important issues. In this paper we propose the noble approach to mitigate the biased opinions using conventional machine learning methods. The proposed method extracts the useful features such as inclination and sentiment of the community members. They are classified based on their previous behavior, and the propensity of the members is understood. This information on each community and its members is very useful and improve the ability to make an unbiased decision. The proposed method presented in this paper is shown to have the ability to assist optimal, fair and good decision making while also reducing the influence of implicit bias.

Using Decision Analysis to Select Facility Maintenance Management Information Systems

DTIC Science & Technology

2010-03-01

efficient way possible. Many of today’s maintenance managers thus apply computerized tools that come in the form of information systems that assist in... apply to effectively select a maintenance management information system that enables them to meet the needs of their customers. 3 1.2 Background...recession of the early 1990s. During this time, companies downsized their white-collar workforce performing daily operation and maintenance functions

Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet.

PubMed

Raynes-Greenow, Camille H; Nassar, Natasha; Torvaldsen, Siranda; Trevena, Lyndal; Roberts, Christine L

2010-04-08

Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, > or = 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making) and behavioural outcomes (intention and analgesia use) to assess the impact of the decision aid, which were assessed before labour. 596 women were randomised (395 decision aid group, 201 pamphlet group). There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40). There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07), or anxiety (mean difference 0.3, 95% CI -2.15, 1.50). The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95). There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial registration no: ISRCTN52287533.

Computerized Decision Support System Improves Fluid Resuscitation Outcomes Following Severe Burns: An Original Study

DTIC Science & Technology

2011-01-01

clinical decision- making paradigms, coupled with regula- tory and technical limitations, is just one of the hurdles that has kept advanced information...responses to assist care personnel during the resuscitation phase. CDSSs have been successfully used in the clinical setting for several years (23–24...because of clinical complications, death, or other factors were excluded. The control cohort included only patients who sur- vived for the initial 24

Decision-making style, nicotine and caffeine use and dependence.

PubMed

Phillips, James G; Ogeil, Rowan P

2015-11-01

As therapeutic interventions are being developed utilising telehealth and mobile phones, it is important to understand how substance-dependent individuals will respond to offers of online assistance. The present paper considered the following: (1) how decision-making style is associated with use and dependence upon commonly used stimulants and (2) how it influences behavioural responses to electronic offers of further information about these drugs. An online survey examined patterns of nicotine and caffeine use, administered Severity of Dependence Scales for caffeine and nicotine and assessed decision-making style using the Melbourne Decision Making Questionnaire and mood using the Kessler Distress Scale. Upon completing these scales, the 181 participants with a mean age of 28.14 years were offered further information online. Stimulant dependence was associated with psychological distress. Caffeine dependence was linked to hypervigilance (panic). Decisional self-esteem varied with stimulant dependence and Kessler Distress Scale score. Participants with high decisional self-esteem declined electronic offers of further information. Confidence rather than defensive avoidance was a factor in reducing information-seeking behaviours on the Internet. Copyright © 2015 John Wiley & Sons, Ltd.

Soil moisture monitoring for crop management

NASA Astrophysics Data System (ADS)

Boyd, Dale

2015-07-01

The 'Risk management through soil moisture monitoring' project has demonstrated the capability of current technology to remotely monitor and communicate real time soil moisture data. The project investigated whether capacitance probes would assist making informed pre- and in-crop decisions. Crop potential and cropping inputs are increasingly being subject to greater instability and uncertainty due to seasonal variability. In a targeted survey of those who received regular correspondence from the Department of Primary Industries it was found that i) 50% of the audience found the information generated relevant for them and less than 10% indicted with was not relevant; ii) 85% have improved their knowledge/ability to assess soil moisture compared to prior to the project, with the most used indicator of soil moisture still being rain fall records; and iii) 100% have indicated they will continue to use some form of the technology to monitor soil moisture levels in the future. It is hoped that continued access to this information will assist informed input decisions. This will minimise inputs in low decile years with a low soil moisture base and maximise yield potential in more favourable conditions based on soil moisture and positive seasonal forecasts

EPA Issues November 15, 2010 Memorandum: Integrated Reporting and Listing Decisions Related to Ocean Acidification

EPA Pesticide Factsheets

The memorandum provides information to assist regions and states in preparing and reviewing Integrated Reports related to ocean acidification (OA) impacts under Sections 303(d), 305(b) and 314 of the Clean Water Act (CWA).

75 FR 10809 - Agency Information Collection Activities: United States Visitor and Immigrant Status Indicator...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... intelligence community to assist in the decisions they make related to, and in support of, the homeland... prints to ten. The new collection time of 35 seconds, an increase from the previous 15 seconds, is a...

Introduction to the Community-Focused Exposure and Risk Screening Tool (C-FERST)

EPA Pesticide Factsheets

EPA scientists are working partners to design and test the Community-Focused Exposure and Risk Screening Tool (C-FERST), a community mapping, information access, and assessment tool to help assess risk and assist in decision making with communities

Complex Decision-Making in Heart Failure: A Systematic Review and Thematic Analysis.

PubMed

Hamel, Aimee V; Gaugler, Joseph E; Porta, Carolyn M; Hadidi, Niloufar Niakosari

Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making. The specific aims of this review are to examine complex treatment decision-making, specifically implantable cardiac defibrillators, ventricular assist device, and cardiac transplantation, and to recognize commonalities and key points in the decisional process. MEDLINE, CINAHL, PsycINFO, and Web of Science were searched for English-language studies that included qualitative findings reflecting the complexity of heart failure decision-making. Using a 3-step process, findings were synthesized into themes and subthemes. Twelve articles met criteria for inclusion. Participants included patients, caregivers, and clinicians and included decisions to undergo and decline treatment. Emergent themes were "processing the decision," "timing and prognostication," and "considering the future." Subthemes described how participants received and understood information about the therapy, making and changing a treatment decision, timing their decision and gauging health status outcomes in the context of their decision, the influence of a life or death decision, and the future as a factor in their decisional process. Commonalities were present across therapies, which involved the timing of discussions, the delivery of information, and considerations of the future. Exploring this further could help support patient-centered care and optimize shared decision-making interventions.

Euthanasia and assisted suicide in Dutch hospitals: the role of nurses.

PubMed

van Bruchem-van de Scheur, G G; van der Arend, Arie J G; Huijer Abu-Saad, Huda; van Wijmen, Frans C B; Spreeuwenberg, Cor; Ter Meulen, Ruud H J

2008-06-01

To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions. Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes. A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76.9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows. In almost half of the cases (45.1%), the nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultations between physicians and nurses quite often took place (78.8%). In several cases (15.4%), nurses themselves administered the euthanatics with or without a physician. It is not self-evident that hospitals have guidelines concerning euthanasia/physician-assisted suicide. In the decision-making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings. Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician-assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician-assisted suicide, especially in case these practices should become legalised.

A Decision Support System for Evaluating and Selecting Information Systems Projects

NASA Astrophysics Data System (ADS)

Deng, Hepu; Wibowo, Santoso

2009-01-01

This chapter presents a decision support system (DSS) for effectively solving the information systems (IS) project selection problem. The proposed DSS recognizes the multidimensional nature of the IS project selection problem, the availability of multicriteria analysis (MA) methods, and the preferences of the decision-maker (DM) on the use of specific MA methods in a given situation. A knowledge base consisting of IF-THEN production rules is developed for assisting the DM with a systematic adoption of the most appropriate method with the efficient use of the powerful reasoning and explanation capabilities of intelligent DSS. The idea of letting the problem to be solved determines the method to be used is incorporated into the proposed DSS. As a result, effective decisions can be made for solving the IS project selection problem. An example is presented to demonstrate the applicability of the proposed DSS for solving the problem of selecting IS projects in real world situations.

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.

Modified Navigation Instructions for Spatial Navigation Assistance Systems Lead to Incidental Spatial Learning

PubMed Central

Gramann, Klaus; Hoepner, Paul; Karrer-Gauss, Katja

2017-01-01

Spatial cognitive skills deteriorate with the increasing use of automated GPS navigation and a general decrease in the ability to orient in space might have further impact on independence, autonomy, and quality of life. In the present study we investigate whether modified navigation instructions support incidental spatial knowledge acquisition. A virtual driving environment was used to examine the impact of modified navigation instructions on spatial learning while using a GPS navigation assistance system. Participants navigated through a simulated urban and suburban environment, using navigation support to reach their destination. Driving performance as well as spatial learning was thereby assessed. Three navigation instruction conditions were tested: (i) a control group that was provided with classical navigation instructions at decision points, and two other groups that received navigation instructions at decision points including either (ii) additional irrelevant information about landmarks or (iii) additional personally relevant information (i.e., individual preferences regarding food, hobbies, etc.), associated with landmarks. Driving performance revealed no differences between navigation instructions. Significant improvements were observed in both modified navigation instruction conditions on three different measures of spatial learning and memory: subsequent navigation of the initial route without navigation assistance, landmark recognition, and sketch map drawing. Future navigation assistance systems could incorporate modified instructions to promote incidental spatial learning and to foster more general spatial cognitive abilities. Such systems might extend mobility across the lifespan. PMID:28243219

Expertise Development With Different Types of Automation: A Function of Different Cognitive Abilities.

PubMed

Jipp, Meike

2016-02-01

I explored whether different cognitive abilities (information-processing ability, working-memory capacity) are needed for expertise development when different types of automation (information vs. decision automation) are employed. It is well documented that expertise development and the employment of automation lead to improved performance. Here, it is argued that a learner's ability to reason about an activity may be hindered by the employment of information automation. Additional feedback needs to be processed, thus increasing the load on working memory and decelerating expertise development. By contrast, the employment of decision automation may stimulate reasoning, increase the initial load on information-processing ability, and accelerate expertise development. Authors of past research have not investigated the interrelations between automation assistance, individual differences, and expertise development. Sixty-one naive learners controlled simulated air traffic with two types of automation: information automation and decision automation. Their performance was captured across 16 trials. Well-established tests were used to assess information-processing ability and working-memory capacity. As expected, learners' performance benefited from expertise development and decision automation. Furthermore, individual differences moderated the effect of the type of automation on expertise development: The employment of only information automation increased the load on working memory during later expertise development. The employment of decision automation initially increased the need to process information. These findings highlight the importance of considering individual differences and expertise development when investigating human-automation interaction. The results are relevant for selecting automation configurations for expertise development. © 2015, Human Factors and Ergonomics Society.

Large-Diameter Sewer Rehabilitation Using a Spray-Applied Fiber-Reinforced Geopolymer Mortar

EPA Science Inventory

In order to assist the utilities in making well informed maintenance decisions, the U.S. Environmental Protection Agency (EPA) has developed an innovative technology demonstration program to evaluate technologies that have the potential to reduce costs and increase the effectiven...

The Multi-Sector Sustainability Browser (MSSB): A Tool for Understanding Sustainability

EPA Science Inventory

The MSSB is the first and only decision support tool containing information from scientific literature and technical reports that can be used to develop and implement sustainability initiatives. The MSSB is designed to assist individuals and communities in understanding the impa...

Developing and Applying Synthesis Models of Emerging Space Systems

DTIC Science & Technology

2016-03-01

enables the exploration of small satellite physical trade -offs early in the conceptual design phase of the DOD space acquisition process. Early...provide trade space insights that can assist DOD space acquisition professionals in making better decisions in the conceptual design phase. More informed

Brownfields Assessing Contractor Capabilities for Streamlined Site Investigation: Additional Information Regarding All Appropriate Inquiries and Hiring an Environmental Professional

EPA Pesticide Factsheets

This document assists Brownfields grantees and other decision makers as they assess the capabilities of contractors and consultants to determine their qualifications to provide streamlined and innovative strategies for the assessment and and cleanup.

When withdrawal of life-sustaining care does more than allow death to take its course: the dilemma of left ventricular assist devices.

PubMed

Bramstedt, K A; Wenger, N S

2001-05-01

Left ventricular assist devices (LVADs) are a relatively new technology that is increasingly used to preserve cardiac function. These devices work by a mechanism that may complicate ethical decision-making for patients who subsequently lose decision-making capacity and are no longer considered transplant candidates. Using a clinical case from our medical center, we explored the complex ethical issues associated with the discontinuation of LVAD therapy by discussing how this device is distinct from the withdrawal of other treatments. While halting an implanted LVAD may permit a patient to die, the deactivated device itself may contribute to patient death due to the potential for blood backflow and pooling, as well as the disruption of heart contractility. Inadequate informed consent and failure to appoint a surrogate decision-maker in advance of the implant procedure resulted in a complex ethical dilemma for the patient's family and the medical team. Clinicians and families must consider the benefits and burdens of LVAD therapy as they do when considering removal of other life-sustaining treatment. The informed consent process associated with LVADs as bridging technology should include extensive consideration of the purpose of the device, future circumstances in which it may be halted, and how such situations would be recognized and handled. Appointment of a surrogate decision-maker before the surgical procedure is essential.

[A return on investment tool in tobacco control: what do stakeholders think?].

PubMed

Muñoz, Celia; Trapero-Bertran, Marta; Cheung, Kei Long; Evers, Silvia; Hiligsmann, Mickaël; de Vries, Hein; López-Nicolás, Ángel

2016-01-01

The European EQUIPT study will co-create a return on investment tool in several countries, aiming to provide decision makers with information and justification on the returns that can be generated by investing in tobacco control. This study aimed to identify the needs of potential users in Spain in order to provide information on the transferability of the tool. Telephone interviews with stakeholders were conducted including questions about the implementation of the tool, intended use and tobacco control interventions. Implementing the tool could provide added value to the information used in decision-making to advocate for cost-effective policies. The main drawback would be the training and time needed to learn how the tool works and for internal calculations. Knowledge and ideas from potential users collected in this study could inform the EQUIPT Tool adaptation. Thus, stakeholders could have an instrument that assists them on making healthcare decisions. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Conserving analyst attention units: use of multi-agent software and CEP methods to assist information analysis

NASA Astrophysics Data System (ADS)

Rimland, Jeffrey; McNeese, Michael; Hall, David

2013-05-01

Although the capability of computer-based artificial intelligence techniques for decision-making and situational awareness has seen notable improvement over the last several decades, the current state-of-the-art still falls short of creating computer systems capable of autonomously making complex decisions and judgments in many domains where data is nuanced and accountability is high. However, there is a great deal of potential for hybrid systems in which software applications augment human capabilities by focusing the analyst's attention to relevant information elements based on both a priori knowledge of the analyst's goals and the processing/correlation of a series of data streams too numerous and heterogeneous for the analyst to digest without assistance. Researchers at Penn State University are exploring ways in which an information framework influenced by Klein's (Recognition Primed Decision) RPD model, Endsley's model of situational awareness, and the Joint Directors of Laboratories (JDL) data fusion process model can be implemented through a novel combination of Complex Event Processing (CEP) and Multi-Agent Software (MAS). Though originally designed for stock market and financial applications, the high performance data-driven nature of CEP techniques provide a natural compliment to the proven capabilities of MAS systems for modeling naturalistic decision-making, performing process adjudication, and optimizing networked processing and cognition via the use of "mobile agents." This paper addresses the challenges and opportunities of such a framework for augmenting human observational capability as well as enabling the ability to perform collaborative context-aware reasoning in both human teams and hybrid human / software agent teams.

Does need matter? Needs assessments and decision-making among major humanitarian health agencies.

PubMed

Gerdin, Martin; Chataigner, Patrice; Tax, Leonie; Kubai, Anne; von Schreeb, Johan

2014-07-01

Disasters of physical origin, including earthquakes, floods, landslides, tidal waves, tropical storms, tsunamis, and volcanic eruptions, have affected millions of people globally over the past 100 years. Proportionately, there is far greater likelihood of being affected by such disasters in low-income countries than in high-income countries. Furthermore, low-income countries are in need of international assistance following disasters more often than high-income countries. The funding of international humanitarian assistance has increased from USD 12.9 billion in 2006 to an estimated USD 16.7 billion in 2010. The majority of this funding is channelled through humanitarian agencies and is supposed to be distributed based on the need of those affected, as assessed using needs assessments. Such needs assessments may be used to inform decisions internally, to influence others, to justify response decisions, and to obtain funding. Little is known about the quality of needs assessments in practical applications. Consequently, this paper reports on and analyses the views of operational decision-makers in major health-related humanitarian agencies on needs assessments. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs.

PubMed

Dexter, F

2000-10-01

We examined how to program an operating room (OR) information system to assist the OR manager in deciding whether to move the last case of the day in one OR to another OR that is empty to decrease overtime labor costs. We first developed a statistical strategy to predict whether moving the case would decrease overtime labor costs for first shift nurses and anesthesia providers. The strategy was based on using historical case duration data stored in a surgical services information system. Second, we estimated the incremental overtime labor costs achieved if our strategy was used for moving cases versus movement of cases by an OR manager who knew in advance exactly how long each case would last. We found that if our strategy was used to decide whether to move cases, then depending on parameter values, only 2.0 to 4.3 more min of overtime would be required per case than if the OR manager had perfect retrospective knowledge of case durations. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays, can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved.

In-hospital experiences of families of potential organ donors: A systematic review and qualitative synthesis

PubMed Central

Dicks, Sean Glenton; Ranse, Kristen; van Haren, Frank MP; Boer, Douglas P

2017-01-01

Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences. PMID:28680696

Awareness of pharmaceutical cost-assistance programs among inner-city seniors.

PubMed

Federman, Alex D; Safran, Dana Gelb; Keyhani, Salomeh; Cole, Helen; Halm, Ethan A; Siu, Albert L

2009-04-01

Lack of awareness may be a significant barrier to participation by low- and middle-income seniors in pharmaceutical cost-assistance programs. The goal of this study was to determine whether older adults' awareness of 2 major state and federal pharmaceutical cost-assistance programs was associated with the seniors' ability to access and process information about assistance programs. Data were gathered from a cross-sectional study of independently living, English- or Spanish-speaking adults aged > or =60 years. Participants were interviewed in 30 community-based settings (19 apartment complexes and 11 senior centers) in New York, New York. The analysis focused on adults aged > or =65 years who lacked Medicaid coverage. Multivariable logistic regression was used to model program awareness as a function of information access (family/social support, attendance at senior or community centers and places of worship, viewing of live health insurance presentations, instrumental activities of daily living, site of medical care, computer use, and having a proxy decision maker for health insurance matters) and information-processing ability (education level, English proficiency, health literacy, and cognitive function). The main outcome measure was awareness of New York's state pharmaceutical assistance program (Elderly Pharmaceutical Insurance Coverage [EPIC

The Development and Implementation of an Integrated Career Education and Placement Program For the Washington State System of Community Colleges.

ERIC Educational Resources Information Center

Marble, James E.; And Others

The community colleges in the state of Washington are committed to a Six Year Plan to provide computing and information systems support to all students. The system is intended to make available a broad range of career placement information to assist decision-making, thereby humanizing education by insuring fewer misguided students, counselors and…

"Using Data" to Inform Decisions: How Teachers Use Data to Inform Practice and Improve Student Performance in Mathematics. Results from a Randomized Experiment of Program Efficacy

ERIC Educational Resources Information Center

Cavalluzzo, Linda; Geraghty, Thomas M.; Steele, Jennifer L.; Holian, Laura; Jenkins, Frank; Alexander, Jane M.; Yamasaki, Kelsey Y.

2014-01-01

The purpose of this study is to evaluate, using a randomized experimental design, the efficacy of TERC's "Using Data" program to change teacher behavior and improve student learning outcomes. The "Using Data" intervention provides professional development and technical assistance to teachers to help them use data…

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

PubMed Central

2013-01-01

Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. Results All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running. Conclusions Community practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions. PMID:24351420

Building a SEM Analytics Reporting Portfolio

ERIC Educational Resources Information Center

Goff, Jay W.; Williams, Brian G.; Kilgore, Wendy

2016-01-01

Effective strategic enrollment management (SEM) efforts require vast amounts of internal and external data to ensure that meaningful reporting and analysis systems can assist managers in decision making. A wide range of information is integral for leading effective and efficient student recruitment and retention programs. This article is designed…

Considerations for the implementation and operation of stormwater control measure (SCM) performance monitoring systems

EPA Science Inventory

Green infrastructure (GI) studies are needed to make informed decisions about whether or not to select GI technologies over traditional urban drainage control methods and to assist in the timing of effective maintenance. Two permeable pavement infiltration stormwater control meas...

24 CFR 92.356 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... functions or responsibilities with respect to activities assisted with HOME funds or who are in a position to participate in a decision-making process or gain inside information with regard to these... affected person has withdrawn from his or her functions or responsibilities, or the decisionmaking process...

24 CFR 511.12 - Conflicts of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... administrative functions in the RRP) that receives rental rehabilitation grant amounts and who exercises or has exercised any functions or responsibilities with respect to assisted rehabilitation activities, or who is in a position to participate in a decision-making process or gain inside information with regard to...

24 CFR 574.625 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities, may obtain a... the affected person has withdrawn from his or her functions or responsibilities, or the decisionmaking...

24 CFR 511.12 - Conflicts of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... administrative functions in the RRP) that receives rental rehabilitation grant amounts and who exercises or has exercised any functions or responsibilities with respect to assisted rehabilitation activities, or who is in a position to participate in a decision-making process or gain inside information with regard to...

24 CFR 574.625 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities, may obtain a... the affected person has withdrawn from his or her functions or responsibilities, or the decisionmaking...

24 CFR 574.625 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities, may obtain a... the affected person has withdrawn from his or her functions or responsibilities, or the decisionmaking...

24 CFR 511.12 - Conflicts of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... administrative functions in the RRP) that receives rental rehabilitation grant amounts and who exercises or has exercised any functions or responsibilities with respect to assisted rehabilitation activities, or who is in a position to participate in a decision-making process or gain inside information with regard to...

24 CFR 511.12 - Conflicts of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... administrative functions in the RRP) that receives rental rehabilitation grant amounts and who exercises or has exercised any functions or responsibilities with respect to assisted rehabilitation activities, or who is in a position to participate in a decision-making process or gain inside information with regard to...

24 CFR 574.625 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities, may obtain a... the affected person has withdrawn from his or her functions or responsibilities, or the decisionmaking...

Show Me the Data: Kristin Eschenfelder--University of Wisconsin-Madison

ERIC Educational Resources Information Center

Library Journal, 2005

2005-01-01

Many librarians have been concerned with the unintended consequences of new technologies, but Kristin Eschenfelder--librarian, scholar, and social scientist--gathers the data to enable rational policy decisions about technology's ramifications. As assistant professor in the School of Library and Information Studies at University of…

Waste in Place Elementary Curriculum Guide.

ERIC Educational Resources Information Center

Keep America Beautiful, Inc., Stamford, CT.

This curriculum guide is a behavioral-based, systematic approach to changing attitudes and practices related to waste handling. Activities included are on litter prevention, waste reduction, reuse, recycling, composting, waste-to-energy, and landfill. These activities are used to assist students in making informed decisions about waste disposal…

Merged GIS, GPS data assist siting for gulf gas line

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

Scott, D.R.; Schmidt, J.A.

1998-06-29

A GIS-based decision-support system was developed for a US Gulf of Mexico onshore and offshore pipeline that has assisted in locating a cost-effective pipeline route based on landcover type, wetland distribution, and proximity to other environmentally sensitive resources. Described here are the methods used to integrate various sources of available GIS data with satellite imagery and surveyed information. Costs of collecting and processing these data are compared with benefits of the system over use of manual methods.

Develop a Prototype Personal Health Record Application (PHR-A) that Captures Information About Daily Living Important for Diabetes and Provides Decision Support with Actionable Advice for Diabetes Self Care

DTIC Science & Technology

2014-10-01

designed an Internet-based and mobile application (software) to assist with the following domains pertinent to diabetes self-management: 1...management that provides education, reminders, and support. The new tool is an internet-based and mobile application (software), now called Tracking...is mobile , provides decision support with actionable options, and is based on user input, will enhance diabetes self-care, improve glycemic control

Software for rapid prototyping in the pharmaceutical and biotechnology industries.

PubMed

Kappler, Michael A

2008-05-01

The automation of drug discovery methods continues to develop, especially techniques that process information, represent workflow and facilitate decision-making. The magnitude of data and the plethora of questions in pharmaceutical and biotechnology research give rise to the need for rapid prototyping software. This review describes the advantages and disadvantages of three solutions: Competitive Workflow, Taverna and Pipeline Pilot. Each of these systems processes large amounts of data, integrates diverse systems and assists novice programmers and human experts in critical decision-making steps.

Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda

PubMed Central

Kabakyenga, Jerome K.; Östergren, Per-Olof; Turyakira, Eleanor; Pettersson, Karen Odberg

2012-01-01

Introduction Assistance by skilled birth attendants (SBAs) during childbirth is one of the strategies aimed at reducing maternal morbidity and mortality in low-income countries. However, the relationship between birth preparedness and decision-making on location of birth and assistance by skilled birth attendants in this context is not well studied. The aim of this study was to assess the influence of birth preparedness practices and decision-making and assistance by SBAs among women in south-western Uganda. Methods Community survey methods were used to identify 759 recently delivered women from 120 villages in rural Mbarara district. Interviewer-administered questionnaires were used to collect data. Logistic regression analyses were conducted to assess the relationship between birth preparedness, decision-making on location of birth and assistance by SBAs. Results 35% of the women had been prepared for childbirth and the prevalence of assistance by SBAs in the sample was 68%. The final decision regarding location of birth was made by the woman herself (36%), the woman with spouse (56%) and the woman with relative/friend (8%). The relationships between birth preparedness and women decision-making on location of birth in consultation with spouse/friends/relatives and choosing assistance by SBAs showed statistical significance which persisted after adjusting for possible confounders (OR 1.5, 95% CI: 1.0–2.4) and (OR 4.4, 95% CI: 3.0–6.7) respectively. Education, household assets and birth preparedness showed clear synergistic effect on the relationship between decision-maker on location of birth and assistance by SBAs. Other factors which showed statistical significant relationships with assistance by SBAs were ANC attendance, parity and residence. Conclusion Women’s decision-making on location of birth in consultation with spouse/friends/relatives and birth preparedness showed significant effect on choosing assistance by SBAs at birth. Education and household assets ownership showed a synergistic effect on the relationship between the decision-maker and assistance by SBAs. PMID:22558214

Upper Colorado River Basin Climate Effects Network

USGS Publications Warehouse

Belnap, Jayne; Campbell, Donald; Kershner, Jeff

2011-01-01

The Upper Colorado River Basin (UCRB) Climate Effects Network (CEN) is a science team established to provide information to assist land managers in future decision making processes by providing a better understanding of how future climate change, land use, invasive species, altered fire cycles, human systems, and the interactions among these factors will affect ecosystems and the services they provide to human communities. The goals of this group are to (1) identify science needs and provide tools to assist land managers in addressing these needs, (2) provide a Web site where users can access information pertinent to this region, and (3) provide managers technical assistance when needed. Answers to the team's working science questions are intended to address how interactions among climate change, land use, and management practices may affect key aspects of water availability, ecosystem changes, and societal needs within the UCRB.

Nanotoxicology and nanomedicine: making development decisions in an evolving governance environment

NASA Astrophysics Data System (ADS)

Rycroft, Taylor; Trump, Benjamin; Poinsatte-Jones, Kelsey; Linkov, Igor

2018-02-01

The fields of nanomedicine, risk analysis, and decision science have evolved considerably in the past decade, providing developers of nano-enabled therapies and diagnostic tools with more complete information than ever before and shifting a fundamental requisite of the nanomedical community from the need for more information about nanomaterials to the need for a streamlined method of integrating the abundance of nano-specific information into higher-certainty product design decisions. The crucial question facing nanomedicine developers that must select the optimal nanotechnology in a given situation has shifted from "how do we estimate nanomaterial risk in the absence of good risk data?" to "how can we derive a holistic characterization of the risks and benefits that a given nanomaterial may pose within a specific nanomedical application?" Many decision support frameworks have been proposed to assist with this inquiry; however, those based in multicriteria decision analysis have proven to be most adaptive in the rapidly evolving field of nanomedicine—from the early stages of the field when conditions of significant uncertainty and incomplete information dominated, to today when nanotoxicology and nano-environmental health and safety information is abundant but foundational paradigms such as chemical risk assessment, risk governance, life cycle assessment, safety-by-design, and stakeholder engagement are undergoing substantial reformation in an effort to address the needs of emerging technologies. In this paper, we reflect upon 10 years of developments in nanomedical engineering and demonstrate how the rich knowledgebase of nano-focused toxicological and risk assessment information developed over the last decade enhances the capability of multicriteria decision analysis approaches and underscores the need to continue the transition from traditional risk assessment towards risk-based decision-making and alternatives-based governance for emerging technologies.

Assessing internet-based information used to aid patient decision-making about surgery for perianal Crohn's fistula.

PubMed

Marshall, J H; Baker, D M; Lee, M J; Jones, G L; Lobo, A J; Brown, S R

2017-06-01

Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. A search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch-Kincaid score. Of the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion (n = 13). The least common surgical intervention reported was proctectomy (n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2-8) and 2.93 ± 0.73 out of 5 (range = 1-5), respectively. The mean reading ease was US college standard. We found no patient decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a patient tool to assist decision-making in pCD.

Distance Education: A Consumer's Guide. What Distance Learners Need To Know.

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, Boulder, CO. Western Cooperative for Educational Communications.

This pamphlet is intended to assist the consumer in making informed decisions when choosing between distance learning programs. Distance education and distance learners are defined. Included is advice on beginning a program search; choosing a school; accreditation; evaluating quality of electronically offered programs; evaluate non-accredited…

Residential Wood Combustion Emissions and Safety Guidebook.

ERIC Educational Resources Information Center

Becker, Mimi, Ed.; Barnett, Lucy, Ed.

This seven-part guidebook provides information to assist decision makers and other individuals involved in the residential wood energy fuel cycle. It can be used as a tool for designing or implementing programs, strategies, and policies that encourage, prevent, or mitigate safety or air emission related impacts of residential woodburning equipment…

Iowa Population Trends.

ERIC Educational Resources Information Center

Tait, John L.; Johnson, Arthur H.

The trends in population distribution and the composition of Iowa's population are reported in this document in order to provide the leaders and citizens of Iowa with information to assist them in making decisions relating to growth and development. Birth and death rates, rural and urban residence, population by race, and age structure are…

Guide for Managers of Adult Education Programs.

ERIC Educational Resources Information Center

Hudson River Center for Program Development, Glenmont, NY.

This document is intended to help adult education program managers throughout New York become oriented to the world of adult education, handle their new responsibilities as program managers, and obtain up-to-date information to assist them in making educational and administrative decisions. The following are among the topics discussed in the…

So You're Going To Have a Fund Raiser.

ERIC Educational Resources Information Center

Lemieux, Russ

1997-01-01

Provides a fundraising checklist for preschools and centers to use as a tool for evaluating companies which provide services and goods, to help providers make informed solicitation decisions. The checklist assists in evaluating product quality and cost, company professionalism, educational value, company history, organization of services, and…

Informal Caregivers: Communication and Decision Making

ERIC Educational Resources Information Center

Whitlatch, Carol

2008-01-01

It is estimated that 13 million to 15 million adults in the United States have chronic conditions that impair cognitive function, such as Alzheimer's disease, stroke, Parkinson's disease, and traumatic brain injury. The growing number of people with chronic conditions that include cognitive impairment and the family members who assist them face…

Helping Youth Decide: A Workshop Guide.

ERIC Educational Resources Information Center

Duquette, Donna Marie; Boo, Katherine

This guide was written to complement the publication "Helping Youth Decide," a manual designed to help parents develop effective parent-child communication and help their children make responsible decisions during the adolescent years. The workshop guide is intended to assist people who work with families to provide additional information and…

76 FR 41293 - Solicitation of Proposals for Technical Assistance Funding From the Native American Business...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... informed decisions regarding their economic futures. Feasibility studies may concern the viability of an... regarding their economic futures. Feasibility studies may concern the viability of an economic development..., Interior. ACTION: Notice. SUMMARY: The Office of Indian Energy and Economic Development (IEED), through its...

Community Involvement in Transportation Planning. Technical Report Series 37.

ERIC Educational Resources Information Center

Roden, David

This paper is designed to assist city staffs and transportation agencies in organizing effective community involvement programs. The role of nontechnical information in the decision making process is addressed first, to help professional engineers and planners consider its importance in planning and implementation. In a chapter on value…

Incentives for Reporting Infectious Disease Outbreaks

ERIC Educational Resources Information Center

Malani, Anup; Laxminarayan, Ramanan

2011-01-01

The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…

40 CFR 35.3555 - Intended Use Plan (IUP).

Code of Federal Regulations, 2010 CFR

2010-07-01

... description of the financial planning process undertaken for the Fund and the impact of funding decisions on the long-term financial health of the Fund. (4) Financial status. The IUP must describe the sources... project; the expected terms of financial assistance based on the best information available at the time...

The Adolescent Smoking and Health Project.

ERIC Educational Resources Information Center

Sutherland, Mary; And Others

This project was designed to specifically apply a health planning management system to a school based health education risk reduction program. Additionally, the Adolescent Smoking and Alcohol Project assisted youth in making informed decisions about the use/abuse of alcohol and cigarettes. Program components included a related knowledge base;…

76 FR 76120 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... ERS is to provide timely research and analysis to public and private decision makers on topics related... Supplemental Nutrition Assistance Program (SNAP) in delivering nutrition-related benefits. Need and Use of the... above information as it relates to low-income households. It is critical for USDA to better understand...

Stories of Success and Struggle: California's Small Farms.

ERIC Educational Resources Information Center

Warnert, Jeannette; McCue, Susan

1999-01-01

Describes the University of California's Small Farms Program, which aims to support the sustainability of small farms by providing small-scale farmers with state-of-the-art information, research, support networks, and technical assistance in technology adoption and decision making. Profiles four successful small farms that grow strawberries,…

Department of Defense Curricula: Information Concerning Conversion for Civilian Use.

ERIC Educational Resources Information Center

Forgione, Pascal D., Jr.; Orth, Mollie N.

Designed to assist in the selection of national priorities for the conversion of military curricula to civilian use, a study selected curricula pertinent to occupations with high growth potential and evaluated them against criteria important for curriculum conversion decisions. Procedures consisted of identification of priority occupational areas…

Homebuyer's Guide.

ERIC Educational Resources Information Center

Sindt, Roger P.; Harris, Jack

Designed to assist prospective buyers in making such important decisions as whether to buy a new or older home and within what price range, the guide provides information on the purchase process. Discussion of the purchase process covers the life-cycle costs (recurring homeownership costs that must be met every month); selection of a home;…

Modeling Learner Situation Awareness in Collaborative Mobile Web 2.0 Learning

ERIC Educational Resources Information Center

Norman, Helmi; Nordin, Norazah; Din, Rosseni; Ally, Mohamed

2016-01-01

The concept of situation awareness is essential in enhancing collaborative learning. Learners require information from different awareness aspects to deduce a learning situation for decision-making. Designing learning environments that assist learners to understand situation awareness via monitoring actions and reaction of other learners has been…

Designing Privacy Notices: Supporting User Understanding and Control

ERIC Educational Resources Information Center

Kelley, Patrick Gage

2013-01-01

Users are increasingly expected to manage complex privacy settings in their normal online interactions. From shopping to social networks, users make decisions about sharing their personal information with corporations and contacts, frequently with little assistance. Current solutions require consumers to read long documents or go out of their way…

The development of a model and decision support system to use in forecasting truck freight flow in the continental United States

DOT National Transportation Integrated Search

2001-01-01

This research develops a regression-based model for forecasting truck borne freight in the continental United States. This model is capable of predicting freight commodity flow information via trucks to assist transportation planners who wish to unde...

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

Prioritization of information using decision support systems for seismic risk in Bucharest city

NASA Astrophysics Data System (ADS)

Armas, Iuliana; Gheorghe, Diana

2014-05-01

Nowadays, because of the ever increasing volume of information, policymakers are faced with decision making problems. Achieving an objective and suitable decision making may become a challenge. In such situations decision support systems (DSS) have been developed. DSS can assist in the decision making process, offering support on how a decision should be made, rather than what decision should be made (Simon, 1979). This in turn potentially involves a huge number of stakeholders and criteria. Regarding seismic risk, Bucharest City is highly vulnerable (Mandrescu et al., 2007). The aim of this study is to implement a spatial decision support system in order to secure a suitable shelter in case of an earthquake occurrence in the historical centre of Bucharest City. In case of a seismic risk, a shelter is essential for sheltering people who lost their homes or whose homes are in danger of collapsing while people at risk receive first aid in the post-disaster phase. For the present study, the SMCE Module for ILWIS 3.4 was used. The methodology included structuring the problem by creating a decision tree, standardizing and weighting of the criteria. The results showed that the most suitable buildings are Tania Hotel, Hanul lui Manuc, The National Bank of Romania, The Romanian Commercial Bank and The National History Museum.

Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk.

PubMed

Willis, Amanda M; Smith, Sian K; Meiser, Bettina; Ballinger, Mandy L; Thomas, David M; Tattersall, Martin; Young, Mary-Anne

2018-02-17

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.

The Contribution of a Decision Support System to Educational Decision-Making Processes

ERIC Educational Resources Information Center

Klein, Joseph; Ronen, Herman

2003-01-01

In the light of reports of bias, the present study investigated the hypothesis that administrative educational decisions assisted by Decision Support Systems (DSS) are characterized by different pedagogical and organizational orientation than decisions made without computer assistance. One hundred and ten high school teachers were asked to suggest…

Editorial Comments, 1974-1986: The Case For and Against the Use of Computer-Assisted Decision Making

PubMed Central

Weaver, Robert R.

1987-01-01

Journal editorials are an important medium for communicating information about medical innovations. Evaluative statements contained in editorials pertain to the innovation's technical merits, as well as its probable economic, social and political, and ethical consequences. This information will either promote or impede the subsequent diffusion of innovations. This paper analyzes the evaluative information contained in thirty editorials that pertain to the topic of computer-assisted decision making (CDM). Most editorials agree that CDM technology is effective and economical in performing routine clinical tasks; controversy surrounds the use of more sophisticated CDM systems for complex problem solving. A few editorials argue that the innovation should play an integral role in transforming the established health care system. Most, however, maintain that it can or should be accommodated within the existing health care framework. Finally, while few editorials discuss the ethical ramifications of CDM technology, those that do suggest that it will contribute to more humane health care. The editorial analysis suggests that CDM technology aimed at routine clinical task will experience rapid diffusion. In contrast, the diffusion of more sophisticated CDM systems will, in the foreseeable future, likely be sporadic at best.

Asset Management Plans. Sections 1-5: Framework [and] Property Information Systems and Schools Premises Data [and] condition Assessment [and] Suitability Assessment [and] Sufficiency Assessment.

ERIC Educational Resources Information Center

Department for Education and Employment, London (England).

The aim of these documents is to assist Local Authorities in Britain with asset management planning (AMPs) for schools. AMPs set out the information needed, and the criteria used, to make decisions about spending on school premises which will: raise standards of educational attainment; provide sustainable and energy-efficient buildings that are…

The Fort Collins Science Center

USGS Publications Warehouse

Wilson, Juliette T.; Banowetz, Michele M.

2012-01-01

With a focus on biological research, the U.S. Geological Survey Fort Collins Science Center (FORT) develops and disseminates science-based information and tools to support natural resource decision-making. This brochure succinctly describes the integrated science capabilities, products, and services that the FORT science community offers across the disciplines of aquatic systems, ecosystem dynamics, information science, invasive species science, policy analysis and social science assistance, and trust species and habitats.

Enabling joined-up decision making with geotemporal information

NASA Astrophysics Data System (ADS)

Smith, M. J.; Ahmed, S. E.; Purves, D. W.; Emmott, S.; Joppa, L. N.; Caldararu, S.; Visconti, P.; Newbold, T.; Formica, A. F.

2015-12-01

While the use of geospatial data to assist in decision making is becoming increasingly common, the use of geotemporal information: information that can be indexed by geographical space AND time, is much rarer. I will describe our scientific research and software development efforts intended to advance the availability and use of geotemporal information in general. I will show two recent examples of "stacking" geotemporal information to support land use decision making in the Brazilian Amazon and Kenya, involving data-constrained predictive models and empirically derived datasets of road development, deforestation, carbon, agricultural yields, water purification and poverty alleviation services and will show how we use trade-off analyses and constraint reasoning algorithms to explore the costs and benefits of different decisions. For the Brazilian Amazon we explore tradeoffs involved in different deforestation scenarios, while for Kenya we explore the impacts of conserving forest to support international carbon conservation initiatives (REDD+). I will also illustrate the cloud-based software tools we have developed to enable anyone to access geotemporal information, gridded (e.g. climate) or non-gridded (e.g. protected areas), for the past, present or future and incorporate such information into their analyses (e.g. www.fetchclimate.org), including how we train new predictive models to such data using Bayesian techniques: on this latter point I will show how we combine satellite and ground measured data with predictive models to forecast how crops might respond to climate change.

Women's health nursing in the context of the National Health Information Infrastructure.

PubMed

Jenkins, Melinda L; Hewitt, Caroline; Bakken, Suzanne

2006-01-01

Nurses must be prepared to participate in the evolving National Health Information Infrastructure and the changes that will consequently occur in health care practice and documentation. Informatics technologies will be used to develop electronic health records with integrated decision support features that will likely lead to enhanced health care quality and safety. This paper provides a summary of the National Health Information Infrastructure and highlights electronic health records and decision support systems within the context of evidence-based practice. Activities at the Columbia University School of Nursing designed to prepare nurses with the necessary informatics competencies to practice in a National Health Information Infrastructure-enabled health care system are described. Data are presented from electronic (personal digital assistant) encounter logs used in our Women's Health Nurse Practitioner program to support evidence-based advanced practice nursing care. Implications for nursing practice, education, and research in the evolving National Health Information Infrastructure are discussed.

29 CFR 1910.7 - Definition and requirements for a nationally recognized testing laboratory.

Code of Federal Regulations, 2010 CFR

2010-07-01

... prejudice, at any time prior to the final decision by the Assistant Secretary in paragraph I.B.7.c. of this... writing by the close of the comment period. 6. Action after public comment—a. Final decision by Assistant... comment period. b. Public announcement. A copy of the Assistant Secretary's final decision will be...

Intended parents' motivations and information and support needs when seeking extraterritorial compensated surrogacy.

PubMed

Hammarberg, Karin; Stafford-Bell, Martyn; Everingham, Sam

2015-11-01

Cross-border reproductive care (CBRC) is becoming increasingly common. Little is known about the motivations and information and support needs of people who cross borders to access surrogacy. This study aimed to explore: how those considering or undertaking extraterritorial surrogacy reach their decision; what other avenues they have considered and tried to have children; their sources of information and support; and perceptions of how others view their decision. Members of two Australian parenting support forums completed an anonymous online survey. Of the 249 respondents, 51% were gay men, 43% heterosexual women and 7% heterosexual men. Most heterosexual respondents had tried to conceive spontaneously and with assisted reproductive technology before considering surrogacy. Most respondents felt supported in their decision to try extraterritorial surrogacy by close family and friends. Surrogacy-related information was mostly sourced online and from other parents through surrogacy. Few sought information from a local general practitioner or IVF clinic and those who did reported IVF clinic staff were significantly (P < 0.001) more likely than other groups to communicate negative reactions to their decision to seek surrogacy. The apparent negative attitudes to cross-border surrogacy among health professionals warrants further research into health professionals' knowledge, beliefs and attitudes relating to surrogacy. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

What information do parents need when facing end-of-life decisions for their child? A meta-synthesis of parental feedback.

PubMed

Xafis, Vicki; Wilkinson, Dominic; Sullivan, Jane

2015-04-30

The information needs of parents facing end-of-life decisions for their child are complex due to the wide-ranging dimensions within which such significant events unfold. While parents acknowledge that healthcare professionals are their main source of information, they also turn to a variety of additional sources of written information in an attempt to source facts, discover solutions, and find hope. Much has been written about the needs of parents faced with end-of-life decisions for their child but little is known about the written information needs such parents have. Research in the adult intensive care context has shown that written resources impact positively on the understanding of medical facts, including diagnoses and prognoses, communication between families and healthcare professionals, and the emotional wellbeing of families after their relative's death. A meta-synthesis of predominantly empirical research pertaining to features which assist or impede parental end-of-life decisions was undertaken to provide insight and guidance in our development of written resources (short print and online comprehensive version) for parents. The most prominently cited needs in the literature related to numerous aspects of information provision; the quantity, quality, delivery, and timing of information and its provision impacted not only on parents' ability to make end-of-life decisions but also on their emotional wellbeing. The meta-synthesis supports the value of written materials, as these provide guidance for both parents and healthcare professionals in pertinent content areas. Further research is required to determine the impact that written resources have on parental end-of-life decision-making and on parents' wellbeing during and after their experience and time in the hospital environment.

Pruning a decision tree for selecting computer-related assistive devices for people with disabilities.

PubMed

Chi, Chia-Fen; Tseng, Li-Kai; Jang, Yuh

2012-07-01

Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.

Innovative assistive technology in Finnish public elderly-care services: a focus on productivity.

PubMed

Melkas, Helinä

2013-01-01

The study investigates ways in which technology use may help municipalities improve productivity in elderly-care services. A case study of Finnish elderly-care services provides responses concerning impacts, decisions and options in technology use. The research data were collected during a 'smart home pilot' implemented in four housing service units. Over 60 assistive devices were introduced in the smart homes used during short-term housing periods. Both customers and care staff's experiences as well as processes related to the use of assistive devices were investigated on the basis of survey questionnaires, interviews and feedback. Assistive device-related operational processes were investigated with the help of concepts of 'resource focus', 'lost motion' and 'intermediate storage'. Four central operational processes were identified. Design and desirability as well as costs, such as opportunity costs of assistive devices were also a focus. Significant factors related to productivity were disclosed in this way. Technology use versus productivity needs to be 'circled' from the points of view of individual users, workplaces, service processes, and larger technology options. There must be long-term patience to introduce technology properly into use to produce positive impacts on productivity. Customers and care staff have an interlinked, vital role to play as decision-makers' informants.

The Research of Spatial-Temporal Analysis and Decision-Making Assistant System for Disabled Person Affairs Based on Mapworld

NASA Astrophysics Data System (ADS)

Zhang, J. H.; Yang, J.; Sun, Y. S.

2015-06-01

This system combines the Mapworld platform and informationization of disabled person affairs, uses the basic information of disabled person as center frame. Based on the disabled person population database, the affairs management system and the statistical account system, the data were effectively integrated and the united information resource database was built. Though the data analysis and mining, the system provides powerful data support to the decision making, the affairs managing and the public serving. It finally realizes the rationalization, normalization and scientization of disabled person affairs management. It also makes significant contributions to the great-leap-forward development of the informationization of China Disabled Person's Federation.

Effective information management and assurance for a modern organisation during a crisis.

PubMed

MacLeod, Andrew

2015-01-01

During a crisis, organisations face a major unpredictable event with potentially negative consequences. Effective information management and assurance can assist the organisation in making sure that they have the correct information in a secure format to make decisions to recover their operations. The main elements of effective information management and assurance are confidentiality, integrity and availability, combined with non-repudiation. Should an element of effective information management or assurance be removed it can have a detrimental effect on the other elements and render the information management and assurance practices of the organisation ineffectual.

Word-of-mouth communications in health care marketing.

PubMed

MacStravic, R S

1985-10-01

Word-of-mouth (WOM) advertising can be an important communications tool, since it addresses the right target--the decision maker, contains the needed information, and occurs at the right time. An effective WOM communications program will use a marketing survey to identify decision makers and measure their degree of preference for the provider to determine which decision makers can be influenced. A survey also should be used to discover the most significant information sources. To involve those sources in a WOM communications effort requires that they be satisfied with their provider and that they be convinced the provider is the best choice for the person who has requested the recommendation. To increase the likelihood that sources will be informed about a specific provider, pamphlets or other materials can be distributed to assist them. Other forms of encouragement include patient surveys and employee bonuses. An institution's WOM program should also be consistent with its other communications efforts. Messages must be compatible with the themes of advertising and publicity campaigns.

A framework for ecological decision support systems: Building the right systems and building the systems right

USGS Publications Warehouse

D'Erchia, Frank; Korschgen, Carl E.; Nyquist, M.; Root, Ralph; Sojda, Richard S.; Stine, Peter

2001-01-01

Workshops in the late 1990's launched the commitment of the U.S. Geological Survey's Biological Resources Division (BRD) to develop and implement decision support systems (DSS) applications. One of the primary goals of this framework document is to provide sufficient background and information for Department of the Interior (DOI) bureau stakeholders and other clients to determine the potential for DSS development. Such an understanding can assist them in carrying out effective land planning and management practices. This document provides a definition of DSS and its characteristics and capabilities. It proceeds to describe issues related to meeting resource managers needs, such as the needs for specific applications, customer requirements, information and technology transfer, user support, and institutionalization. Using the decision process as a means to guide DSS development and determine users needs is also discussed. We conclude with information on method to evaluate DSS development efforts and recommended procedures for verification and validation. 

Mapping ICT access and disability in the workplace: An empirical study in Italy.

PubMed

Gastaldi, Luca; Ghezzi, Antonio; Mangiaracina, Riccardo; Rangone, Andrea; Cortimiglia, Marcelo N; Zanatta, Mateus; Amaral, Fernando G

2015-06-05

It is well known that the Information and Communication Technologies (ICT) are important to assist people with disability in the workplace. In this context, this paper sheds light on the state of ICT accessibility for Italian employees with disabilities in private sector companies by mapping and critically analyzing the assistive role of ICT. To do this, empirical evidence was drawn from a multi-methods research with middle and top managers from 97 medium and large Italian companies. Quantitative data was collected using a survey was directed at personnel identified as Human Resource (HR) and Information System (IS) managers, followed by a qualitative study with selected firms whose aim was to understand the inner workings of assistive technology and the decision making process related to assistive technology acquisition and use. The main results show the role and the integration level of people with disabilities, and the presence and effectiveness of specific assistive technologies. Ways to improve the inclusion of people with disability in the workplace, as well as the use of assistive technologies are discussed. ICT could be more disseminated within companies and best used with modifications to improve usability.

[The role of information in public health decision-making].

PubMed

Cecchi, Catherine

2008-01-01

Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. Irrespective of the type of choice to be made, the need for information, knowledge, and know-how is inseparable from that of other tools or regulatory measures required for decision-making. Information is the same as competence, epidemiological and population data, health data, scientific opinion, and expert conferences--all are needed to assist in decision-making. Based on the principle of precaution, information must increasingly take into account the rejection of a society which often reasons on the basis of a presumption of zero-risk, in an idealistic manner, and which also excludes the possibility of new risks. The consumer positions himself as the regulator of decisions, specifically those with regard to the notion of acceptable level of risk. All of the actors involved in the health system are or become at one moment or another public health decision-makers. Their decision might be based either on an analytical approach, or on an intuitive approach. Although the act of decision-making is the least visible part of public health policy, it is certainly the driving force. This process should integrate the perspective of all of the relevant players, including consumers, who are currently situated more and more frequently at the heart of the health system. Public health decision-making is conducted as a function of political, strategic and environmental issues; of lobbies and their power; and of social maturation. Decision-making is a necessity. Making the right choice at the right time requires high quality information, and it is often necessary to respect a certain amount of time for reflection and ripening of an issue in order to make the best possible decision. The media and consumers play an increasingly significant role in public health decision-making and in the ensuing legislative consequences and debates which come as a result. Access to information is changing, especially thanks to the Internet which is completely modifying the global scenery of knowledge and know-how. Information supports decision-making with calculated risk, and it offers the opportunity to make choices and decisions, recognising that "to choose, is sometimes to relinquish".

Development and evaluation of a decision aid for patients considering first‐line chemotherapy for metastatic breast cancer

PubMed Central

Chiew, Kimberly S.; Shepherd, Heather; Vardy, Janette; Tattersall, Martin H.N.; Butow, Phyllis N.; Leighl, Natasha B.

2007-01-01

Abstract Objective  Treatment decisions in advanced breast cancer are complex, with enhanced quality of life and survival among important treatment goals. Patients with metastatic breast cancer face the decision of whether or not to have chemotherapy, and many wish to be involved in this decision. We report the development and evaluation of a decision aid (DA) designed to assist patients facing this treatment decision. Design and sample  Women with metastatic breast cancer (n = 17) and medical oncologists in Australia and Canada (n = 7) were invited to evaluate the DA. Intervention  A DA was developed for patients with hormone‐resistant metastatic breast cancer considering chemotherapy. The DA presented options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence‐based prognostic estimates were described, and a values clarification exercise included. Main outcome measures  Patient questionnaires evaluating information and decision involvement preferences, attitudes toward the DA and oncologist feedback regarding attitudes toward the DA. Results  Seventeen patients participated; fifteen desired as much information about their illness as possible; sixteen wished to be actively involved in the decision‐making process. The majority rated the DA as highly acceptable, clear and informative, and would recommend it to others facing this treatment decision. Conclusion  This is the first DA for patients with advanced metastatic breast cancer considering chemotherapy. A randomized trial is underway to evaluate its role in clinical decision‐making. PMID:18297781

13 CFR 134.409 - Decision on appeal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Decision on appeal. 134.409 Section 134.409 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION RULES OF PROCEDURE GOVERNING... § 134.409 Decision on appeal. (a) A decision of the Administrative Law Judge under this subpart is the...

Enterprise digital assistants: the progression of wireless clinical computing.

PubMed

Bergeron, Bryan P

2002-01-01

By virtue of increasingly pervasive wireless connectivity, the proliferation of wireless handheld devices in clinical care is rapidly transforming the concept of the personal digital assistant (PDA) to the enterprise digital assistant (EDA). Wireless handheld devices are becoming extensions of the central hospital information system, in which it's understood that the health care enterprise, not the clinician carrying the information-dispensing device, owns the data. The practical implication for clinicians is that, despite the potential long-term benefits of seamless, just-in-time clinical data access, this paradigm shift portends decreased efficiency in the short term, as clinicians duplicate clinical data collection on private devices. Assuming eventual clinician acceptance, EDAs can form the basis of a national real-time clinical data acquisition system that ensures uniform prescribing, decision support, and diagnosis, and the means for tracking unusual disease presentation patterns that could be indicative of bioterrorism or natural disease outbreaks.

Organ donation after assisted death: Is it more or less ethically-problematic than donation after circulatory death?

PubMed

Kirby, Jeffrey

2016-12-01

A provocative question has emerged since the Supreme Court of Canada's decision on assisted dying: Should Canadians who request, and are granted, an assisted death be considered a legitimate source of transplantable organs? A related question is addressed in this paper: is controlled organ donation after assisted death (cDAD) more or less ethically-problematic than standard, controlled organ donation after circulatory determination of death (cDCDD)? Controversial, ethics-related dimensions of cDCD that are of relevance to this research question are explored, and morally-relevant distinctions between cDAD and cDCD are identified. In addition, a set of morally-relevant advantages of one practice over the other is uncovered, and a few potential, theoretical issues specifically related to cDAD practice are articulated. Despite these concerns, the analysis suggests a counterintuitive conclusion: cDAD is, overall, less ethically-problematic than cDCDD. The former practice better respects the autonomy interests of the potential donor, and a claim regarding irreversibility of cessation of the donor's circulatory function in the cDAD context can be supported. Further, with cDAD, there is no possibility that the donor will have negative sensory experiences during organ procurement surgery. Although the development of appropriate policy-decision and regulatory approaches in this domain will be complex and challenging, the comparative ethical analysis of these two organ donation practices has the potential to constructively inform the deliberations of relevant stakeholders, resource persons and decision makers.

Does Education for Sustainability Encourage Leopold's "Intense Consciousness of Land"?

ERIC Educational Resources Information Center

Kentish, Barry; Robottom, Ian

2008-01-01

In Australia there has been a rapid move to an acceptance of education for sustainability as mainstream environmental education. We argue that education for sustainability, with its platform of assisting individuals in making apparently informed decisions to create a more sustainable world, is at some distance from promoting more ethically-based…

AEGIS: a wildfire prevention and management information system

Treesearch

Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos

2016-01-01

We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to...

Data and Tools | State, Local, and Tribal Governments | NREL

Science.gov Websites

governments with making informed decisions about clean energy policy and projects. Photo of two people in in our podcasts Clean Energy Policy Basics Understand how to build a clean energy policy portfolio reduce petroleum consumption. Clean Energy Solutions Center No-cost expert policy assistance, webinars

The Role of Supervisors of Agricultural Education in Educating Society about Agriculture. A Position Paper.

ERIC Educational Resources Information Center

National Association of Supervisors of Agricultural Education.

The vocational agriculture supervisor should assist consumers in making better choices, provide career information for young adults, point out job change and retraining opportunities, and impart accurate facts to be used for decision making. Certain personal characteristics are necessary for success in fulfilling the expected role of the…

Lithologic composition and rock weathering potential of forested, glacial-till soils

Treesearch

Scott W. Bailey; James W. Hornbeck; James W. Hornbeck

1992-01-01

Describes methods for predicting lithologies present in soils developed on glacial till, and the potential weathering contributions from rock particles >2 mm in diameter. The methods are not quantitative in terms of providing weathering rates, but provide information that can further the understanding of forest nutrient cycles, and possibly assist with decisions...

Computer Simulation of a Hardwood Processing Plant

Treesearch

D. Earl Kline; Philip A. Araman

1990-01-01

The overall purpose of this paper is to introduce computer simulation as a decision support tool that can be used to provide managers with timely information. A simulation/animation modeling procedure is demonstrated for wood products manufacuring systems. Simulation modeling techniques are used to assist in identifying and solving problems. Animation is used for...

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....

10 CFR 10.10 - Application of the criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Application of the criteria. (a) The decision as to access authorization and/or employment clearance is a... in § 10.11 set forth a number of the types of derogatory information used to assist in making... be adherence to such criteria, the NRC is not limited to them, nor precluded from exercising its...

Current Health Problems.

ERIC Educational Resources Information Center

Gay, John; And Others

The basic premise of this text is that, in addition to the presentation of basic cognitive and affective information, health education should go one step further by assisting student in developing decision-making skills. The text begins by offering the student a basic foundation of what is meant by health and how this meaning applies to the world,…

78 FR 62798 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... information for complex strategies and other market data. NYSE offers market data products entitled ``NYSE... assist them in tracking prices and market trends and making trading decisions. The Exchange believes that... fee schedule of Market Data Express, LLC (``MDX''), an affiliate of CBOE, to establish fees for the...

19 CFR 207.93 - Protection of proprietary information during panel and committee proceedings.

Code of Federal Regulations, 2014 CFR

2014-04-01

... address by facsimile transmission, expedited courier service, expedited mail service; or by personal... or an extraordinary challenge committee, any assistant to a member, court reporters and translators... competitive decision-making, as defined in US Steel Corp. v. United States, 730 F.2d 1465 (Fed. Cir. 1984...

19 CFR 207.93 - Protection of proprietary information during panel and committee proceedings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... address by facsimile transmission, expedited courier service, expedited mail service; or by personal... or an extraordinary challenge committee, any assistant to a member, court reporters and translators... competitive decision-making, as defined in US Steel Corp. v. United States, 730 F.2d 1465 (Fed. Cir. 1984...

19 CFR 207.93 - Protection of proprietary information during panel and committee proceedings.

Code of Federal Regulations, 2011 CFR

2011-04-01

... address by facsimile transmission, expedited courier service, expedited mail service; or by personal... or an extraordinary challenge committee, any assistant to a member, court reporters and translators... competitive decision-making, as defined in US Steel Corp. v. United States, 730 F.2d 1465 (Fed. Cir. 1984...

19 CFR 207.93 - Protection of proprietary information during panel and committee proceedings.

Code of Federal Regulations, 2012 CFR

2012-04-01

... address by facsimile transmission, expedited courier service, expedited mail service; or by personal... or an extraordinary challenge committee, any assistant to a member, court reporters and translators... competitive decision-making, as defined in US Steel Corp. v. United States, 730 F.2d 1465 (Fed. Cir. 1984...

What Legislators Need To Know about Mental Retardation and Developmental Disabilities.

ERIC Educational Resources Information Center

Wright, Barbara

This publication provides background information on financing and programming for persons with developmental disabilities to assist state legislators in making public policy and funding decisions. The booklet is in a question-and-answer format and covers the following topics: (1) definition of developmental disabilities and factors of concern to…

Humane Education for Students with Visual Impairments: Learning about Working Dogs

ERIC Educational Resources Information Center

Bruce, Susan M.; Feinstein, Jennie Dapice; Kennedy, Meghan C.; Liu, Ming

2015-01-01

Introduction: This study examined the effect of an animal-assisted humane education course on the knowledge of students about caring for dogs physically and psychologically and making informed decisions about dog ownership, including working dogs. Method: This collaborative action-research study employed case study design to examine the effect of…

75 FR 28034 - National Protection and Programs Directorate; Agency Information Collection Activities: United...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... enforcement agencies; and the Federal intelligence community to assist in the decisions they make related to... the collection of fingerprints from two prints to 10. The new collection time of 35 seconds, an... overseas posts; other DHS officers; and appropriate officers of the United States intelligence and law...

The Smart Approach to Student Loans and Consumer Debt.

ERIC Educational Resources Information Center

Missouri State Dept. of Higher Education, Jefferson City.

This brochure contains information about student loans for college applicants and students in Missouri. It is a resource to assist borrowers in making smart repayment decisions and in understanding the options to avoid delinquency and default. Things to consider before one borrows, how to increase one's resources, and how to decrease one's…

Manual para Compradores de Casas (Homebuyer's Guide).

ERIC Educational Resources Information Center

Sindt, Roger P.; Harris, Jack

Designed to assist prospective buyers in making such important decisions as whether to buy a new or older home and within what price range, the guide, written in Spanish, provides information on the purchase process. Discussion of the purchase process covers the life-cycle costs (recurring homeownership costs that must be met every month);…

Equine pituitary pars intermedia dysfunction: current understanding and recommendations from the Australian and New Zealand Equine Endocrine Group.

PubMed

Secombe, C J; Bailey, S R; de Laat, M A; Hughes, K J; Stewart, A S; Sonis, J M; Tan, Rhh

2018-06-03

The purpose of this article is to provide a review of the current knowledge and opinions about the epidemiology, clinical findings (including sequelae), diagnosis, treatment and monitoring of equine pituitary pars intermedia dysfunction, particularly in the Australian context. This information and the recommendations provided will assist practitioners in making informed decisions regarding the diagnosis and management of this disorder. © 2018 Australian Veterinary Association.

Geospatial Optimization of Siting Large-Scale Solar Projects

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

Macknick, Jordan; Quinby, Ted; Caulfield, Emmet

2014-03-01

Recent policy and economic conditions have encouraged a renewed interest in developing large-scale solar projects in the U.S. Southwest. However, siting large-scale solar projects is complex. In addition to the quality of the solar resource, solar developers must take into consideration many environmental, social, and economic factors when evaluating a potential site. This report describes a proof-of-concept, Web-based Geographical Information Systems (GIS) tool that evaluates multiple user-defined criteria in an optimization algorithm to inform discussions and decisions regarding the locations of utility-scale solar projects. Existing siting recommendations for large-scale solar projects from governmental and non-governmental organizations are not consistent withmore » each other, are often not transparent in methods, and do not take into consideration the differing priorities of stakeholders. The siting assistance GIS tool we have developed improves upon the existing siting guidelines by being user-driven, transparent, interactive, capable of incorporating multiple criteria, and flexible. This work provides the foundation for a dynamic siting assistance tool that can greatly facilitate siting decisions among multiple stakeholders.« less

Women's views of two interventions designed to assist in the prophylactic oophorectomy decision: a qualitative pilot evaluation

PubMed Central

Bhavnani, Vanita; Clarke, Aileen; Dowie, Jack; Kennedy, Andrew; Pell, Ian

2002-01-01

Abstract Introduction  A qualitative pilot evaluation of two different decision interventions for the prophylactic oophorectomy (PO) decision: a Decision Chart and a computerized clinical guidance programme (CGP) was undertaken. The Decision Chart, representing current practice in decision interventions, presents population‐based information. The CGP elicits individual values to allow for quality‐adjusted life years to be calculated and an explicit guidance statement is given. Prophylactic oophorectomy involves removal of the ovaries as an adjunct to hysterectomy to prevent ovarian cancer. The decision is complex because the operation can affect a number of long‐term outcomes including breast cancer, coronary heart disease and osteoporosis. Methods  Both interventions were based on the evidence and were administered by a facilitator. The Decision Chart is a file, which progressively reveals information in the form of bar charts. The CGP is a decision‐analysis based program integrating the results from a cluster of Markov cycle trees. The research evidence is incorporated with woman's individual risk factors, values and preferences. A purposive sample of 19 women awaiting hysterectomy used the decision interventions (10 CGP, nine Decision Chart). In‐depth semi‐structured interviews were undertaken. Interviews were transcribed and analysed to derive themes. Results  Reactions to the different decision interventions were mixed. Both were seen as clarifying the decision. Some women found some of the tasks difficult (e.g. rating health status). Some were surprised by the ‘individualized’ guidance, which the CGP offered. The Decision Chart provided some with a sense of empowerment, although some found that it provided too much information. Conclusions  Women were able to use both decision interventions. Both provided decision clarification. Problems were evident with both interventions, which give useful pointers for future development. These included the possibility for women to see how their individual risks of different outcomes are affected in the Decision Chart and enhanced explanation of the CGP tasks. Future design and evaluation of decision aids, will need to accommodate differences between patients in the desire for amount and type of information and level of involvement in the decision‐making process. PMID:12031056

Contrasting models of driver behaviour in emergencies using retrospective verbalisations and network analysis.

PubMed

Banks, Victoria A; Stanton, Neville A

2015-01-01

Automated assistance in driving emergencies aims to improve the safety of our roads by avoiding or mitigating the effects of accidents. However, the behavioural implications of such systems remain unknown. This paper introduces the driver decision-making in emergencies (DDMiEs) framework to investigate how the level and type of automation may affect driver decision-making and subsequent responses to critical braking events using network analysis to interrogate retrospective verbalisations. Four DDMiE models were constructed to represent different levels of automation within the driving task and its effects on driver decision-making. Findings suggest that whilst automation does not alter the decision-making pathway (e.g. the processes between hazard detection and response remain similar), it does appear to significantly weaken the links between information-processing nodes. This reflects an unintended yet emergent property within the task network that could mean that we may not be improving safety in the way we expect. This paper contrasts models of driver decision-making in emergencies at varying levels of automation using the Southampton University Driving Simulator. Network analysis of retrospective verbalisations indicates that increasing the level of automation in driving emergencies weakens the link between information-processing nodes essential for effective decision-making.

Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses.

PubMed

Wahl, Stacy E; Thompson, Anita M

2013-10-01

Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities. This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention. The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators. Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills. Copyright 2013, SLACK Incorporated.

Effective mental health consumer education: a preliminary exploration.

PubMed

Bielavitz, Sarann; Wisdom, Jennifer; Pollack, David A

2011-01-01

People with serious mental illnesses are increasingly becoming more active participants in their treatment and recovery. At times, their participation may be limited by incomplete, unclear, or insufficient information. The authors used a grounded theory approach to look at the unmet informational needs described by consumers. Participants in this study called for materials appropriate to their level of understanding, assistance with interpreting and comprehending information when necessary, and information on policies that affect the treatment they receive. Ultimately, an informed consumer is one empowered to make decisions about the course of his or her recovery and participate meaningfully in the patient-provider relationship.

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.

Conceptual framework for nutrition surveillance systems.

PubMed

Mock, N B; Bertrand, W E

1993-01-01

This article describes the evolution of nutrition surveillance as an intervention strategy and presents a framework for improving the usefulness of nutrition surveillance programs. It seems clear that such programs' impact on nutritional well-being will depend increasingly on their ability to reach and influence decision-makers. Therefore, it is important to consider political and social forces, and also to realize that if a program is too decentralized or too far removed from key decision-makers, its ability to influence resource flows may be limited. It is of course important that the surveillance information provided be appropriate and of good quality. Therefore, the data collected should be analyzed to ensure they are accurate and representative. Once that has been done, relevant findings should be presented in a readily understandable form designed to meet the intended recipients' information needs. Such findings should also be disseminated to all important decision-maker constituencies, including external donors of nutrition assistance and the general public.

Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial [ISRCTN22532458].

PubMed

Nagle, C; Gunn, J; Bell, R; Lewis, S; Meiser, B; Metcalfe, S; Ukoumunne, O C; Halliday, J

2008-02-01

To evaluate the effectiveness of a decision aid for prenatal testing of fetal abnormalities compared with a pamphlet in supporting women's decision making. A cluster randomised controlled trial. Primary health care. Women in early pregnancy consulting a GP. GPs were randomised to provide women with either a decision aid or a pamphlet. The decision aid was a 24-page booklet designed using the Ottowa Decision Framework. The pamphlet was an existing resource available in the trial setting. Validated scales were used to measure the primary outcomes, informed choice and decisional conflict, and the secondary outcomes, anxiety, depression, attitudes to the pregnancy/fetus and acceptability of the resource. Outcomes were measured at 14 weeks of gestation from questionnaires that women completed and returned by post. Women in the intervention group were more likely to make an informed decision 76% (126/165) than those in the control group 65% (107/165) (adjusted OR 2.08; 95% CI 1.14-3.81). A greater proportion of women in the intervention group 88% (147/167) had a 'good' level of knowledge than those in the control group 72% (123/171) (adjusted OR 3.43; 95% CI 1.79-6.58). Mean (SD) decisional conflict scores were low in both groups, decision aid 1.71 (0.49), pamphlet 1.65 (0.55) (adjusted mean difference 0.10; 95% CI -0.02 to 0.22). There was no strong evidence of differences between the trial arms in the measures of psychological or acceptability outcomes. A tailored prenatal testing decision aid plays an important role in improving women's knowledge of first and second trimester screening tests and assisting them to make decisions about screening and diagnostic tests that are consistent with their values.

13 CFR 134.715 - Can a Judge reconsider his decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Can a Judge reconsider his decision? 134.715 Section 134.715 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION RULES OF....715 Can a Judge reconsider his decision? (a) The Judge may reconsider an appeal decision within 20...

POLE.VAULT: A Semantic Framework for Health Policy Evaluation and Logical Testing.

PubMed

Shaban-Nejad, Arash; Okhmatovskaia, Anya; Shin, Eun Kyong; Davis, Robert L; Buckeridge, David L

2017-01-01

The major goal of our study is to provide an automatic evaluation framework that aligns the results generated through semantic reasoning with the best available evidence regarding effective interventions to support the logical evaluation of public health policies. To this end, we have designed the POLicy EVAlUation & Logical Testing (POLE.VAULT) Framework to assist different stakeholders and decision-makers in making informed decisions about different health-related interventions, programs and ultimately policies, based on the contextual knowledge and the best available evidence at both individual and aggregate levels.

Development Impact Assessment Highlights Co-benefits of GHG Mitigation Actions

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

2016-06-01

This EC-LEDS document describes the Development Impact Assessment (DIA) process that explores interactions between development goals and the low emission development strategies. DIA aims to support informed decision-making by considering how policies and programs intended to meet one goal may impact other development priorities. Enhancing Capacity for Low Emission Development Strategies (EC-LEDS) is a flagship U.S. government-led effort that assists countries in developing and implementing LEDS. The program enhances partner country efforts by providing targeting technical assistance and building a shared global knowledge base on LEDS. is a flagship U.S. government-led effort that assists countries in developing and implementing LEDS.more » The program enhances partner country efforts by providing targeting technical assistance and building a shared global knowledge base on LEDS.« less

Decisional conflict among women considering antidepressant medication use in pregnancy.

PubMed

Walton, Georgia D; Ross, Lori E; Stewart, Donna E; Grigoriadis, Sophie; Dennis, Cindy-Lee; Vigod, Simone

2014-12-01

The purpose of this study was to examine decision-making among women considering antidepressant medication use in pregnancy. Decisional conflict was assessed using the Decisional Conflict Scale (DCS) among pregnant women considering antidepressant medication treatment (N = 40). Overall DCS and subscale scores were compared between women who were antidepressant users and non-users. Semi-structured interviews (N = 10) explored barriers and facilitators of decision-making. Twenty-one women (52 %) had moderate or high decisional conflict (DCS ≥ 25). Overall DCS scores did not differ between groups, but antidepressant use was associated with feeling more adequately informed (subscale mean 17.5, SD 17.9 vs. 42.1, SD 23.8, p = 0.001) and clear about values (subscale mean 16.7, SD 15.1 vs. 29.8, SD 24.0, p = 0.043). Barriers to decision-making were (1) difficulty weighing maternal versus infant health, (2) lack of high quality information, (3) negative external influences, and (4) emotional reactions to decision-making. Facilitators were (1) interpersonal supports, (2) accessible subspecialty care, and (3) severe depressive symptoms. Many pregnant women facing decisions regarding antidepressant medication use experience decisional conflict. Interventions that provide accurate information, assistance with weighing risks and benefits of treatment, management of problematic external influences, and emotional support may reduce decisional conflict and facilitate the decision-making process.

Use of handheld computers in clinical practice: a systematic review.

PubMed

Mickan, Sharon; Atherton, Helen; Roberts, Nia Wyn; Heneghan, Carl; Tilson, Julie K

2014-07-06

Many healthcare professionals use smartphones and tablets to inform patient care. Contemporary research suggests that handheld computers may support aspects of clinical diagnosis and management. This systematic review was designed to synthesise high quality evidence to answer the question; Does healthcare professionals' use of handheld computers improve their access to information and support clinical decision making at the point of care? A detailed search was conducted using Cochrane, MEDLINE, EMBASE, PsycINFO, Science and Social Science Citation Indices since 2001. Interventions promoting healthcare professionals seeking information or making clinical decisions using handheld computers were included. Classroom learning and the use of laptop computers were excluded. Two authors independently selected studies, assessed quality using the Cochrane Risk of Bias tool and extracted data. High levels of data heterogeneity negated statistical synthesis. Instead, evidence for effectiveness was summarised narratively, according to each study's aim for assessing the impact of handheld computer use. We included seven randomised trials investigating medical or nursing staffs' use of Personal Digital Assistants. Effectiveness was demonstrated across three distinct functions that emerged from the data: accessing information for clinical knowledge, adherence to guidelines and diagnostic decision making. When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources. When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources. Finally, healthcare professionals made significantly more appropriate diagnostic decisions using clinical decision making tools on handheld computers compared to colleagues who did not have access to these tools. For these clinical decisions, the numbers need to test/screen were all less than 11. Healthcare professionals' use of handheld computers may improve their information seeking, adherence to guidelines and clinical decision making. Handheld computers can provide real time access to and analysis of clinical information. The integration of clinical decision support systems within handheld computers offers clinicians the highest level of synthesised evidence at the point of care. Future research is needed to replicate these early results and to identify beneficial clinical outcomes.

Use of handheld computers in clinical practice: a systematic review

PubMed Central

2014-01-01

Background Many healthcare professionals use smartphones and tablets to inform patient care. Contemporary research suggests that handheld computers may support aspects of clinical diagnosis and management. This systematic review was designed to synthesise high quality evidence to answer the question; Does healthcare professionals’ use of handheld computers improve their access to information and support clinical decision making at the point of care? Methods A detailed search was conducted using Cochrane, MEDLINE, EMBASE, PsycINFO, Science and Social Science Citation Indices since 2001. Interventions promoting healthcare professionals seeking information or making clinical decisions using handheld computers were included. Classroom learning and the use of laptop computers were excluded. Two authors independently selected studies, assessed quality using the Cochrane Risk of Bias tool and extracted data. High levels of data heterogeneity negated statistical synthesis. Instead, evidence for effectiveness was summarised narratively, according to each study’s aim for assessing the impact of handheld computer use. Results We included seven randomised trials investigating medical or nursing staffs’ use of Personal Digital Assistants. Effectiveness was demonstrated across three distinct functions that emerged from the data: accessing information for clinical knowledge, adherence to guidelines and diagnostic decision making. When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources. When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources. Finally, healthcare professionals made significantly more appropriate diagnostic decisions using clinical decision making tools on handheld computers compared to colleagues who did not have access to these tools. For these clinical decisions, the numbers need to test/screen were all less than 11. Conclusion Healthcare professionals’ use of handheld computers may improve their information seeking, adherence to guidelines and clinical decision making. Handheld computers can provide real time access to and analysis of clinical information. The integration of clinical decision support systems within handheld computers offers clinicians the highest level of synthesised evidence at the point of care. Future research is needed to replicate these early results and to identify beneficial clinical outcomes. PMID:24998515

Factors Affecting Employment Among Informal Caregivers Assisting People with Multiple Sclerosis

PubMed Central

Huang, Chunfeng; Zheng, Zhida

2013-01-01

The objective of this study was to identify characteristics of informal caregivers, caregiving, and the people with multiple sclerosis (MS) receiving assistance that are associated with reduced caregiver employment. Data were collected during telephone interviews with 530 MS caregivers, including 215 employed caregivers, with these survey data analyzed using logistic regression. Poorer cognitive ability by the care recipient to make decisions about daily tasks and more caregiving hours per week predicted reduced caregiver employment. Better physical health domains of caregiver quality of life were associated with significantly lower odds of reduced employment. Health professionals treating informal caregivers, as well as those treating people with MS, need to be aware of respite, support, and intervention programs available to MS caregivers and refer them to these programs, which could reduce the negative impact of caregiving on employment. PMID:24453784

The Use of Biomarkers in Prostate Cancer Screening and Treatment

PubMed Central

Alford, Ashley V.; Brito, Joseph M.; Yadav, Kamlesh K.; Yadav, Shalini S.; Tewari, Ashutosh K.; Renzulli, Joseph

2017-01-01

Prostate cancer screening and diagnosis has been guided by prostate-specific antigen levels for the past 25 years, but with the most recent US Preventive Services Task Force screening recommendations, as well as concerns regarding overdiagnosis and overtreatment, a new wave of prostate cancer biomarkers has recently emerged. These assays allow the testing of urine, serum, or prostate tissue for molecular signs of prostate cancer, and provide information regarding both diagnosis and prognosis. In this review, we discuss 12 commercially available biomarker assays approved for the diagnosis and treatment of prostate cancer. The results of clinical validation studies and clinical decision-making studies are presented. This information is designed to assist urologists in making clinical decisions with respect to ordering and interpreting these tests for different patients. There are numerous fluid and biopsy-based genomic tests available for prostate cancer patients that provide the physician and patient with different information about risk of future disease and treatment outcomes. It is important that providers be able to recommend the appropriate test for each individual patient; this decision is based on tissue availability and prognostic information desired. Future studies will continue to emphasize the important role of genomic biomarkers in making individualized treatment decisions for prostate cancer patients. PMID:29472826

Clinical decision making: how surgeons do it.

PubMed

Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

2013-06-01

Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

Cyanotic Premature Babies: A Videodisc-Based Program

PubMed Central

Tinsley, L.R.; Ashton, G.C.; Boychuk, R.B.; Easa, D.J.

1989-01-01

This program for the IBM InfoWindow system is designed to assist medical students and pediatric residents with diagnosis and management of premature infants exhibiting cyanosis. The program consists of six diverse case simulations, with additional information available on diagnosis, procedures, and relevant drugs. Respiratory difficulties accompanied by cyanosis are a common problem in premature infants at or just after birth, but the full diversity of causes is rarely seen in a short training period. The purpose of the program is to assist the student or resident with diagnosis and management of a variety of conditions which they may or may not see during their training. The opening menu permits selection from six cases, covering (1) respiratory distress syndrome proceeding through patent ductus arteriosus to pneumothorax, (2) a congenital heart disorder, (3) sepsis/pneumonia, (4) persistent fetal circulation, (5) diaphragmatic hernia, and (6) tracheo-esophageal fistula. In each case the student is provided with relevant introductory information and must then proceed with diagnosis and management. At each decision point the student may view information about relevant procedures, obtain assistance with diagnosis, or see information about useful drugs. Segments between decision points may be repeated if required. Provision is made for backtracking and review of instructional segments. The program is written in IBM's InfoWindow Presentation System authoring language and the video segments are contained on one side of a standard 12″ laserdisc. The program runs on IBM's InfoWindow System, with the touch screen used to initiate all student actions. The extensive graphics in the program were developed with Storyboard Plus, using the 640×350 resolution mode. This program is one of a number being developed for the Health Sciences Interactive Videodisc Consortium, and was funded in part by IBM Corporation.

A study on building data warehouse of hospital information system.

PubMed

Li, Ping; Wu, Tao; Chen, Mu; Zhou, Bin; Xu, Wei-guo

2011-08-01

Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is required for further research.

Fort Collins Science Center: Policy Analysis and Science Assistance

USGS Publications Warehouse

Lamb, Berton L.

2004-01-01

PASA's mission is to integrate biological, social, and economic research so that resource managers can use the resulting information to make informed decisions and resolve resource management conflicts. PASA scientists pursue and conduct scientific analyses that help agencies and Native American tribes to (1) identify impending policy controversies and areas where social and natural science research is needed to address future policy questions; (2) develop methods and approaches to assist researchers in preparing scientific evidence; (3) assess habitat alteration in a manner consistent with policy needs; and (4) evaluate policy options. Branch scientists also evaluate policy options (e.g., effects of different land treatments, fish and wildlife management practices, or visitor/recreation management practices) in response to specific questions faced by policymakers and managers.

Predictive analytics and child protection: constraints and opportunities.

PubMed

Russell, Jesse

2015-08-01

This paper considers how predictive analytics might inform, assist, and improve decision making in child protection. Predictive analytics represents recent increases in data quantity and data diversity, along with advances in computing technology. While the use of data and statistical modeling is not new to child protection decision making, its use in child protection is experiencing growth, and efforts to leverage predictive analytics for better decision-making in child protection are increasing. Past experiences, constraints and opportunities are reviewed. For predictive analytics to make the most impact on child protection practice and outcomes, it must embrace established criteria of validity, equity, reliability, and usefulness. Copyright © 2015 Elsevier Ltd. All rights reserved.

Information disclosure and decision-making: the Middle East versus the Far East and the West.

PubMed

Mobeireek, A F; Al-Kassimi, F; Al-Zahrani, K; Al-Shimemeri, A; al-Damegh, S; Al-Amoudi, O; Al-Eithan, S; Al-Ghamdi, B; Gamal-Eldin, M

2008-04-01

to assess physicians' and patients' views in Saudi Arabia (KSA) towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan. A self-completion questionnaire (used previously to study these issues in Japan and the USA) was translated to Arabic and validated. Physicians (n = 321) from different specialties and ranks and patients (n = 264) in a hospital or attending outpatient clinics from 6 different regions in KSA. In the case of a patient with incurable cancer, 67% of doctors and 51% of patients indicated that they would inform the patient in preference to the family of the diagnosis (p = 0.001). Assuming the family already knew, 56% of doctors and 49% of patients would tell the patient even if family objected (p NS). However, in the case of HIV infection, 59% of physicians and 81% of patients would inform the family about HIV status without the patient's consent (p = 0.001). With regards to withholding ventilatory support, about 50% of doctors and over 60% of patients supported the use of mechanical ventilation in a patient with advanced cancer, regardless of the wishes of the patient or the family. Finally, the majority of doctors and patients (>85%) were against assisted suicide. Although there was more recognition for a patient's autonomy amongst physicians, most patients preferred a family centred model of care. Views towards information disclosure were midway between those of the USA and Japan. Distinctively, however, decisions regarding life prolonging therapy and assisted suicide were not influenced to a great extent by wishes of the patient or family, but more likely by religious beliefs.

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

PubMed

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

2017-06-01

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

Knowledge and decision-making for labour analgesia of Australian primiparous women.

PubMed

Raynes-Greenow, Camille H; Roberts, Christine L; McCaffery, Kirsten; Clarke, Judith

2007-06-01

to assess and investigate knowledge of labour pain management options and decision-making among primiparous women. a semi-structured guide was used in focus groups to gather pregnant women's knowledge concerning labour analgesia. Attitudes to labour and pain relief, knowledge of pain relief, trustworthiness of knowledge sources, and plans and expectations for labour pain relief were investigated. a major tertiary obstetric hospital in metropolitan Sydney, Australia. twenty five primiparous women, who were 25 weeks or more gestation, and planning a vaginal birth. although women considered themselves knowledgeable, they were unable to describe labour analgesic risks or benefits. There was a large discrepancy between perception and actual knowledge. The main source of knowledge was anecdotal information. Late in pregnancy was considered the ideal time to be given information about labour analgesia. Women described their labour pain relief plans as flexible in relation to their labour circumstances; however, most women wanted to take an active role in decision-making. the large discrepancy between perceived knowledge and actual knowledge of the likely consequences of labour analgesia suggests that women rely too heavily on anecdotal information. clinicians should be aware that some women overestimate their knowledge and understanding of analgesic options, which is often based on anecdotal information. Standardised labour analgesia information at an appropriate time in their pregnancy may benefit some women and assist health-care providers and women to practice shared decision-making.

Promotion Assistance Tool for Mobile Phone Users

NASA Astrophysics Data System (ADS)

Intraprasert, P.; Jatikul, N.; Chantrapornchai, C.

In this paper, we propose an application tool to help analyze the usage of a mobile phone for a typical user. From the past usage, the tool can analyze the promotion that is suitable for the user which may save the total expense. The application consists of both client and server side. On the server side, the information for each promotion package for a phone operator is stored as well as the usage database for each client. The client side is a user interface for both phone operators and users to enter their information. The analysis engine are based on KNN, ANN, decision tree and Naïve Bayes models. For comparison, it is shown that KNN and decision outperforms the others.

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

Mental Health Providers' Decision-Making Around the Implementation of Evidence-Based Treatment for PTSD.

PubMed

Osei-Bonsu, Princess E; Bolton, Rendelle E; Wiltsey Stirman, Shannon; Eisen, Susan V; Herz, Lawrence; Pellowe, Maura E

2017-04-01

It is estimated that <15% of veterans with posttraumatic stress disorder (PTSD) have engaged in two evidence-based psychotherapies highly recommended by VA-cognitive processing therapy (CPT) and prolonged exposure (PE). CPT and PE guidelines specify which patients are appropriate, but research suggests that providers may be more selective than the guidelines. In addition, PTSD clinical guidelines encourage "shared decision-making," but there is little research on what processes providers use to make decisions about CPT/PE. Sixteen licensed psychologists and social workers from two VA medical centers working with ≥1 patient with PTSD were interviewed about patient factors considered and decision-making processes for CPT/PE use. Qualitative analyses revealed that patient readiness and comorbid conditions influenced decisions to use or refer patients with PTSD for CPT/PE. Providers reported mentally derived and instances of patient-involved decision-making around CPT/PE use. Continued efforts to assist providers in making informed and collaborative decisions about CPT/PE use are discussed.

A Report of Progress. Annual Report of the NFE Network Project: Operating a Clearinghouse on NFE Information (September 1981-August 1982) and Semi-Annual Reports of the NFE Network Project: Providing Technical Assistance in Creating LDC National/Regional Information Centers (September 1981-February 1982; March 1982-August 1982).

ERIC Educational Resources Information Center

Pigozzi, Mary Joy

This report describes the clearinghouse activities of the Non-Formal Education (NFE) Information Center from September 1981 through August 1982 and details efforts to strengthen the capacity of selected NFE resource centers in Africa, Asia, and Latin America. It first addresses the decision to extend the NFE Network Project, and then turns to the…

Measuring Teaching Best Practice in the Induction Years: Development and Validation of an Item-Level Assessment

ERIC Educational Resources Information Center

Kingsley, Laurie; Romine, William

2014-01-01

Schools and teacher induction programs around the world routinely assess teaching best practice to inform accreditation, tenure/promotion, and professional development decisions. Routine assessment is also necessary to ensure that teachers entering the profession get the assistance they need to develop and succeed. We introduce the Item-Level…

Monitoring and management of recreation in protected areas: the contributions and limitations of science

Treesearch

David N. Cole

2004-01-01

Scientists assist protected area managers by developing information and knowledge that can be used to better monitor and manage recreation use and its impacts. Most recreation management decisions have both a descriptive and an evaluative component. There is widespread consensus that science is well suited to discovering, synthesizing and applying descriptive...

42 CFR 460.112 - Specific rights to which a participant is entitled.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Specific rights to which a participant is entitled... appeals processes as well as civil and other legal rights. (7) To be encouraged and assisted to recommend... health care decisions. Specifically, each participant has the following rights: (1) To be fully informed...

42 CFR 460.112 - Specific rights to which a participant is entitled.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Specific rights to which a participant is entitled... appeals processes as well as civil and other legal rights. (7) To be encouraged and assisted to recommend... health care decisions. Specifically, each participant has the following rights: (1) To be fully informed...

42 CFR 460.112 - Specific rights to which a participant is entitled.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Specific rights to which a participant is entitled... appeals processes as well as civil and other legal rights. (7) To be encouraged and assisted to recommend... health care decisions. Specifically, each participant has the following rights: (1) To be fully informed...

42 CFR 460.112 - Specific rights to which a participant is entitled.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Specific rights to which a participant is entitled... appeals processes as well as civil and other legal rights. (7) To be encouraged and assisted to recommend... health care decisions. Specifically, each participant has the following rights: (1) To be fully informed...

42 CFR 460.112 - Specific rights to which a participant is entitled.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Specific rights to which a participant is entitled... appeals processes as well as civil and other legal rights. (7) To be encouraged and assisted to recommend... health care decisions. Specifically, each participant has the following rights: (1) To be fully informed...

Validating TOEFL[R] iBT Speaking and Setting Score Requirements for ITA Screening

ERIC Educational Resources Information Center

Xi, Xiaoming

2007-01-01

Although the primary use of the speaking section of the Test of English as a Foreign Language Internet-based test (TOEFL[R] iBT Speaking) is to inform admissions decisions at English medium universities, it may also be useful as an initial screening measure for international teaching assistants (ITAs). This study provides criterion-related…

Ensuring coordination and collaboration across climate science entities: toward effective stakeholder engagement for science-informed decisions

USDA-ARS?s Scientific Manuscript database

As one of the newest federal programs to emerge in response to climate change, the U.S. Department of Agriculture (USDA) Climate Hubs were established to assist farmers, ranchers and forest landowners in their adaptation and mitigation efforts under a changing climate. The Hubs’ mission is to delive...

A synthesis of postfire road treatments for BAER teams: methods, treatment effectiveness, and decisionmaking tools for rehabilitation

Treesearch

Randy B. Foltz; Peter R. Robichaud; Hakjun Rhee

2008-01-01

We synthesized post-fire road treatment information to assist BAER specialists in making road rehabilitation decisions. We developed a questionnaire; conducted 30 interviews of BAER team engineers and hydrologists; acquired and analyzed gray literature and other relevant publications; and reviewed road rehabilitation procedures and analysis tools. Post-fire road...

Records of Backcountry Use Can Assist Trail Managers

Treesearch

H.J. Plumley; H.T. Peet; R.E. Leonard

1978-01-01

Records of recreational use of Eastern backcountry areas have not been systematically kept by many trail management groups in the past. Decisions on backcountry site designs and facilities should not be made without information on visitor use and behavior. An analysis of sample data from records of overnight shelter use on the Long Trail, Vermont, indicates how such...

78 FR 62849 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... includes order and last sale information for complex strategies and other market data. NYSE offers market... assist them in tracking prices and market trends and making trading decisions. The Exchange believes that... (the ``Exchange'' or ``C2'') proposes to amend the fee schedule of Market Data Express, LLC (``MDX...

Catalogue of Workforce Information Sources: Decision Making Assistance for Regional Economic Development. U.S. Department of Labor, Employment and Training Administration

ERIC Educational Resources Information Center

US Department of Labor, 2009

2009-01-01

In early 2006, The U.S. Department of Labor (DOL), Employment and Training Administration (ETA) began an initiative called Workforce Innovation in Regional Economic Development (WIRED) to help regions create competitive conditions, integrate economic and workforce development activities, and demonstrate that talent development can successfully…

Techniques of remote sensing and GIS as tools for visualizing impact of climate change-induced flood in the southern African region.

USDA-ARS?s Scientific Manuscript database

This study employs remote sensing and Geographical Information Systems (GIS) data to visualize the impact of climate change caused by flooding in the Southern African region in order to assist decision makers’ plans for future occurrences. In pursuit of this objective, this study uses Digital Elevat...

Computer Network Operations Methodology

DTIC Science & Technology

2004-03-01

means of their computer information systems. Disrupt - This type of attack focuses on disrupting as “attackers might surreptitiously reprogram enemy...by reprogramming the computers that control distribution within the power grid. A disruption attack introduces disorder and inhibits the effective...between commanders. The use of methodologies is widespread and done subconsciously to assist individuals in decision making. The processes that

76 FR 46893 - Agency Information Collection Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... manufacturer certifies to a FTA grantee that the bus the grantee is purchasing has been tested at the Center. Also, grantees about to purchase a bus use this report to assist them in making their purchasing decisions. PTI maintains a reference file for all the test reports which are made available to the public...

12 CFR 1202.9 - How do I appeal a response denying my FOIA request?

Code of Federal Regulations, 2012 CFR

2012-01-01

.... The electronic mail address is: [email protected]gov. For mail or delivery service, the mailing address is...://www.fhfa.gov, provides additional information to assist you in making your appeal. (b) Timing, form... with the decision; or (3) Remand a request to FHFA or FHFA-OIG, as appropriate, for re-processing...

13 CFR 130.430 - Application decisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Application decisions. 130.430 Section 130.430 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS DEVELOPMENT CENTERS § 130.430 Application decisions. (a) The AA/SBDCs may approve, conditionally approve, or reject...

Harnessing Vehicle-to-Pedestrian (V2P) Communication Technology: Sending Traffic Warnings to Texting Pedestrians.

PubMed

Rahimian, Pooya; O'Neal, Elizabeth E; Zhou, Shiwen; Plumert, Jodie M; Kearney, Joseph K

2018-06-01

We examined how sending mobile-device warnings to texting pedestrians when they initiate an unsafe road crossing influences their decisions and actions. Pedestrian texting has been identified as a key risk factor in pedestrian-vehicle collisions. Advances in sensing and communications technology offer the possibility of providing pedestrians with information about traffic conditions to assist them in safely crossing traffic-filled roadways. However, it is unclear how this information can be most effectively communicated to pedestrians. We examined how texting and nontexting pedestrians crossed roads with continuous traffic in a large-screen, immersive pedestrian simulator using a between-subjects design with three conditions: texting, warning, and control. Texting participants in the warning condition received an alarm on their cell phone when they began to cross a dangerously small gap. The results demonstrate the detrimental influence of texting on pedestrians' gap selection, movement timing, and gaze behavior, and show the potential of warnings to improve decision making and safety. However, the results also reveal the limits of warning texting participants once they initiate a crossing and possible overreliance on technology that may lead to reduced situation awareness. Mobile devices and short-range communication technologies offer enormous potential to assist pedestrians, but further study is needed to better understand how to provide useful information in a timely manner. The technology for communicating traffic information to pedestrians via mobile devices is on the horizon. Research on how such information influences all aspects of pedestrian behavior is critical to developing effective solutions.

Factors influencing parental decision making about stimulant treatment for attention-deficit/hyperactivity disorder.

PubMed

Ahmed, Rana; McCaffery, Kirsten J; Aslani, Parisa

2013-04-01

Attention-deficit/hyperactivity disorder (ADHD) is a pediatric psychological condition commonly treated with stimulant medications. Negative media reports and stigmatizing societal attitudes surrounding the use of these medications make it difficult for parents of affected children to accept stimulant treatment, despite it being first line therapy. The purpose of this study was to identify factors that influence parental decision making regarding stimulant treatment for ADHD. A systematic review of the literature was conducted to identify studies: 1) that employed qualitative methodology, 2) that highlighted treatment decision(s) about stimulant medication, 3) in which the decision(s) were made by the parent of a child with an official ADHD diagnosis, and 4) that examined the factors affecting the decision(s) made. Individual factors influencing parental treatment decision making, and the major themes encompassing these factors, were identified and followed by a thematic analysis. Eleven studies reporting on the experiences of 335 parents of children with ADHD were included. Four major themes encompassing influences on parents' decisions were derived from the thematic analysis performed: confronting the diagnosis, external influences, apprehension regarding therapy, and experience with the healthcare system. The findings of this systematic review reveal that there are multiple factors that influence parents' decisions about stimulant therapy. This information can assist clinicians in enhancing information delivery to parents of children with ADHD, and help reduce parental ambivalence surrounding stimulant medication use. Future work needs to address parental concerns about stimulants, and increase their involvement in shared decision making with clinicians to empower them to make the most appropriate treatment decision for their child.

Context-Aware Intelligent Assistant Approach to Improving Pilot's Situational Awareness

NASA Technical Reports Server (NTRS)

Spirkovska, Lilly; Lodha, Suresh K.

2004-01-01

Faulty decision making due to inaccurate or incomplete awareness of the situation tends to be the prevailing cause of fatal general aviation accidents. Of these accidents, loss of weather situational awareness accounts for the largest number of fatalities. We describe a method for improving weather situational awareness through the support of a contextaware,domain and task knowledgeable, personalized and adaptive assistant. The assistant automatically monitors weather reports for the pilot's route of flight and warns her of detected anomalies. When and how warnings are issued is determined by phase of flight, the pilot s definition of acceptable weather conditions, and the pilot's preferences for automatic notification. In addition to automatic warnings, the pilot is able to verbally query for weather and airport information. By noting the requests she makes during the approach phase of flight, our system learns to provide the information without explicit requests on subsequent flights with similar conditions. We show that our weather assistant decreases the effort required to maintain situational awareness by more than 5.5 times when compared to the conventional method of in-flight weather briefings.

Mobile technology supporting trainee doctors' workplace learning and patient care: an evaluation.

PubMed

Hardyman, Wendy; Bullock, Alison; Brown, Alice; Carter-Ingram, Sophie; Stacey, Mark

2013-01-21

The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded "iDoc", a project offering trainee doctors a Smartphone library of medical textbooks. Data on trainee doctors' (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors' discussions with seniors; independent practice; patient care; and this 'just-in-time' access to reliable information supported confident and efficient decision-making. A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice.

Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making.

PubMed

Kageyama, Yoko; Asano, Midori

2017-12-01

The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

A randomized comparative trial of two decision tools for pregnant women with prior cesareans.

PubMed

Eden, Karen B; Perrin, Nancy A; Vesco, Kimberly K; Guise, Jeanne-Marie

2014-01-01

Evaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor. Randomized comparative trial. A research assistant with a laptop met the women in quiet locations at clinics and at health fairs. Pregnant women (N = 131) who had one prior cesarean and were eligible for vaginal birth after cesarean (VBAC) participated one time between 2005 and 2007. Women were randomized to receive either an evidence-based, interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC. Effect on the decision-making process was assessed before and after the interventions. Compared to baseline, women in both groups felt more informed (F = 23.8, p < .001), were more clear about their birth priorities (F = 9.7, p = .002), felt more supported (F = 9.8, p = .002, and overall reported less conflict (F = 18.1, p < 0.001) after receiving either intervention. Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures (F = 9.8, p = .003). Although both decision tools significantly reduced conflict around the birth decision compared to baseline, more work is needed to understand which format, the interactive decision aid or paper brochures, are more effective early and late in pregnancy. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Smart strategies for doctors and doctors-in-training: heuristics in medicine.

PubMed

Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

2009-08-01

How do doctors make sound decisions when confronted with probabilistic data, time pressures and a heavy workload? One theory that has been embraced by many researchers is based on optimisation, which emphasises the need to integrate all information in order to arrive at sound decisions. This notion makes heuristics, which use less than complete information, appear as second-best strategies. In this article, we challenge this pessimistic view of heuristics. We introduce two medical problems that involve decision making to the reader: one concerns coronary care issues and the other macrolide prescriptions. In both settings, decision-making tools grounded in the principles of optimisation and heuristics, respectively, have been developed to assist doctors in making decisions. We explain the structure of each of these tools and compare their performance in terms of their facilitation of correct predictions. For decisions concerning both the coronary care unit and the prescribing of macrolides, we demonstrate that sacrificing information does not necessarily imply a forfeiting of predictive accuracy, but can sometimes even lead to better decisions. Subsequently, we discuss common misconceptions about heuristics and explain when and why ignoring parts of the available information can lead to the making of more robust predictions. Heuristics are neither good nor bad per se, but, if applied in situations to which they have been adapted, can be helpful companions for doctors and doctors-in-training. This, however, requires that heuristics in medicine be openly discussed, criticised, refined and then taught to doctors-in-training rather than being simply dismissed as harmful or irrelevant. A more uniform use of explicit and accepted heuristics has the potential to reduce variations in diagnoses and to improve medical care for patients.

Knowledge Assisted Integrated Design of a Component and Its Manufacturing Process

NASA Astrophysics Data System (ADS)

Gautham, B. P.; Kulkarni, Nagesh; Khan, Danish; Zagade, Pramod; Reddy, Sreedhar; Uppaluri, Rohith

Integrated design of a product and its manufacturing processes would significantly reduce the total cost of the products as well as the cost of its development. However this would only be possible if we have a platform that allows us to link together simulations tools used for product design, performance evaluation and its manufacturing processes in a closed loop. In addition to that having a comprehensive knowledgebase that provides systematic knowledge guided assistance to product or process designers who may not possess in-depth design knowledge or in-depth knowledge of the simulation tools, would significantly speed up the end-to-end design process. In this paper, we propose a process and illustrate a case for achieving an integrated product and manufacturing process design assisted by knowledge support for the user to make decisions at various stages. We take transmission component design as an example. The example illustrates the design of a gear for its geometry, material selection and its manufacturing processes, particularly, carburizing-quenching and tempering, and feeding the material properties predicted during heat treatment into performance estimation in a closed loop. It also identifies and illustrates various decision stages in the integrated life cycle and discusses the use of knowledge engineering tools such as rule-based guidance, to assist the designer make informed decisions. Simulation tools developed on various commercial, open-source platforms as well as in-house tools along with knowledge engineering tools are linked to build a framework with appropriate navigation through user-friendly interfaces. This is illustrated through examples in this paper.

75 FR 69653 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CW-015] Energy... November 4, 2010. Cathy Zoi, Assistant Secretary, Energy Efficiency and Renewable Energy. Decision and...)(1)(iii). The Assistant Secretary for Energy Efficiency and Renewable Energy (the Assistant Secretary...

A Web-based graphical user interface for evidence-based decision making for health care allocations in rural areas

PubMed Central

Schuurman, Nadine; Leight, Margo; Berube, Myriam

2008-01-01

Background The creation of successful health policy and location of resources increasingly relies on evidence-based decision-making. The development of intuitive, accessible tools to analyse, display and disseminate spatial data potentially provides the basis for sound policy and resource allocation decisions. As health services are rationalized, the development of tools such graphical user interfaces (GUIs) is especially valuable at they assist decision makers in allocating resources such that the maximum number of people are served. GIS can used to develop GUIs that enable spatial decision making. Results We have created a Web-based GUI (wGUI) to assist health policy makers and administrators in the Canadian province of British Columbia make well-informed decisions about the location and allocation of time-sensitive service capacities in rural regions of the province. This tool integrates datasets for existing hospitals and services, regional populations and road networks to allow users to ascertain the percentage of population in any given service catchment who are served by a specific health service, or baskets of linked services. The wGUI allows policy makers to map trauma and obstetric services against rural populations within pre-specified travel distances, illustrating service capacity by region. Conclusion The wGUI can be used by health policy makers and administrators with little or no formal GIS training to visualize multiple health resource allocation scenarios. The GUI is poised to become a critical decision-making tool especially as evidence is increasingly required for distribution of health services. PMID:18793428

Protocol for the evaluation of a decision aid for women with a breech-presenting baby [ISRCTN14570598

PubMed Central

Roberts, Christine L; Nassar, Natasha; Barratt, Alexandra; Raynes-Greenow, Camille H; Peat, Brian; Henderson-Smart, David

2004-01-01

Background There is now good evidence about the management options for pregnant women with a breech presentation (buttocks or feet rather than head-first) at term; external cephalic version (ECV) – the turning of a breech baby to a head-down position and/or planned caesarean section (CS). Each of these options has benefits and risks and the relative importance of these vary for each woman, subject to her personal values and preferences, a situation where a decision aid may be helpful. Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. The ECV decision aid was developed using the Ottawa Decision Support Framework, including a systematic review of the evidence about the benefits and risks of the options for breech pregnancy. It comprises an audiotape with a supplementary booklet and worksheet, a format that can be taken home and discussed with a partner. This project aims to evaluate the ECV decision aid for women with a breech presenting baby in late pregnancy. Study design We aim to evaluate the effectiveness of the decision aid compared with usual care in a randomised controlled trial in maternity hospitals that offer ECV. The study group will receive the decision aid in addition to usual care and the control group will receive standard information on management options for breech presentation from their usual pregnancy care provider. Approximately 184 women with a single breech-presenting baby at greater than 34 weeks gestation and who are clinically eligible for ECV will be recruited for the trial. The primary outcomes of the study are knowledge, decisional conflict, anxiety and satisfaction with decision-making that will be assessed using self-administered questionnaires. The decision aid is not intended to influence either the uptake of either ECV or planned CS, however we will monitor health service utilisation rates and maternal and perinatal outcomes. PMID:15606926

Structured reports of videofluoroscopic swallowing studies have the potential to improve overall report quality compared to free text reports.

PubMed

Schoeppe, Franziska; Sommer, Wieland H; Haack, Mareike; Havel, Miriam; Rheinwald, Marika; Wechtenbruch, Juliane; Fischer, Martin R; Meinel, Felix G; Sabel, Bastian O; Sommer, Nora N

2018-01-01

To compare free text (FTR) and structured reports (SR) of videofluoroscopic swallowing studies (VFSS) and evaluate satisfaction of referring otolaryngologists and speech therapists. Both standard FTR and SR of 26 patients with VFSS were acquired. A dedicated template focusing on oropharyngeal phases was created for SR using online software with clickable decision-trees and concomitant generation of semantically structured reports. All reports were evaluated regarding overall quality and content, information extraction and clinical decision support (10-point Likert scale (0 = I completely disagree, 10 = I completely agree)). Two otorhinolaryngologists and two speech therapists evaluated FTR and SR. SR received better ratings than FTR in all items. SR were perceived to contain more details on the swallowing phases (median rating: 10 vs. 5; P < 0.001), penetration and aspiration (10 vs. 5; P < 0.001) and facilitated information extraction compared to FTR (10 vs. 4; P < 0.001). Overall quality was rated significantly higher in SR than FTR (P < 0.001). SR of VFSS provide more detailed information and facilitate information extraction. SR better assist in clinical decision-making, might enhance the quality of the report and, thus, are recommended for the evaluation of VFSS. • Structured reports on videofluoroscopic exams of deglutition lead to improved report quality. • Information extraction is facilitated when using structured reports based on decision trees. • Template-based reports add more value to clinical decision-making than free text reports. • Structured reports receive better ratings by speech therapists and otolaryngologists. • Structured reports on videofluoroscopic exams may improve the comparability between exams.

Impact of a decision-support tool on decision making at the district level in Kenya

PubMed Central

2013-01-01

Background In many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions. Methods Thirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts. Results Findings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement. Conclusions This paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems. PMID:24011028

Soak Up the Rain New England Webinar Series: National ...

EPA Pesticide Factsheets

Presenters will provide an introduction to the most recent EPA green infrastructure tools to R1 stakeholders; and their use in making decisions about implementing green infrastructure. We will discuss structuring your green infrastructure decision, finding appropriate information and tools, evaluating options and selecting the right Best Management Practices mix for your needs.WMOST (Watershed Management Optimization Support Tool)- for screening a wide range of practices for cost-effectiveness in achieving watershed or water utilities management goals.GIWiz (Green Infrastructure Wizard)- a web application connecting communities to EPA Green Infrastructure tools and resources.Opti-Tool-designed to assist in developing technically sound and optimized cost-effective Stormwater management plans. National Stormwater Calculator- a desktop application for estimating the impact of land cover change and green infrastructure controls on stormwater runoff. DASEES-GI (Decision Analysis for a Sustainable Environment, Economy, and Society) – a framework for linking objectives and measures with green infrastructure methods. Presenters will provide an introduction to the most recent EPA green infrastructure tools to R1 stakeholders; and their use in making decisions about implementing green infrastructure. We will discuss structuring your green infrastructure decision, finding appropriate information and tools, evaluating options and selecting the right Best Management Pr

The Effects of Assistant Principals' Decision-Making Processes on Advanced Diploma Rates in Long Island High Schools

ERIC Educational Resources Information Center

Murillo, Leo

2017-01-01

The purpose of this causal comparative study is to determine whether the assistant principal decision-making process and their years of experience influence the advanced diploma rates in high schools on Long Island, New York. The subjects for this study were 75 assistant principals in Long Island high schools during 2016. Assistant principals'…

29 CFR 1905.30 - Decision of the Assistant Secretary.

Code of Federal Regulations, 2010 CFR

2010-07-01

... UNDER THE WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Hearings § 1905.30 Decision of the... 29 Labor 5 2010-07-01 2010-07-01 false Decision of the Assistant Secretary. 1905.30 Section 1905.30 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION...

Application of Adaptive Decision Aiding Systems to Computer-Assisted Instruction. Final Report, January-December 1974.

ERIC Educational Resources Information Center

May, Donald M.; And Others

The minicomputer-based Computerized Diagnostic and Decision Training (CDDT) system described combines the principles of artificial intelligence, decision theory, and adaptive computer assisted instruction for training in electronic troubleshooting. The system incorporates an adaptive computer program which learns the student's diagnostic and…

13 CFR 134.404 - Decision by Administrative Law Judge.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Decision by Administrative Law Judge. 134.404 Section 134.404 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION RULES OF... 8(a) Program § 134.404 Decision by Administrative Law Judge. Appeal proceedings brought under this...

45 CFR 99.33 - Effective date of Assistant Secretary's decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Effective date of Assistant Secretary's decision. 99.33 Section 99.33 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROCEDURE FOR HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Posthearing Procedures, Decisions § 99.33...

Effective Mental Health Consumer Education: A Preliminary Exploration

PubMed Central

Bielavitz, Sarann; Pollack, David A.

2011-01-01

People with serious mental illnesses are increasingly becoming more active participants in their treatment and recovery. At times, their participation may be limited by incomplete, unclear, or insufficient information. The authors used a grounded theory approach to look at the unmet informational needs described by consumers. Participants in this study called for materials appropriate to their level of understanding, assistance with interpreting and comprehending information when necessary, and information on policies that affect the treatment they receive. Ultimately, an informed consumer is one empowered to make decisions about the course of his or her recovery and participate meaningfully in the patient–provider relationship. PMID:20358303

Three-Dimensional Model for Preservation and Restoration of Architectural Heritage

NASA Technical Reports Server (NTRS)

Marchis, Elena

2011-01-01

Thc aim of the research will be to create a model, three-dimensional mathematical. implementation. consultation and assistance to "large" restoration projects that will assist the structural analysis, allowing easier display of dynamic strain. analysis and lighting noise. It could also be a valuable tool for decision support. therefore. may simulate several possible scenarios for intervention, This model appears therefore an excellent support for recovering. ordering and monitoring information about materials and data (stage of restoration. photographs. sampling points. results of diagnostic tests, etc.) collected dynamically during the "life" of the cultural heritage. allowing to document its complete history

Laboratory cost control and financial management software.

PubMed

Mayer, M

1998-02-09

Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

Influence of Genetic Counseling Graduate Program Websites on Student Application Decisions.

PubMed

Ivan, Kristina M; Hassed, Susan; Darden, Alix G; Aston, Christopher E; Guy, Carrie

2017-12-01

This study investigated how genetic counseling educational program websites affect application decisions via an online survey sent to current students and recent graduates. Program leadership: directors, assistant directors, associate directors, were also surveyed to determine where their opinions coincided or differed from those reported by students and recent graduates. Chi square analysis and t-tests were used to determine significance of results. A two-sample t-test was used to compare factors students identified as important on a 5-point Likert scale with those identified by directors. Thematic analysis revealed three major themes students consider important for program websites: easy navigation, website content, and website impression. Directors were interested in how prospective students use their program website and what information they found most useful. Students indicated there were specific programs they chose not to apply to due to the difficulty of using the website for that program. Directors significantly underestimated how important information about application requirements was to students in making application decisions. The information reported herein will help individual genetic counseling graduate programs improve website functionality and retain interested applicants.

Supporting Clinical Cognition: A Human-Centered Approach to a Novel ICU Information Visualization Dashboard.

PubMed

Faiola, Anthony; Srinivas, Preethi; Duke, Jon

2015-01-01

Advances in intensive care unit bedside displays/interfaces and electronic medical record (EMR) technology have not adequately addressed the topic of visual clarity of patient data/information to further reduce cognitive load during clinical decision-making. We responded to these challenges with a human-centered approach to designing and testing a decision-support tool: MIVA 2.0 (Medical Information Visualization Assistant, v.2). Envisioned as an EMR visualization dashboard to support rapid analysis of real-time clinical data-trends, our primary goal originated from a clinical requirement to reduce cognitive overload. In the study, a convenience sample of 12 participants were recruited, in which quantitative and qualitative measures were used to compare MIVA 2.0 with ICU paper medical-charts, using time-on-task, post-test questionnaires, and interviews. Findings demonstrated a significant difference in speed and accuracy with the use of MIVA 2.0. Qualitative outcomes concurred, with participants acknowledging the potential impact of MIVA 2.0 for reducing cognitive load and enabling more accurate and quicker decision-making.

42 CFR 430.102 - Decisions following hearing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Hearings on Conformity of State Medicaid Plans and Practice to Federal Requirements § 430.102 Decisions following hearing...

Adaptive automation of human-machine system information-processing functions.

PubMed

Kaber, David B; Wright, Melanie C; Prinzel, Lawrence J; Clamann, Michael P

2005-01-01

The goal of this research was to describe the ability of human operators to interact with adaptive automation (AA) applied to various stages of complex systems information processing, defined in a model of human-automation interaction. Forty participants operated a simulation of an air traffic control task. Automated assistance was adaptively applied to information acquisition, information analysis, decision making, and action implementation aspects of the task based on operator workload states, which were measured using a secondary task. The differential effects of the forms of automation were determined and compared with a manual control condition. Results of two 20-min trials of AA or manual control revealed a significant effect of the type of automation on performance, particularly during manual control periods as part of the adaptive conditions. Humans appear to better adapt to AA applied to sensory and psychomotor information-processing functions (action implementation) than to AA applied to cognitive functions (information analysis and decision making), and AA is superior to completely manual control. Potential applications of this research include the design of automation to support air traffic controller information processing.

Situation awareness and documentation of changes that affect patient outcomes in progress notes.

PubMed

Tower, Marion; Chaboyer, Wendy

2014-05-01

To report on registered nurses' situation awareness as a precursor to decision-making when recording changes in patients' conditions. Progress notes are important to communicate patients' progress and detail changes in patients' conditions. However, documentation is often poorly completed. There is little work that examines nurses' decision-making during documentation. This study focused on describing situation awareness as a precursor to decision-making during documentation. This study used Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) work on situation awareness to guide and conceptualise information. The study was situated in a naturalistic paradigm to provide an interpretation of nurses' decision-making. Think-aloud research methods and semi-structured interviews were employed to illuminate decision-making processes. Audio recordings and interview texts were individually examined for evidence of cues, informed by Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) descriptions of situation awareness. As patients' conditions changed, nurses used complex mental models and pattern-matching of information, drawing on all 3 levels of situation awareness during documentation. Level 1 situation awareness provided context, level 2 situation awareness signified a change in condition and its significance for the patient, and level 3 situation awareness was evident when nurses thought aloud about what this information indicated. Three themes associated with changes in patients' conditions emerged: deterioration in condition, not responding to prescribed treatments as expected and issues related to professional practice that impacted on patients' conditions. Nurses used a complex mental model for decision-making, drawing on 3 levels of situation awareness. Hamm's cognitive continuum theory, when related to situation awareness, is a useful decision-making theory to provide a platform on which to draw together components of situation awareness and provide a framework on which to base decision-making regarding documentation. Understanding how RNs employ situation awareness and providing a framework for decision-making during documentation may assist effective documentation about changes in patients' conditions. © 2013 John Wiley & Sons Ltd.

42 CFR 430.96 - Record for decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MEDICAL ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Hearings on Conformity of State Medicaid Plans and Practice to Federal Requirements § 430.96 Record for decision. The transcript...

Knowledge bases, clinical decision support systems, and rapid learning in oncology.

PubMed

Yu, Peter Paul

2015-03-01

One of the most important benefits of health information technology is to assist the cognitive process of the human mind in the face of vast amounts of health data, limited time for decision making, and the complexity of the patient with cancer. Clinical decision support tools are frequently cited as a technologic solution to this problem, but to date useful clinical decision support systems (CDSS) have been limited in utility and implementation. This article describes three unique sources of health data that underlie fundamentally different types of knowledge bases which feed into CDSS. CDSS themselves comprise a variety of models which are discussed. The relationship of knowledge bases and CDSS to rapid learning health systems design is critical as CDSS are essential drivers of rapid learning in clinical care. Copyright © 2015 by American Society of Clinical Oncology.

Dietary Supplements for Musculoskeletal Pain: Science Versus Claims.

PubMed

Crawford, Cindy; Saldanha, Leila; Costello, Rebecca; Deuster, Patricia A

2018-01-01

Special Operations Forces (SOF) face unique challenges that manifest themselves both mentally and physically. The extremes of training and combat can affect the readiness to perform at peak levels, especially when confronted with musculoskeletal pain. Many SOF Operators turn to dietary supplements in hopes of gaining an edge. Although some supplements are now being marketed for pain, decisions to use these products need to be driven by information that is evidence based. We describe SOF-specific evidence-based recommendations for the use of dietary ingredients for pain that emerged from a rigorous scientific evaluation. These recommendations are compared with the label claims made in the commercial market by companies selling products to combat musculoskeletal pain. This information can be used by the SOF medical community to assist Operators in making informed decisions when considering or selecting dietary supplements for maintaining and optimizing performance. 2018.

Organizational structure and job satisfaction in public health nursing.

PubMed

Campbell, Sara L; Fowles, Eileen R; Weber, B Jan

2004-01-01

The purpose of this descriptive study was to describe the characteristics and relationship of organizational structure and job satisfaction in public health nursing. A significant relationship was found between organizational structure variables and job satisfaction for public health nurses employed in down state Illinois local health departments. The findings of this study suggest that work environments in which supervisors and subordinates consult together concerning job tasks and decisions, and in which individuals are involved with peers in decision making and task definition, are positively related to job satisfaction. This information will assist nurse administrators in development of work structures that support participative decision making and enhance job satisfaction, critical to retaining and attracting a well-qualified public health nurse workforce.

Decision making and problem solving with computer assistance

NASA Technical Reports Server (NTRS)

Kraiss, F.

1980-01-01

In modern guidance and control systems, the human as manager, supervisor, decision maker, problem solver and trouble shooter, often has to cope with a marginal mental workload. To improve this situation, computers should be used to reduce the operator from mental stress. This should not solely be done by increased automation, but by a reasonable sharing of tasks in a human-computer team, where the computer supports the human intelligence. Recent developments in this area are summarized. It is shown that interactive support of operator by intelligent computer is feasible during information evaluation, decision making and problem solving. The applied artificial intelligence algorithms comprehend pattern recognition and classification, adaptation and machine learning as well as dynamic and heuristic programming. Elementary examples are presented to explain basic principles.

42 CFR 430.104 - Decisions that affect FFP.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Hearings on Conformity of State Medicaid Plans and Practice to Federal Requirements § 430.104 Decisions that affect FFP...

Summary of Research 1997, Interdisciplinary Academic Groups.

DTIC Science & Technology

1999-01-01

Os 656-3775 iosmundson @npsinavy.mii Channel, Ralph N. Senior Lecturer NS/Ch 656-2409 nchannell @nps.navv.mil Kemple, William G. Assistant...Research) Lieutenant Commander Steven J. Iatrou, USN (Information Warfare) Professor Carl R. Jones (Systems Management) Associate Professor William G...to assess the effectiveness of the newly developed decision support system. Adaptive Architectures for Command and Control William Kemple and

Examining winter visitor use in Yellowstone National Park

Treesearch

Mae A. Davenport; Wayne A. Freimund; William T. Borrie; Robert E. Manning; William A. Valliere; Benjamin Wang

2000-01-01

This research was designed to assist the managers of Yellowstone National Park (YNP) in their decision making about winter visitation. The focus of this report is on winter use patterns and winter visitor preferences. It is the author’s hope that this information will benefit both the quality of winter experiences and the stewardship of the park resources. This report...

ACHP | Advisory Council on Historic Preservation Customer Service Standards

Science.gov Websites

conditions are met: there is a Federal or federally assisted project or other action and that action could and decision making when the proposed action may affect historic properties in their jurisdiction or comments will be noted, and you will be informed of remedial action within 10 working days. If you are

Mapping habitat suitability for at-risk plants and its implications for restoration and reintroduction

Treesearch

E. Questad; J.R. Kellner; K. Kinney; S. Cordell; G.P. Asner; J. Thaxton; J. Diep; A. Uowolo; S. Brooks; N. Inman-Narahari; S. Evans; B. Tucker

2014-01-01

The conservation of species at risk of extinction requires data to support decisions at landscape to regional scales. There is a need for information that can assist with locating suitable habitats in fragmented and degraded landscapes to aid the reintroduction of at-risk plant species. In addition, desiccation and water stress can be significant barriers to the...

Financial management of a hospice program.

PubMed

Simione, Robert J; Simione, Kathleen A

2002-07-01

Agencies interested in starting hospice programs or maximizing the benefits of existing programs need to implement and maintain accurate and effective internal cost accounting systems. Once established, a cost accounting system provides the administrators of the hospice program with information to prepare budget projections, perform break-even analysis, and develop other reports to assist in making sound business decisions to ensure success.

Office of Strategic Programs FY 2017 Budget At-A-Glance

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

None

2016-03-01

The Office of Strategic Programs (OSP) increases the overall effectiveness and impact of all EERE activities through key cross-cutting initiatives and strategic analysis, communications, and technology-to-market activities. OSP’s work directly contributes to EERE’s mission, facilitates and amplifies the successes of EERE technology offices, and soundly and consistently informs the Assistant Secretary’s decisions.

The "Total" Newspaper: Suggestions for a Wider Conceptual Approach to Education for Careers in Journalism. Revised.

ERIC Educational Resources Information Center

Hirt, Paul S.

To assist journalism students in making informed decisions regarding newspaper work, a brief course was devised that was based on a total newspaper concept. Defining the newspaper as the interaction of all of its departments in a unique geographic, demographic, and economic setting, this course focused on the traditional approach to a newspaper;…

Department of Defense Environmental Cleanup Cost Allowability Policy.

DTIC Science & Technology

1994-12-01

The environment is directly affected by the industrial requirements and manufacturing processes necessary to provide those goods and services. As...and the industrial base. To begin the process , DCMC initiated the Environmental Initiatives Task Force Pilot Cost Allowance Program at five locations...policy covering environmental cleanup costs. Information will be provided to assist in the decision making process regarding the factors affecting the

Patients' Attitudes towards the Surplus Frozen Embryos in China

PubMed Central

Jin, Xuan; Wang, GongXian; Liu, SiSun; Liu, Ming; Zhang, Jing; Shi, YuFa

2013-01-01

Background. Assisted reproductive techniques have been used in China for more than 20 years. This study investigates the attitudes of surplus embryo holders towards embryos storage and donation for medical research. Methods. A total of 363 couples who had completed in vitro fertilization (IVF) treatment and had already had biological children but who still had frozen embryos in storage were invited to participate. Interviews were conducted by clinics in a narrative style. Results. Family size was the major reason for participants' (dis)continuation of embryo storage; moreover, the moral status of embryos was an important factor for couples choosing embryo storage, while the storage fee was an important factor for couples choosing embryo disposal. Most couples discontinued the storage of their embryos once their children were older than 3 years. In our study, 58.8% of the couples preferred to dispose of surplus embryos rather than donate them to research, citing a lack of information and distrust in science as significant reasons for their decision. Conclusions. Interviews regarding frozen embryos, including patients' expectations for embryo storage and information to assist them with decisions regarding embryo disposal, are beneficial for policies addressing embryo disposition and embryo donation in China. PMID:23509811

13 CFR 105.203 - SBA Assistance to person employing former SBA employee.

Code of Federal Regulations, 2010 CFR

2010-01-01

... nature to the Standards of Conduct Committee for final decision; otherwise, his or her decision is final... relationship of the former employee with the applicant concern; (2) The nature of the SBA Assistance requested... requested; and (4) Whether an apparent conflict of interest might exist if the SBA Assistance were granted. ...

Computer-Assisted Diagnostic Decision Support: History, Challenges, and Possible Paths Forward

ERIC Educational Resources Information Center

Miller, Randolph A.

2009-01-01

This paper presents a brief history of computer-assisted diagnosis, including challenges and future directions. Some ideas presented in this article on computer-assisted diagnostic decision support systems (CDDSS) derive from prior work by the author and his colleagues (see list in Acknowledgments) on the INTERNIST-1 and QMR projects. References…

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

An overview of methods for comparative effectiveness research.

PubMed

Meyer, Anne-Marie; Wheeler, Stephanie B; Weinberger, Morris; Chen, Ronald C; Carpenter, William R

2014-01-01

Comparative effectiveness research (CER) is a broad category of outcomes research encompassing many different methods employed by researchers and clinicians from numerous disciplines. The goal of cancer-focused CER is to generate new knowledge to assist cancer stakeholders in making informed decisions that will improve health care and outcomes of both individuals and populations. There are numerous CER methods that may be used to examine specific questions, including randomized controlled trials, observational studies, systematic literature reviews, and decision sciences modeling. Each has its strengths and weaknesses. To both inform and serve as a reference for readers of this issue of Seminars in Radiation Oncology as well as the broader oncology community, we describe CER and several of the more commonly used approaches and analytical methods. © 2013 Published by Elsevier Inc.

Effective communication about the use of complementary and integrative medicine in cancer care.

PubMed

Frenkel, Moshe; Cohen, Lorenzo

2014-01-01

Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the "how" and the "what". The "how" relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The "what" relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making.

Predicting Early Death Among Elderly Dialysis Patients: Development and Validation of a Risk Score to Assist Shared Decision Making for Dialysis Initiation.

PubMed

Thamer, Mae; Kaufman, James S; Zhang, Yi; Zhang, Qian; Cotter, Dennis J; Bang, Heejung

2015-12-01

A shared decision-making tool could help elderly patients with advanced chronic kidney disease decide about initiating dialysis therapy. Because mortality may be high in the first few months after initiating dialysis therapy, incorporating early mortality predictors in such a tool would be important for an informed decision. Our objective is to derive and validate a predictive risk score for early mortality after initiating dialysis therapy. Retrospective observational cohort, with development and validation cohorts. US Renal Data System and claims data from the Centers for Medicare & Medicaid Services for 69,441 (aged ≥67 years) patients with end-stage renal disease with a previous 2-year Medicare history who initiated dialysis therapy from January 1, 2009, to December 31, 2010. Demographics, predialysis care, laboratory data, functional limitations, and medical history. All-cause mortality in the first 3 and 6 months. Predicted mortality by logistic regression. The simple risk score (total score, 0-9) included age (0-3 points), low albumin level, assistance with daily living, nursing home residence, cancer, heart failure, and hospitalization (1 point each), and showed area under the receiver operating characteristic curve (AUROC)=0.69 in the validation sample. A comprehensive risk score with additional predictors was also developed (with AUROC=0.72, high concordance between predicted vs observed risk). Mortality probabilities were estimated from these models, with the median score of 3 indicating 12% risk in 3 months and 20% in 6 months, and the highest scores (≥8) indicating 39% risk in 3 months and 55% in 6 months. Patients who did not choose dialysis therapy and did not have a 2-year Medicare history were excluded. Routinely available information can be used by patients with chronic kidney disease, families, and their nephrologists to estimate the risk of early mortality after dialysis therapy initiation, which may facilitate informed decision making regarding treatment options. Copyright © 2015 National Kidney Foundation, Inc. All rights reserved.

A GIS Based 3D Online Decision Assistance System for Underground Energy Storage in Northern Germany

NASA Astrophysics Data System (ADS)

Nolde, M.; Schwanebeck, M.; Biniyaz, E.; Duttmann, R.

2014-12-01

We would like to present a GIS-based 3D online decision assistance system for underground energy storage. Its aim is to support the local land use planning authorities through pre-selection of possible sites for thermal, electrical and substantial underground energy storages. Since the extension of renewable energies has become legal requirement in Germany, the underground storing of superfluously produced green energy (such as during a heavy wind event) in the form of compressed air, gas or heated water has become increasingly important. However, the selection of suitable sites is a complex task. The assistance system uses data of geological features such as rock layers, salt caverns and faults enriched with attribute data such as rock porosity and permeability. This information is combined with surface data of the existing energy infrastructure, such as locations of wind and biogas stations, power line arrangement and cable capacity, and energy distribution stations. Furthermore, legal obligations such as protected areas on the surface and current underground mining permissions are used for the decision finding process. Not only the current situation but also prospective scenarios, such as expected growth in produced amount of energy are incorporated in the system. The decision process is carried out via the 'Analytic Hierarchy Process' (AHP) methodology of the 'Multi Object Decision Making' (MODM) approach. While the process itself is completely automated, the user has full control of the weighting of the different factors via the web interface. The system is implemented as an online 3D server GIS environment, with no software needed to be installed on the user side. The results are visualized as interactive 3d graphics. The implementation of the assistance system is based exclusively on free and open source software, and utilizes the 'Python' programming language in combination with current web technologies, such as 'HTML5', 'CSS3' and 'JavaScript'. It is developed at Kiel University for the federal state of Schleswig-Holstein in northern Germany. This work is part of project 'ANGUS+', lead by Prof. Dr. Sebastian Bauer and funded by the German Ministry for Education and Research (BMBF).

Presenting risk information to people with diabetes: evaluating effects and preferences for different formats by a web-based randomised controlled trial.

PubMed

Edwards, Adrian; Thomas, Richard; Williams, Rhys; Ellner, Andrew L; Brown, Polly; Elwyn, Glyn

2006-11-01

Web-based patient information is widespread and information on the benefits and risks of treatments is often difficult to understand. We therefore evaluated different risk presentation formats - numerical, graphical and others - addressing the pros and cons of tight control versus usual treatment approaches for diabetes. Randomised controlled trial. Online. Publicity disseminated via Diabetes UK. People with diabetes or their carers. Control group information based on British Medical Journal 'Best Treatments'. Four intervention groups received enhanced information resources: (1) detailed numerical information (absolute/relative risk, numbers-needed-to-treat); (2) 'anchoring' to familiar risks or descriptions; (3) graphical (bar charts, thermometer scales, crowd figure formats); (4) combination of 1-3. Decision conflict scale (DCS, a measure of uncertainty); satisfaction with information; further free text responses for qualitative content analysis. Seven hundred and ten people visited the website and were randomised. Five hundred and eight completed the questionnaire for quantitative data. Mean DCS scores ranged from 2.12 to 2.24 for the five randomisation groups, indicating neither clear delay or vacillation about decisions (usually DCS>2.5) nor tending to make decisions (usually DCS<2.0). There were no statistically significant effects of the interventions on DCS, or satisfaction with information. Two hundred and fifty-six participants provided responses for qualitative analysis: most found graphical representations helpful, specifically bar chart formats; many found other graphic formats (thermometer style, crowd figures/smiley faces) and 'anchoring' information unhelpful, and indicated information overload. Many negative experiences with healthcare indicate a challenging context for effective information provision and decision support. Online evaluation of different risk representation formats was feasible. There was a lack of intervention effects on quantitative outcomes, perhaps reflecting already well-informed participants from the Diabetes UK patient organisation. The large qualitative dataset included many comments about what participants found helpful as formats for communicating risk information. These findings assist the design of online decision aids and the representation of risk information. The challenge is to provide more information, in appropriate and clear formats, but without risking information overload. Interactive web designs hold much promise to achieve this.

Informing clinical policy decision-making practices in ambulance services.

PubMed

Muecke, Sandy; Curac, Nada; Binks, Darryn

2013-12-01

This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles. A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review. There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

The USAID Office of U.S. Foreign Disaster Assistance: Using Disaster Risk Reduction Programs to Increase Community Resiliency to Geologic Hazards and Promote Sustained Development

NASA Astrophysics Data System (ADS)

Mayberry, G. C.

2009-12-01

The U.S. Agency for International Development’s (USAID) Office of U.S. Foreign Disaster Assistance (OFDA) supports several geologic-hazard related projects that help reduce the impact of geologic disasters by utilizing advances in science to monitor hazards and mitigate their effects. OFDA’s main responsibility is to rapidly respond to disasters, but OFDA also supports disaster risk reduction activities that aim to ultimately decrease the need for external responders and help to sustain development efforts by lessening the impact of potential disasters and strengthening at-risk community’s resiliency. One of OFDA’s success stories in geologic hazard risk reduction is the Volcano Disaster Assistance Program (VDAP). Following the deadly 1985 eruption of Nevado del Ruiz volcano in Colombia that killed about 25,000 people, the U.S. Geological Survey (USGS) and OFDA formed the VDAP team to provide technical assistance worldwide when potentially dangerous volcanoes show signs of unrest. VDAP also provides technical assistance for capacity-building projects at foreign observatories in order to strengthen their volcano monitoring networks and better prepare them for future activity. VDAP has deployed to 24 major crises in the past 23 years and helped to build infrastructure in 12 countries. They have helped their local counterparts save tens of thousands of lives, and hundreds of millions of dollars in property. Several factors contribute to VDAP’s success: sustained technical assistance allows VDAP to build upon previous efforts, working in the background with counterparts promotes independence, and addressing response and capacity-building needs leads to sustained development among counterpart agencies. Some of the lessons learned from VDAP will be parlayed into the newly formed OFDA-USGS Earthquake Disaster Assistance Team (EDAT), which will provide technical assistance to scientists shortly after large earthquakes occur in foreign countries so that they can “build back better” after events. An example of how OFDA is using advances in science to address the impact of earthquakes on society is the Prompt Assessment of Global Earthquakes for Response (PAGER). PAGER, which is implemented by the USGS, distributes notifications that provide an estimate of the impact of significant earthquakes shortly after they occur. The notifications include earthquake information such as location, magnitude and depth, an estimate of the number of people exposed to varying levels of shaking based on the Modified Mercalli Intensity Scale, and a description of the region’s vulnerability to earthquakes. The science-based information that PAGER provides has proven to be a valuable asset for responders who have to quickly make potentially life-saving decisions often with little data. In addition, scenarios can be run using the PAGER system that provide a visual means to communicate the potential seismic hazard to at-risk communities and decision makers so that they can make informed decisions about future development. OFDA’s disaster risk reduction projects such as VDAP, EDAT, and PAGER, help promote sustained development by lessening the impact of future geologic events.

The Assisted Decision-Making (Capacity) Act 2015: what it is and why it matters.

PubMed

Kelly, B D

2017-05-01

Ireland's Assisted Decision-Making (Capacity) Act 2015 was signed by President Higgins in December 2015 and scheduled for commencement in 2016. To explore the content and implications of the 2015 Act. Review of the 2015 Act and related literature. The 2015 Act places the "will and preferences" of persons with impaired mental capacity at the heart of decision-making relating to "personal welfare" (including healthcare) and "property and affairs". Capacity is to be "construed functionally" and interventions must be "for the benefit of the relevant person". The Act outlines three levels of decision-making assistance: "decision-making assistant", "co-decision-maker" (joint decision-maker) and "decision-making representative" (substitute decision-maker). There are procedures relating to "enduring power of attorney" and "advance healthcare directives"; in the case of the latter, a "refusal of treatment" can be legally binding, while a "request for a specific treatment" must "be taken into consideration". The 2015 Act is considerably more workable than the 2013 Bill that preceded it. Key challenges include the subtle decision-making required by patients, healthcare staff, Circuit Court judges and the director of the Decision Support Service; implementation of "advance healthcare directives", especially if they do not form part of a broader model of advance care planning (incorporating the flexibility required for unpredictable future circumstances); and the over-arching issue of logistics, as very many healthcare decisions are currently made in situations where the patient's capacity is impaired. A key challenge will lie in balancing the emphasis on autonomy with principles of beneficence, mutuality and care.

Design and implementation of intelligent electronic warfare decision making algorithm

NASA Astrophysics Data System (ADS)

Peng, Hsin-Hsien; Chen, Chang-Kuo; Hsueh, Chi-Shun

2017-05-01

Electromagnetic signals and the requirements of timely response have been a rapid growth in modern electronic warfare. Although jammers are limited resources, it is possible to achieve the best electronic warfare efficiency by tactical decisions. This paper proposes the intelligent electronic warfare decision support system. In this work, we develop a novel hybrid algorithm, Digital Pheromone Particle Swarm Optimization, based on Particle Swarm Optimization (PSO), Ant Colony Optimization (ACO) and Shuffled Frog Leaping Algorithm (SFLA). We use PSO to solve the problem and combine the concept of pheromones in ACO to accumulate more useful information in spatial solving process and speed up finding the optimal solution. The proposed algorithm finds the optimal solution in reasonable computation time by using the method of matrix conversion in SFLA. The results indicated that jammer allocation was more effective. The system based on the hybrid algorithm provides electronic warfare commanders with critical information to assist commanders in effectively managing the complex electromagnetic battlefield.

Fort Collins Science Center- Policy Analysis and Science Assistance Branch : Integrating social, behavioral, economic and biological sciences

USGS Publications Warehouse

2010-01-01

The Fort Collins Science Center's Policy Analysis and Science Assistance (PASA) Branch is a team of approximately 22 scientists, technicians, and graduate student researchers. PASA provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and biological analyses in the context of human-natural resource interactions. Resource planners, managers, and policymakers in the U.S. Departments of the Interior (DOI) and Agriculture (USDA), State and local agencies, as well as international agencies use information from PASA studies to make informed natural resource management and policy decisions. PASA scientists' primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to advance performance in policy relevant research areas. Management and research issues associated with human-resource interactions typically occur in a unique context, involve difficult to access populations, require knowledge of both natural/biological science in addition to social science, and require the skill to integrate multiple science disciplines. In response to these difficult contexts, PASA researchers apply traditional and state-of-the-art social science methods drawing from the fields of sociology, demography, economics, political science, communications, social-psychology, and applied industrial organization psychology. Social science methods work in concert with our rangeland/agricultural management, wildlife, ecology, and biology capabilities. The goal of PASA's research is to enhance natural resource management, agency functions, policies, and decision-making. Our research is organized into four broad areas of study.

Quantifying the Value of Downscaled Climate Model Information for Adaptation Decisions: When is Downscaling a Smart Decision?

NASA Astrophysics Data System (ADS)

Terando, A. J.; Wootten, A.; Eaton, M. J.; Runge, M. C.; Littell, J. S.; Bryan, A. M.; Carter, S. L.

2015-12-01

Two types of decisions face society with respect to anthropogenic climate change: (1) whether to enact a global greenhouse gas abatement policy, and (2) how to adapt to the local consequences of current and future climatic changes. The practice of downscaling global climate models (GCMs) is often used to address (2) because GCMs do not resolve key features that will mediate global climate change at the local scale. In response, the development of downscaling techniques and models has accelerated to aid decision makers seeking adaptation guidance. However, quantifiable estimates of the value of information are difficult to obtain, particularly in decision contexts characterized by deep uncertainty and low system-controllability. Here we demonstrate a method to quantify the additional value that decision makers could expect if research investments are directed towards developing new downscaled climate projections. As a proof of concept we focus on a real-world management problem: whether to undertake assisted migration for an endangered tropical avian species. We also take advantage of recently published multivariate methods that account for three vexing issues in climate impacts modeling: maximizing climate model quality information, accounting for model dependence in ensembles of opportunity, and deriving probabilistic projections. We expand on these global methods by including regional (Caribbean Basin) and local (Puerto Rico) domains. In the local domain, we test whether a high resolution (2km) dynamically downscaled GCM reduces the multivariate error estimate compared to the original coarse-scale GCM. Initial tests show little difference between the downscaled and original GCM multivariate error. When propagated through to a species population model, the Value of Information analysis indicates that the expected utility that would accrue to the manager (and species) if this downscaling were completed may not justify the cost compared to alternative actions.

Decision-making contexts involving Earth observations in federal and state government agencies

NASA Astrophysics Data System (ADS)

Kuwayama, Y.; Thompson, A.

2017-12-01

National and international organizations are placing greater emphasis on the societal and economic benefits that can be derived from applications of Earth observations, yet improvements are needed to connect to the decision processes that produce actions with direct societal benefits. The Consortium for the Valuation of Applications Benefits Linked with Earth Science (VALUABLES), a cooperative agreement between Resources for the Future (RFF) and the National Aeronautics and Space Administration (NASA), has the goal of advancing methods for the valuation and communication of the applied benefits linked with Earth observations. One of the Consortium's activities is a set of Policy Briefs that document the use of Earth observations for decision making in federal and state government agencies. In developing these Policy Briefs, we pay special attention to documenting the entire information value chain associated with the use of Earth observations in government decision making, namely (a) the specific data product, modeling capability, or information system used by the agency, (b) the decision context that employs the Earth observation information and translates it into an agency action, (c) the outcomes that are realized as a result of the action, and (d) the beneficiaries associated with the outcomes of the decision. Two key examples include the use of satellite data for informing the US Drought Monitor (USDM), which is used to determine the eligibility of agricultural communities for drought disaster assistance programs housed at the US Department of Agriculture (USDA), and the use of satellite data by the Florida Department of Environmental Protection to develop numeric nutrient water quality standards and monitoring methods for chlorophyll-a, which is codified in Florida state code (62-302.532).

Automatic staging of bladder cancer on CT urography

NASA Astrophysics Data System (ADS)

Garapati, Sankeerth S.; Hadjiiski, Lubomir M.; Cha, Kenny H.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Alva, Ajjai; Paramagul, Chintana; Wei, Jun; Zhou, Chuan

2016-03-01

Correct staging of bladder cancer is crucial for the decision of neoadjuvant chemotherapy treatment and minimizing the risk of under- or over-treatment. Subjectivity and variability of clinicians in utilizing available diagnostic information may lead to inaccuracy in staging bladder cancer. An objective decision support system that merges the information in a predictive model based on statistical outcomes of previous cases and machine learning may assist clinicians in making more accurate and consistent staging assessments. In this study, we developed a preliminary method to stage bladder cancer. With IRB approval, 42 bladder cancer cases with CTU scans were collected from patient files. The cases were classified into two classes based on pathological stage T2, which is the decision threshold for neoadjuvant chemotherapy treatment (i.e. for stage >=T2) clinically. There were 21 cancers below stage T2 and 21 cancers at stage T2 or above. All 42 lesions were automatically segmented using our auto-initialized cascaded level sets (AI-CALS) method. Morphological features were extracted, which were selected and merged by linear discriminant analysis (LDA) classifier. A leave-one-case-out resampling scheme was used to train and test the classifier using the 42 lesions. The classification accuracy was quantified using the area under the ROC curve (Az). The average training Az was 0.97 and the test Az was 0.85. The classifier consistently selected the lesion volume, a gray level feature and a contrast feature. This predictive model shows promise for assisting in assessing the bladder cancer stage.

A Survey of Practice Patterns in Concussion Assessment and Management.

PubMed

Ferrara, Michael S.; McCrea, Michael; Peterson, Connie L.; Guskiewicz, Kevin M.

2001-06-01

OBJECTIVES: To identify methods used by athletic trainers to assess concussions and the use of that information to assist in return-to-play decisions and to determine athletic trainers' familiarity with new standardized methods of concussion assessment. DESIGN AND SETTING: A 21-item questionnaire was distributed to attendees of a minicourse at the 1999 National Athletic Trainers' Association Annual Meeting and Clinical Symposia entitled "Use of Standardized Assessment of Concussion (SAC) in the Immediate Sideline Evaluation of Injured Athletes." SUBJECTS: A total of 339 valid surveys were returned by the attendees of the minicourse. MEASUREMENTS: We used frequency analysis and descriptive statistics. RESULTS: Clinical examination (33%) and a symptom checklist (15.3%) were the most common evaluative tools used to assess concussions. The Colorado Guidelines (28%) were used more than other concussion management guidelines. Athletic trainers (34%) and team physicians (40%) were primarily responsible for making decisions regarding return to play. A large number of respondents (83.5%) believed that the use of a standardized method of concussion assessment provided more information than routine clinical and physical examination alone. CONCLUSIONS: Athletic trainers are using a variety of clinical tools to evaluate concussions in athletes. Clinical evaluation and collaboration with physicians still appear to be the primary methods used for return-to-play decisions. However, athletic trainers are beginning to use standardized methods of concussion to evaluate these injuries and to assist them in assessing the severity of injury and deciding when it is safe to return to play.

13 CFR 127.605 - What are the procedures for appealing an EDWOSB or WOSB status protest decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... appealing an EDWOSB or WOSB status protest decision? 127.605 Section 127.605 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION WOMEN-OWNED SMALL BUSINESS FEDERAL CONTRACT ASSISTANCE PROCEDURES Protests § 127.605 What are the procedures for appealing an EDWOSB or WOSB status protest decision? The protested...

A Decision Support Model and Tool to Assist Financial Decision-Making in Universities

ERIC Educational Resources Information Center

Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

2015-01-01

In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…

44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT..., App. A Appendix A to Part 9—Decision-making Process for E.O. 11988 EC02FE91.074 ...

Information Use Differences in Hot and Cold Risk Processing: When Does Information About Probability Count in the Columbia Card Task?

PubMed

Markiewicz, Łukasz; Kubińska, Elżbieta

2015-01-01

This paper aims to provide insight into information processing differences between hot and cold risk taking decision tasks within a single domain. Decision theory defines risky situations using at least three parameters: outcome one (often a gain) with its probability and outcome two (often a loss) with a complementary probability. Although a rational agent should consider all of the parameters, s/he could potentially narrow their focus to only some of them, particularly when explicit Type 2 processes do not have the resources to override implicit Type 1 processes. Here we investigate differences in risky situation parameters' influence on hot and cold decisions. Although previous studies show lower information use in hot than in cold processes, they do not provide decision weight changes and therefore do not explain whether this difference results from worse concentration on each parameter of a risky situation (probability, gain amount, and loss amount) or from ignoring some parameters. Two studies were conducted, with participants performing the Columbia Card Task (CCT) in either its Cold or Hot version. In the first study, participants also performed the Cognitive Reflection Test (CRT) to monitor their ability to override Type 1 processing cues (implicit processes) with Type 2 explicit processes. Because hypothesis testing required comparison of the relative importance of risky situation decision weights (gain, loss, probability), we developed a novel way of measuring information use in the CCT by employing a conjoint analysis methodology. Across the two studies, results indicated that in the CCT Cold condition decision makers concentrate on each information type (gain, loss, probability), but in the CCT Hot condition they concentrate mostly on a single parameter: probability of gain/loss. We also show that an individual's CRT score correlates with information use propensity in cold but not hot tasks. Thus, the affective dimension of hot tasks inhibits correct information processing, probably because it is difficult to engage Type 2 processes in such circumstances. Individuals' Type 2 processing abilities (measured by the CRT) assist greater use of information in cold tasks but do not help in hot tasks.

Information Use Differences in Hot and Cold Risk Processing: When Does Information About Probability Count in the Columbia Card Task?

PubMed Central

Markiewicz, Łukasz; Kubińska, Elżbieta

2015-01-01

Objective: This paper aims to provide insight into information processing differences between hot and cold risk taking decision tasks within a single domain. Decision theory defines risky situations using at least three parameters: outcome one (often a gain) with its probability and outcome two (often a loss) with a complementary probability. Although a rational agent should consider all of the parameters, s/he could potentially narrow their focus to only some of them, particularly when explicit Type 2 processes do not have the resources to override implicit Type 1 processes. Here we investigate differences in risky situation parameters' influence on hot and cold decisions. Although previous studies show lower information use in hot than in cold processes, they do not provide decision weight changes and therefore do not explain whether this difference results from worse concentration on each parameter of a risky situation (probability, gain amount, and loss amount) or from ignoring some parameters. Methods: Two studies were conducted, with participants performing the Columbia Card Task (CCT) in either its Cold or Hot version. In the first study, participants also performed the Cognitive Reflection Test (CRT) to monitor their ability to override Type 1 processing cues (implicit processes) with Type 2 explicit processes. Because hypothesis testing required comparison of the relative importance of risky situation decision weights (gain, loss, probability), we developed a novel way of measuring information use in the CCT by employing a conjoint analysis methodology. Results: Across the two studies, results indicated that in the CCT Cold condition decision makers concentrate on each information type (gain, loss, probability), but in the CCT Hot condition they concentrate mostly on a single parameter: probability of gain/loss. We also show that an individual's CRT score correlates with information use propensity in cold but not hot tasks. Thus, the affective dimension of hot tasks inhibits correct information processing, probably because it is difficult to engage Type 2 processes in such circumstances. Individuals' Type 2 processing abilities (measured by the CRT) assist greater use of information in cold tasks but do not help in hot tasks. PMID:26635652

[Each person has to make their own individual decision - arguments for physician assisted suicide].

PubMed

Posa, Andreas

2016-06-01

Since November 2015, businesslike assisted suicide is punishable in Germany. But who acts businesslike? The majority of the German population prefers to make own decisions about the circumstances of their arriving death, and many of them would also accept (physician) assisted suicide if necessary. Only a minority of physicians plead for prohibiting assisted suicide in general. In the end everyone should be able to take position on his own. No one is obliged to use or execute assisted suicide. © Georg Thieme Verlag KG Stuttgart · New York.

Hospice-assisted death? A study of Oregon hospices on death with dignity.

PubMed

Campbell, Courtney S; Cox, Jessica C

2012-05-01

Nearly 90% of terminally ill patients who have used Oregon's distinctive death with dignity law to receive a medication to end their lives are enrolled in hospice care programs. In 2009-2010, we conducted a study of the policies developed by Oregon hospices to address patient inquiries and requests for death with dignity. The study examined the stated hospice values and positions and identified the boundaries to participation drawn by the hospice programs to protect personal and programmatic integrity. The boundaries were drawn around 6 key caregiving considerations: (1) language regarding physician-assisted death (PAD); (2) informed decision making by patients; (3) collaboration with physicians; (4) provision of lethal medication; (5) assistance in the patient's act of taking the medication; and (6) staff presence at the time of medication ingestion.

2018 Cyber Enabled Emerging Technologies Symposium

DTIC Science & Technology

2018-03-08

Principles • Better data = better outcomes • Training > Programming • AI anxiety?... Think IA (Intelligent Assistant) • Ingest much more information • Make...Local Marketing 7 Usage: “Local” / Specific AI • Healthcare (oncology) • Data Mining/Discovery • Chat bots • Personnel • Finance • Sourcing...cognitive- principles / So, Our Priorities for AI Adoption and Ethics • Purpose: human augmentation versus replacement • Human decision-making • Human

Computers in medicine: liability issues for physicians.

PubMed

Hafner, A W; Filipowicz, A B; Whitely, W P

1989-07-01

Physicians routinely use computers to store, access, and retrieve medical information. As computer use becomes even more widespread in medicine, failure to utilize information systems may be seen as a violation of professional custom and lead to findings of professional liability. Even when a technology is not widespread, failure to incorporate it into medical practice may give rise to liability if the technology is accessible to the physician and reduces risk to the patient. Improvement in the availability of medical information sources imposes a greater burden on the physician to keep current and to obtain informed consent from patients. To routinely perform computer-assisted literature searches for informed consent and diagnosis is 'good medicine'. Clinical and diagnostic applications of computer technology now include computer-assisted decision making with the aid of sophisticated databases. Although such systems will expand the knowledge base and competence of physicians, malfunctioning software raises a major liability question. Also, complex computer-driven technology is used in direct patient care. Defective or improperly used hardware or software can lead to patient injury, thus raising additional complicated questions of professional liability and product liability.

Computer-assisted diagnostic decision support: history, challenges, and possible paths forward.

PubMed

Miller, Randolph A

2009-09-01

This paper presents a brief history of computer-assisted diagnosis, including challenges and future directions. Some ideas presented in this article on computer-assisted diagnostic decision support systems (CDDSS) derive from prior work by the author and his colleagues (see list in Acknowledgments) on the INTERNIST-1 and QMR projects. References indicate the original sources of many of these ideas.

Informed consent in posthumous sperm procurement.

PubMed

Hostiuc, Sorin; Curca, Cristian George

2010-10-01

Assisted reproductive technologies are increasingly more present in our everyday life: from classical sperm/egg donation or in vitro fertilization to newer, more controversial methods such as surrogate motherhood, male pregnancies or posthumous sperm procurement. Every year, new concepts are emerging in this field and the medical world is not always prepared to deal with them. The greatest problem of using posthumous sperm procurement as an assisted reproductive method resides in analyzing consent related. An extensive research of the scientific literature revealed eight possible situations which we will present and analyze in this article. By analyzing consent related issues we present a decision making algorithm for posthumous sperm procurement.

Wireless Sensor Networks for Ambient Assisted Living

PubMed Central

Aquino-Santos, Raúl; Martinez-Castro, Diego; Edwards-Block, Arthur; Murillo-Piedrahita, Andrés Felipe

2013-01-01

This paper introduces wireless sensor networks for Ambient Assisted Living as a proof of concept. Our workgroup has developed an arrhythmia detection algorithm that we evaluate in a closed space using a wireless sensor network to relay the information collected to where the information can be registered, monitored and analyzed to support medical decisions by healthcare providers. The prototype we developed is then evaluated using the TelosB platform. The proposed architecture considers very specific restrictions regarding the use of wireless sensor networks in clinical situations. The seamless integration of the system architecture enables both mobile node and network configuration, thus providing the versatile and robust characteristics necessary for real-time applications in medical situations. Likewise, this system architecture efficiently permits the different components of our proposed platform to interact efficiently within the parameters of this study. PMID:24351665

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

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.

Do parents of children with attention-deficit/hyperactivity disorder (ADHD) receive adequate information about the disorder and its treatments? A qualitative investigation.

PubMed

Ahmed, Rana; Borst, Jacqueline M; Yong, Cheng Wei; Aslani, Parisa

2014-01-01

Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent pediatric neurodevelopmental condition, commonly treated using pharmacological agents such as stimulant medicines. The use of these agents remains contentious, placing parents in a difficult position when deciding to initiate and/or continue their child's treatment. Parents refer to a range of information sources to assist with their treatment decision-making. This qualitative study aimed to investigate 1) parents' ADHD-related knowledge pre- and post-diagnosis, 2) the information sources accessed by parents, 3) whether parents' information needs were met post-diagnosis, and 4) parents' views about strategies to meet their information needs. Three focus groups (n=16 parents), each lasting 1.0-1.5 hours were conducted. Focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using the framework method, coded, and categorized into themes. Generally, parents had limited ADHD-related knowledge prior to their child's diagnosis and perceived prescription medicines indicated for ADHD in a negative context. Parents reported improved knowledge after their child's diagnosis; however, they expressed dissatisfaction with information that they accessed, which was often technical and not tailored to their child's needs. Verbal information sought from health care professionals was viewed to be reliable but generally medicine-focused and not necessarily comprehensive. Parents identified a need for concise, tailored information about ADHD, the medicines used for its treatment, and changes to their child's medication needs with age. They also expressed a desire for increased availability of support groups and tools to assist them in sourcing information from health care professionals during consultations, such as question prompt lists. There are gaps in parents' knowledge about ADHD and its treatment, and an expressed need for tailored and reliable information. Future research needs to focus on providing parents with avenues to access concise, reliable, and relevant information and support in order to empower them to make the best treatment decision for their child.

SPATIAL ANALYSIS AND DECISION ASSISTANCE (SADA) TRAINING COURSE

EPA Science Inventory

Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from environmental assessment into an effective problem-solving environment. SADA was developed by the Institute for Environmental Modeling at the University of Tennessee and inc...

Closed-Loop- and Decision-Assist-Guided Fluid Therapy of Human Hemorrhage.

PubMed

Hundeshagen, Gabriel; Kramer, George C; Ribeiro Marques, Nicole; Salter, Michael G; Koutrouvelis, Aristides K; Li, Husong; Solanki, Daneshvari R; Indrikovs, Alexander; Seeton, Roger; Henkel, Sheryl N; Kinsky, Michael P

2017-10-01

We sought to evaluate the efficacy, efficiency, and physiologic consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based bolus resuscitation. Experimental human hemorrhage and resuscitation. Clinical research laboratory. Healthy volunteers. Subjects (n = 7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid administration; and 3) fully autonomous (closed loop) resuscitation. Hemodynamic variables, volume shifts, fluid balance, and cardiac function were monitored during hemorrhage and resuscitation. Treatment modalities were compared based on resuscitation efficacy and efficiency. All approaches achieved target blood pressure by 60 minutes. Following hemorrhage, the total amount of infused fluid (bolus resuscitation: 30 mL/kg, decision assist: 5.6 ± 3 mL/kg, closed loop: 4.2 ± 2 mL/kg; p < 0.001), plasma volume, extravascular volume (bolus resuscitation: 17 ± 4 mL/kg, decision assist: 3 ± 1 mL/kg, closed loop: -0.3 ± 0.3 mL/kg; p < 0.001), body weight, and urinary output remained stable under decision assist and closed loop and were significantly increased under bolus resuscitation. Mean arterial pressure initially decreased further under bolus resuscitation (-10 mm Hg; p < 0.001) and was lower under bolus resuscitation than closed loop at 20 minutes (bolus resuscitation: 57 ± 2 mm Hg, closed loop: 69 ± 4 mm Hg; p = 0.036). Colloid osmotic pressure (bolus resuscitation: 19.3 ± 2 mm Hg, decision assist, closed loop: 24 ± 0.4 mm Hg; p < 0.05) and hemoglobin concentration were significantly decreased after bolus fluid administration. We define efficacy of decision-assist and closed-loop resuscitation in human hemorrhage. In comparison with formula-based bolus resuscitation, both semiautonomous and autonomous approaches were more efficient in goal-directed resuscitation of hemorrhage. They provide favorable conditions for the avoidance of over-resuscitation and its adverse clinical sequelae. Decision-assist and closed-loop resuscitation algorithms are promising technological solutions for constrained environments and areas of limited resources.

Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

PubMed

Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

2012-01-01

Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation.

Principles of health economic evaluations of lipid-lowering strategies.

PubMed

Ara, Roberta; Basarir, Hasan; Ward, Sue Elizabeth

2012-08-01

Policy decision-making in cardiovascular disease is increasingly informed by the results generated from decision-analytic models (DAMs). The methodological approaches and assumptions used in these DAMs impact on the results generated and can influence a policy decision based on a cost per quality-adjusted life year (QALY) threshold. Decision makers need to be provided with a clear understanding of the key sources of evidence and how they are used in the DAM to make an informed judgement on the quality and appropriateness of the results generated. Our review identified 12 studies exploring the cost-effectiveness of pharmaceutical lipid-lowering interventions published since January 2010. All studies used Markov models with annual cycles to represent the long-term clinical pathway. Important differences in the model structures and evidence base used within the DAMs were identified. Whereas the reporting standards were reasonably good, there were many instances when reporting of methods could be improved, particularly relating to baseline risk levels, long-term benefit of treatment and health state utility values. There is a scope for improvement in the reporting of evidence and modelling approaches used within DAMs to provide decision makers with a clearer understanding of the quality and validity of the results generated. This would be assisted by fuller publication of models, perhaps through detailed web appendices.

A QUESTIONNAIRE TO ASSESS THE RELEVANCE AND CREDIBILITY OF OBSERVATIONAL STUDIES TO INFORM HEALTH CARE DECISION MAKING: AN ISPOR-AMCP-NPC GOOD PRACTICE TASK FORCE REPORT

PubMed Central

Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, Dan; Yang, Winnie; Mullins, C. Daniel; Kahler, Kristijan; Quon, Nicole C.; Devine, Scott; Graham, John; Cannon, Eric; Crown, William

2014-01-01

Evidence-based healthcare decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. However, widespread adoption of evidence from observational studies has been limited due to a variety of factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two Task Forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision-making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. PMID:24636373

Menopause and the virtuous woman: the importance of the moral order in accounting for medical decision making.

PubMed

Stephens, Christine; Breheny, Mary

2008-01-01

Whether or not to use hormone replacement therapy (HRT) around the time of menopause is seen as an important decision for many mid-aged women. Recent studies of information provided to women to assist them in making a medical decision about the use of HRT have highlighted the importance of understanding the broader social context of the decision. In this article we examine one important aspect of western mid-aged women's social world: the moral order and the imperative of virtue. Qualitative data from a survey, focus group discussions, and interviews with mid-aged women about HRT use are used to provide examples of the importance of the local moral order in women's talk about menopause and HRT use. The implications of these data will be discussed in terms of the different narrative resources available to construct menopause and HRT, the role of morality, and the demonstration of virtue in daily social life, including medical decision making.

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

PubMed

Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

2017-01-01

We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

Decision support system for outage management and automated crew dispatch

DOEpatents

Kang, Ning; Mousavi, Mirrasoul

2018-01-23

A decision support system is provided for utility operations to assist with crew dispatch and restoration activities following the occurrence of a disturbance in a multiphase power distribution network, by providing a real-time visualization of possible location(s). The system covers faults that occur on fuse-protected laterals. The system uses real-time data from intelligent electronics devices coupled with other data sources such as static feeder maps to provide a complete picture of the disturbance event, guiding the utility crew to the most probable location(s). This information is provided in real-time, reducing restoration time and avoiding more costly and laborious fault location finding practices.

“Do your homework…and then hope for the best”: the challenges that medical tourism poses to Canadian family physicians’ support of patients’ informed decision-making

PubMed Central

2013-01-01

Background Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism. Methods Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants’ perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians’ abilities to support medical tourists’ informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Results Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician’s role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician’s reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians’ concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Conclusions Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad. PMID:24053385

"Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

2013-09-22

Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad.

Global nonfuel mineral exploration trends 2001-2015

USGS Publications Warehouse

Karl, Nick; Wilburn, David R.

2017-01-01

The mission of the U.S. Geological Survey (USGS) National Minerals Information Center (NMIC) is to collect, analyze and disseminate information on the domestic and international supply of and demand for minerals and mineral materials essential to the U.S. economy and national security. Understanding mineral exploration activities and trends assists government policy makers, minerals industry decision makers and research entities in identifying where future sources of mineral supply are likely to be discovered, the amount and type of these resources and factors that may affect exploration and development.

Evaluation of Story Maps to Enhance Public Engagement and Communication at Legacy Management Sites – 17334

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

Castillo, Darina; Carpenter, Cliff; Linard, Joshua

Story Maps are being used in both public and private sectors to convey information to stakeholders, create enterprise platforms, and assist in decision making. Story Maps are web applications that combine maps, narrative text, images, and multimedia content to provide information. These applications provide a user-friendly platform to share the remarkable history of our sites, the complexity of their contamination and remediation, successes we achieve in our LTS&M activities, and even the challenges we face as we aim to fulfill our mission.

Earthquake Advisory Services: A prototype development project

NASA Astrophysics Data System (ADS)

Lagorio, H. J.; Levin, H.

1980-10-01

Development of the prototype Earthquake Advisory Service (EAS) is reported. The EAS is designed to provide direct technical assistance and written materials to advise people who wish to make informed decisions about earthquake hazard reduction in their residences. It is intended also to be adapted to local conditions by community-based agencies. The EAS prototype involved the testing of early assumptions about program implementation, establishment of a systematic methodology review process, and a review of published information pertinent to the project. Operational procedures of the program and the process leading to implementation guidelines are described.

Enhancing Worker Health Through Clinical Decision Support (CDS): An Introduction to a Compilation.

PubMed

Filios, Margaret S; Storey, Eileen; Baron, Sherry; Luensman, Genevieve B; Shiffman, Richard N

2017-11-01

This article outlines an approach to developing clinical decision support (CDS) for conditions related to work and health. When incorporated in electronic health records, such CDS will assist primary care providers (PCPs) care for working patients. Three groups of Subject Matter Experts (SMEs) identified relevant clinical practice guidelines, best practices, and reviewed published literature concerning work-related asthma, return-to-work, and management of diabetes at work. SMEs developed one recommendation per topic that could be supported by electronic CDS. Reviews with PCPs, staff, and health information system implementers in five primary care settings confirmed that the approach was important and operationally sound. This compendium is intended to stimulate a dialogue between occupational health specialists and PCPs that will enhance the use of work information about patients in the primary care setting.

Integrating research, legal technical assistance, and advocacy to inform shared use legislation in Mississippi.

PubMed

Spengler, John O; Frost, Natasha R; Bryant, Katherine K

2014-01-01

The purpose of this article was to describe the process by which research findings informed the successful passage of legislation designed to increase opportunities for physical activity in Mississippi, and discuss implications and lessons learned from this process. The article is descriptive and conceptual, and addresses the collaborative process by which research, legal technical assistance, and advocacy informed and shaped shared use legislation in Mississippi. Collaborators informing this article were an Active Living Research grantee, a staff attorney with the Public Health Law Center, the American Heart Association Mississippi Government Relations Director, and community partners. The American Heart Association and Public Health Law Center developed policy guidance in the form of sample language for legislation as a starting point for states in determining policy needed to eliminate or reduce barriers to the shared use of school recreational facilities. The policy guidance was informed by evidence from Active Living Research-funded research studies. The American Heart Association, supporting a bill shaped by the policy guidance, led the effort to advocate for successful shared use legislation in Mississippi. Research should be policy relevant and properly translated and disseminated. Legal technical assistance should involve collaboration with both researchers and advocates so that policymakers have the information to make evidence-based decisions. Government relations directors should collaborate with legal technical staff to obtain and understand policy guidance relevant to their advocacy efforts. Effective collaborations, with an evidence-based approach, can lead to informed, successful policy change.

The breakdown of coordinated decision making in distributed systems.

PubMed

Bearman, Christopher; Paletz, Susannah B F; Orasanu, Judith; Thomas, Matthew J W

2010-04-01

This article aims to explore the nature and resolution of breakdowns in coordinated decision making in distributed safety-critical systems. In safety-critical domains, people with different roles and responsibilities often must work together to make coordinated decisions while geographically distributed. Although there is likely to be a large degree of overlap in the shared mental models of these people on the basis of procedures and experience, subtle differences may exist. Study 1 involves using Aviation Safety Reporting System reports to explore the ways in which coordinated decision making breaks down between pilots and air traffic controllers and the way in which the breakdowns are resolved. Study 2 replicates and extends those findings with the use of transcripts from the Apollo 13 National Aeronautics and Space Administration space mission. Across both studies, breakdowns were caused in part by different types of lower-level breakdowns (or disconnects), which are labeled as operational, informational, or evaluative. Evaluative disconnects were found to be significantly harder to resolve than other types of disconnects. Considering breakdowns according to the type of disconnect involved appears to capture useful information that should assist accident and incident investigators. The current trend in aviation of shifting responsibilities and providing increasingly more information to pilots may have a hidden cost of increasing evaluative disconnects. The proposed taxonomy facilitates the investigation of breakdowns in coordinated decision making and draws attention to the importance of considering subtle differences between participants' mental models when considering complex distributed systems.

Assisted Suicide in Switzerland: Clarifying Liberties and Claims.

PubMed

Hurst, Samia A; Mauron, Alex

2017-03-01

Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the 'Swiss model' for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the 'Swiss model' using the framework of Hohfeldian rights as modified by Wenar. After outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany. Based on this approach, we conclude that in Switzerland, claim rights exist for those requesting suicide assistance, and for those who are considering providing such assistance, even though no entitlements exist toward suicide assistance. We then describe the implementation of the 'Swiss model' and difficulties arising within it. Clarifying these issues is important to understand the Swiss situation, to evaluate what features of it may or may not be worth correcting or emulating, and to understand how it can impact requests for suicide assistance in other countries due to 'suicide tourism'. It is also important to understand exactly what sets Switzerland apart from other countries with different legislations regarding suicide assistance. © 2016 John Wiley & Sons Ltd.

Delegating Informed Consent.

PubMed

Koch, Valerie Gutmann

2017-11-01

Ten years ago, Megan Shinal sought the care of neurosurgeon Steven Toms for the surgical treatment of a recurrent nonmalignant tumor in the pituitary region of her brain. In their twenty-minute meeting, Shinal did not make a final decision about which surgical approach she wished to pursue. Subsequently, she spoke with Tom's physician assistant once by phone and once in person, when she signed the consent form, which did not appear to designate which surgical approach she had chosen. During the operation-a total resection-Toms perforated Shinal's carotid artery, resulting in hemorrhage, stroke, brain injury, and partial blindness. The jury found that Toms had fulfilled his informed-consent obligations prior to performing the resection; however, in June 2017, the Supreme Court of Pennsylvania overturned the decision, relying on the Pennsylvania Medical Care Availability and Reduction of Error Act. The court found that the language of the act is unambiguous in its requirement that "a physician's duty to provide information to a patient sufficient to obtain her informed consent is non-delegable." Presumably, this rule of nondelegation applies beyond the surgical theater to other major treatment decisions. And it is unclear whether it applies to other professionals in a subordinate position to the treating physician, such as residents and fellows. © 2017 The Hastings Center.

To freeze or not to freeze embryos: clarity, confusion and conflict.

PubMed

Goswami, Mohar; Murdoch, Alison P; Haimes, Erica

2015-06-01

Although embryo freezing is a routine clinical practice, there is little contemporary evidence on how couples make the decision to freeze their surplus embryos, or of their perceptions during that time. This article describes a qualitative study of 16 couples who have had in vitro fertilisation (IVF) treatment. The study question was 'What are the personal and social factors that patients consider when deciding whether to freeze embryos?' We show that while the desire for a baby is the dominant drive, couples' views revealed more nuanced and complex considerations in the decision-making process. It was clear that the desire to have a baby influenced couples' decision-making and that they saw freezing as 'part of the process'. However, there were confusions associated with the term 'freezing' related to concerns about the safety of the procedure. Despite being given written information, couples were confused about the practical aspects of embryo freezing, which suggests they were preoccupied with the immediate demands of IVF. Couples expressed ethical conflicts about freezing 'babies'. We hope the findings from this study will inform clinicians and assist them in providing support to couples confronted with this difficult decision-making.

Tool for Ranking Research Options

NASA Technical Reports Server (NTRS)

Ortiz, James N.; Scott, Kelly; Smith, Harold

2005-01-01

Tool for Research Enhancement Decision Support (TREDS) is a computer program developed to assist managers in ranking options for research aboard the International Space Station (ISS). It could likely also be adapted to perform similar decision-support functions in industrial and academic settings. TREDS provides a ranking of the options, based on a quantifiable assessment of all the relevant programmatic decision factors of benefit, cost, and risk. The computation of the benefit for each option is based on a figure of merit (FOM) for ISS research capacity that incorporates both quantitative and qualitative inputs. Qualitative inputs are gathered and partly quantified by use of the time-tested analytical hierarchical process and used to set weighting factors in the FOM corresponding to priorities determined by the cognizant decision maker(s). Then by use of algorithms developed specifically for this application, TREDS adjusts the projected benefit for each option on the basis of levels of technical implementation, cost, and schedule risk. Based partly on Excel spreadsheets, TREDS provides screens for entering cost, benefit, and risk information. Drop-down boxes are provided for entry of qualitative information. TREDS produces graphical output in multiple formats that can be tailored by users.

Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation

PubMed Central

2013-01-01

Background The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks. Methods Data on trainee doctors’ (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Results Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience. Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making. Conclusion A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge. By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice. PMID:23336964

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

PubMed

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

Can Climate Information be relevant to decision making for Agriculture on the 1-10 year timescale? Case studies from southern Africa

NASA Astrophysics Data System (ADS)

Fujisawa, Mariko

2016-04-01

Climate forecasts have been developed to assist decision making in sectors averse to, and affected by, climate risks, and agriculture is one of those. In agriculture and food security, climate information is now used on a range of timescales, from days (weather), months (seasonal outlooks) to decades (climate change scenarios). Former researchers have shown that when seasonal climate forecast information was provided to farmers prior to decision making, farmers adapted by changing their choice of planting seeds and timing or area planted. However, it is not always clear that the end-users' needs for climate information are met and there might be a large gap between information supplied and needed. It has been pointed out that even when forecasts were available, they were often not utilized by farmers and extension services because of lack of trust in the forecast or the forecasts did not reach the targeted farmers. Many studies have focused on the use of either seasonal forecasts or longer term climate change prediction, but little research has been done on the medium term, that is, 1 to 10 year future climate information. The agriculture and food system sector is one potential user of medium term information, as land use policy and cropping systems selection may fall into this time scale and may affect farmers' decision making process. Assuming that reliable information is provided and it is utilized by farmers for decision making, it might contribute to resilient farming and indeed to longer term food security. To this end, we try to determine the effect of medium term climate information on farmers' strategic decision making process. We explored the end-users' needs for climate information and especially the possible role of medium term information in agricultural system, by conducting interview surveys with farmers and agricultural experts. In this study, the cases of apple production in South Africa, maize production in Malawi and rice production in Tanzania will be presented. With case studies of various crops, we also aim to identify what climatic factors and timescale of prediction may be critical to what crop types of farmers, which may be of value to climate prediction community to further develop climate prediction useful for agricultural system.

Physician sex and other factors associated with type of breast cancer surgery in older women.

PubMed

Cyran, E M; Crane, L A; Palmer, L

2001-02-01

Physician-related factors as well as patient characteristics may explain why women aged 65 years or older with early-stage breast cancer undergo lumpectomy less often than younger women, despite National Institutes of Health recommendations favoring lumpectomy over mastectomy. A descriptive and analytical retrospective computer-assisted telephone survey. A population-based random sample of breast cancer survivors in Colorado, identified from the Colorado Central Cancer Registry. Women aged 65 to 84 years when diagnosed as having stage I or II breast cancer, treated 1 to 6 years previously with mastectomy or lumpectomy, and without recurrence or second primary cancers. Among women contacted, 58% participated. Results of 198 interviews are reported. Survey questions included patient decision-making participation and physician recommendations, sources and amount of treatment information provided by physicians, physician characteristics, and patient surgery preferences and demographic characteristics. A multivariate logistic regression model identified factors independently associated with lumpectomy. Lumpectomy was strongly associated with higher patient education, female physician sex, patient age 75 years or older, and amount of physician-provided information. The number of physician-provided information sources was associated with surgery explanations, and female physicians provided more sources of information. A physician decision or recommendation for surgery type was reported by 61% of women, of whom 93% underwent the recommended procedure. A subset of patients (13%) reported deferring the surgery decision to someone else. These results suggest that better-educated and better-informed older women are more likely to undergo lumpectomy, and that physicians may influence breast cancer patients' decisions about surgery type.

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.

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management.

PubMed

Midboe, Amanda M; Lewis, Eleanor T; Cronkite, Ruth C; Chambers, Dallas; Goldstein, Mary K; Kerns, Robert D; Trafton, Jodie A

2011-03-01

Development of clinical decision support systems (CDSs) has tended to focus on facilitating medication management. An understanding of behavioral medicine perspectives on the usefulness of a CDS for patient care can expand CDSs to improve management of chronic disease. The purpose of this study is to explore feedback from behavioral medicine providers regarding the potential for CDSs to improve decision-making, care coordination, and guideline adherence in pain management. Qualitative methods were used to analyze semi-structured interview responses from behavioral medicine stakeholders following demonstration of an existing CDS for opioid prescribing, ATHENA-OT. Participants suggested that a CDS could assist with decision-making by educating providers, providing recommendations about behavioral therapy, facilitating risk assessment, and improving referral decisions. They suggested that a CDS could improve care coordination by facilitating division of workload, improving patient education, and increasing consideration and knowledge of options in other disciplines. Clinical decision support systems are promising tools for improving behavioral medicine care for chronic pain.

Housing and maintenance of Ambystoma mexicanum, the Mexican axolotl.

PubMed

Farkas, Johanna E; Monaghan, James R

2015-01-01

The aim of this paper is to assemble a significant amount of information on Ambystoma mexicanum, the axolotl salamander, to assist in the basic knowledge needed to raise, breed, and study most aspects of axolotl biology. It is important to understand the basic biology of the axolotl in order to make informed decisions on their proper care and use in experiments. Therefore, we will provide necessary information to the non-herpetologist that will assist in their study of this unique and fascinating animal. We also aim to provide a resource on the general anatomy, behavior, and experimental tips specific to the Mexican axolotl that will be of use to most axolotl laboratories. Axolotls have been actively researched since the 1860s, giving testament to their relatively straightforward maintenance and their versatility as an animal model for development and regeneration. Interest in using the axolotl in laboratory research has grown tremendously over the past decade, so dedicated resources to support the study of this species are needed and encouraged.

Training of perceptual-cognitive skills in offside decision making.

PubMed

Catteeuw, Peter; Gilis, Bart; Jaspers, Arne; Wagemans, Johan; Helsen, Werner

2010-12-01

This study investigates the effect of two off-field training formats to improve offside decision making. One group trained with video simulations and another with computer animations. Feedback after every offside situation allowed assistant referees to compensate for the consequences of the flash-lag effect and to improve their decision-making accuracy. First, response accuracy improved and flag errors decreased for both training groups implying that training interventions with feedback taught assistant referees to better deal with the flash-lag effect. Second, the results demonstrated no effect of format, although assistant referees rated video simulations higher for fidelity than computer animations. This implies that a cognitive correction to a perceptual effect can be learned also when the format does not correspond closely with the original perceptual situation. Off-field offside decision-making training should be considered as part of training because it is a considerable help to gain more experience and to improve overall decision-making performance.

Assisted suicide ruling is flawed. A federal court decision has potentially grave implications for all healthcare workers.

PubMed

Moses, M F

1994-12-01

Last May a federal judge struck down Washington State's law against assisted suicide on the grounds that it violated the U.S. Constitution. The judge ruled that just as a citizen has a right to refuse life-sustaining medical treatment, so does he or she have a right to request a physician's assistance in committing suicide. The court also concluded that because the decision to end one's life is as intimate and personal as a decision to have an abortion, assisted suicide must also be constitutionally protected. The court is mistaken. A "right" to assisted suicide is described nowhere in the text of the Constitution. Assisted suicide, furthermore, does not occupy a fundamental place in American history and traditions, and therefore cannot be deemed implicit in the constitutional guarantee of due process. Indeed, just the opposite is true: Our history and traditions actively discourage and prohibit assisted suicide. The asserted right to assisted suicide finds no support in cases involving either abortion or termination of medical treatment. Two terms ago, the Supreme Court relied heavily on stare decisis in upholding the abortion right, but there is no line of precedent for a right to assisted suicide. Not all "personal" decisions are constitutionally protected, so the personal nature of suicide does not dispose of the question of its constitutional status. Finally, in equating refusal of medical treatment with suicide, the federal court in Washington State ignores a long line of authority that recognizes a fundamental difference between the two.(ABSTRACT TRUNCATED AT 250 WORDS)

Strategies for selecting effective patient nutrition education materials.

PubMed

Clayton, Laura H

2010-10-01

Nutrition and diet therapy are at the center of health promotion activities and self-management of chronic diseases. To assist an individual in making informed decisions regarding his or her diet and increase adherence to dietary recommendations or treatments, healthcare professionals must select health information that is appropriate to the client's level of understanding. A systematic approach in the evaluation of patient education material, whether in print or on the World Wide Web, must focus on the information's content, literacy level, graphical displays, layout and typography, motivating principles, cultural relevance, and feasibility. Additional criteria should be evaluated when accessing Web sites and include source, site credibility, conflict of interest, disclaimer, disclosure, navigation, and interactivity information.

Technologies for Metabolic Monitoring Military Section Editorials in Diabetes Technologies and Therapeutics

DTIC Science & Technology

2004-12-01

monitoring, diabetes, IGF-I, patient decision assist, hyperspectral imaging, actigraphy, accelerometry, foot contact time, Con A-glucose sensing, lactate...was reduced in both con - mottling, and rebound of a skin fold could all ditions. contribute to a diagnosis. Current technologies Hyperspectral imaging...information such as ambient con - responses in the context of various external ditions, meals and recent activity, and specific challenges ("green light

Control of autonomous ground vehicles: a brief technical review

NASA Astrophysics Data System (ADS)

Babak, Shahian-Jahromi; Hussain, Syed A.; Karakas, Burak; Cetin, Sabri

2017-07-01

This paper presents a brief review of the developments achieved in autonomous vehicle systems technology. A concise history of autonomous driver assistance systems is presented, followed by a review of current state of the art sensor technology used in autonomous vehicles. Standard sensor fusion method that has been recently explored is discussed. Finally, advances in embedded software methodologies that define the logic between sensory information and actuation decisions are reviewed.

Teaching Adult Education Courses: The Business Management Model. Social Sciences. Agricultural Education 3. Information Bulletin 98.

ERIC Educational Resources Information Center

Bail, Joe P.; Cushman, Harold R.

The model described here was developed for use as a program planning guide by teachers, many of them business and other lay people, at the secondary school level who offer adult education courses on how to make management decisions and solve problems. Ten features of the model are listed: (1) The purpose is to assist owner-operators or managers to…

Review of the University of Alaska FY 1987 Operating and Capital Budgets. Submitted to the Governor and the Fourteenth Alaska State Legislature. Document No. 86-3.

ERIC Educational Resources Information Center

Alaska State Commission on Postsecondary Education, Juneau.

A review of the University of Alaska's operating and capital budget submission for fiscal year 1987 is presented, with attention to the educational and programmatic impact of the budget request. Information is provided on project components for which funding increments are requested. Included are data to assist decision-makers in reviewing the…

Characteristics, perceptions, and other factors influencing physical therapist assistant program directors in 2001.

PubMed

Page, Catherine G

2003-01-01

Little is known about program directors in physical therapist assistant (PTA) programs. This study describes the characteristics of program directors in PTA programs, such as time spent on responsibilities, influences on decision making, perceptions of current working relationships, and satisfaction with decision making. Program directors of 153 (57.5%) accredited PTA programs responded to the survey. The self-reported data were generated by a mail survey developed by the investigator that included 32 demographic items and 58 Likert-scale items to meet the purpose of the study. The data suggest that PTA program directors have average to extremely good levels of satisfaction with their positions and spend more time on student-related and accreditation/long range planning activities than they do on other activities. Information on years of experience and types of degrees suggest that respondents have a great deal of physical therapy experience but much less experience in teaching and administration within community colleges. This information may be valuable for people who seek, or who are recruited for, PTA program director positions. It provides a foundational database for periodic studies of PTA program directors. As enrollments and new programs stabilize and as new program directors are appointed, their impact on physical therapy education and the profession must be reevaluated.

The impact of cancer diagnosis and treatment on employment, income, treatment decisions and financial assistance and their relationship to socioeconomic and disease factors.

PubMed

Paul, Christine; Boyes, Allison; Hall, Alix; Bisquera, Alessandra; Miller, Annie; O'Brien, Lorna

2016-11-01

The financial impact of cancer diagnosis and treatment can be considerable to individuals and their households, leading to changes in treatment decision making. This study aimed to quantify effects on income and employment; describe how cost-related factors influence treatment decision making and need for financial assistance; and to identify patient sociodemographic factors associated with treatment decision making, use of financial assistance and financial effects. A cross-sectional self-report questionnaire was administered to oncology outpatients from two hospitals in Australia: one regional and one metropolitan. Of 255 participants, 67 % indicated a change in employment and 63 % of those reported reduced household income since their diagnosis. Travel (15 %), loss of income (14 %) and cost of treatments (11 %) were commonly cited factors influencing treatment decision making. Seventy-four percent of participants reported that they did not access financial assistance, with more than a third (37 %) of those being unaware that financial assistance was available. Being currently not employed and more recent diagnosis were associated with a reduced income since diagnosis. After adjusting for employment status and age, patients with private health insurance had higher odds of reporting that financial factors had influenced treatment decision making (OR = 2.5). Unemployment is a major driver of the financial impact of cancer. The costs of treatment may be particularly challenging for those with private health insurance who are more likely to be treated in the private health system where out-of-pocket costs are greater. Improved access to financial assistance is required to better avoid potential inequities.

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

PubMed

Carmody, John; Potter, Jan; Lewis, Kate; Bhargava, Sanjay; Traynor, Victoria; Iverson, Don

2014-03-19

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

Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines.

PubMed

Steel, Emily J

2018-06-08

Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.

Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

PubMed

Li, Ya-pin; Fang, Li-qun; Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-Rui; Li, Yan-Li; Zhu, Xu-Guang; Li, Xin-Lou; Xu, Bo; Li, Yin-Jun; Yang, Hong; de Vlas, Sake J; Shi, Tao-Xing; Cao, Wu-Chun

2013-01-01

For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts.

Aftershock communication during the Canterbury Earthquakes, New Zealand: implications for response and recovery in the built environment

USGS Publications Warehouse

Julia Becker,; Wein, Anne; Sally Potter,; Emma Doyle,; Ratliff, Jamie L.

2015-01-01

On 4 September 2010, a Mw7.1 earthquake occurred in Canterbury, New Zealand. Following the initial earthquake, an aftershock sequence was initiated, with the most significant aftershock being a Mw6.3 earthquake occurring on 22 February 2011. This aftershock caused severe damage to the city of Christchurch and building failures that killed 185 people. During the aftershock sequence it became evident that effective communication of aftershock information (e.g., history and forecasts) was imperative to assist with decision making during the response and recovery phases of the disaster, as well as preparedness for future aftershock events. As a consequence, a joint JCDR-USGS research project was initiated to investigate: • How aftershock information was communicated to organisations and to the public; • How people interpreted that information; • What people did in response to receiving that information; • What information people did and did not need; and • What decision-making challenges were encountered relating to aftershocks. Research was conducted by undertaking focus group meetings and interviews with a range of information providers and users, including scientists and science advisors, emergency managers and responders, engineers, communication officers, businesses, critical infrastructure operators, elected officials, and the public. The interviews and focus group meetings were recorded and transcribed, and key themes were identified. This paper focuses on the aftershock information needs for decision-making about the built environment post-earthquake, including those involved in response (e.g., for building assessment and management), recovery/reduction (e.g., the development of new building standards), and readiness (e.g. between aftershocks). The research has found that the communication of aftershock information varies with time, is contextual, and is affected by interactions among roles, by other information, and by decision objectives. A number of general and specific insights into improving the communication of aftershock information are provided.

Introducing the fit-criteria assessment plot - A visualisation tool to assist class enumeration in group-based trajectory modelling.

PubMed

Klijn, Sven L; Weijenberg, Matty P; Lemmens, Paul; van den Brandt, Piet A; Lima Passos, Valéria

2017-10-01

Background and objective Group-based trajectory modelling is a model-based clustering technique applied for the identification of latent patterns of temporal changes. Despite its manifold applications in clinical and health sciences, potential problems of the model selection procedure are often overlooked. The choice of the number of latent trajectories (class-enumeration), for instance, is to a large degree based on statistical criteria that are not fail-safe. Moreover, the process as a whole is not transparent. To facilitate class enumeration, we introduce a graphical summary display of several fit and model adequacy criteria, the fit-criteria assessment plot. Methods An R-code that accepts universal data input is presented. The programme condenses relevant group-based trajectory modelling output information of model fit indices in automated graphical displays. Examples based on real and simulated data are provided to illustrate, assess and validate fit-criteria assessment plot's utility. Results Fit-criteria assessment plot provides an overview of fit criteria on a single page, placing users in an informed position to make a decision. Fit-criteria assessment plot does not automatically select the most appropriate model but eases the model assessment procedure. Conclusions Fit-criteria assessment plot is an exploratory, visualisation tool that can be employed to assist decisions in the initial and decisive phase of group-based trajectory modelling analysis. Considering group-based trajectory modelling's widespread resonance in medical and epidemiological sciences, a more comprehensive, easily interpretable and transparent display of the iterative process of class enumeration may foster group-based trajectory modelling's adequate use.

Bladder cancer treatment response assessment with radiomic, clinical, and radiologist semantic features

NASA Astrophysics Data System (ADS)

Gordon, Marshall N.; Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Paramagul, Chintana; Alva, Ajjai; Weizer, Alon Z.

2018-02-01

We are developing a decision support system for assisting clinicians in assessment of response to neoadjuvant chemotherapy for bladder cancer. Accurate treatment response assessment is crucial for identifying responders and improving quality of life for non-responders. An objective machine learning decision support system may help reduce variability and inaccuracy in treatment response assessment. We developed a predictive model to assess the likelihood that a patient will respond based on image and clinical features. With IRB approval, we retrospectively collected a data set of pre- and post- treatment CT scans along with clinical information from surgical pathology from 98 patients. A linear discriminant analysis (LDA) classifier was used to predict the likelihood that a patient would respond to treatment based on radiomic features extracted from CT urography (CTU), a radiologist's semantic feature, and a clinical feature extracted from surgical and pathology reports. The classification accuracy was evaluated using the area under the ROC curve (AUC) with a leave-one-case-out cross validation. The classification accuracy was compared for the systems based on radiomic features, clinical feature, and radiologist's semantic feature. For the system based on only radiomic features the AUC was 0.75. With the addition of clinical information from examination under anesthesia (EUA) the AUC was improved to 0.78. Our study demonstrated the potential of designing a decision support system to assist in treatment response assessment. The combination of clinical features, radiologist semantic features and CTU radiomic features improved the performance of the classifier and the accuracy of treatment response assessment.

SUPPORT Tools for evidence-informed health Policymaking (STP) 7: Finding systematic reviews

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Systematic reviews are increasingly seen as a key source of information in policymaking, particularly in terms of assisting with descriptions of the impacts of options. Relative to single studies they offer a number of advantages related to understanding impacts and are also seen as a key source of information for clarifying problems and providing complementary perspectives on options. Systematic reviews can be undertaken to place problems in comparative perspective and to describe the likely harms of an option. They also assist with understanding the meanings that individuals or groups attach to a problem, how and why options work, and stakeholder views and experiences related to particular options. A number of constraints have hindered the wider use of systematic reviews in policymaking. These include a lack of awareness of their value and a mismatch between the terms employed by policymakers, when attempting to retrieve systematic reviews, and the terms used by the original authors of those reviews. Mismatches between the types of information that policymakers are seeking, and the way in which authors fail to highlight (or make obvious) such information within systematic reviews have also proved problematic. In this article, we suggest three questions that can be used to guide those searching for systematic reviews, particularly reviews about the impacts of options being considered. These are: 1. Is a systematic review really what is needed? 2. What databases and search strategies can be used to find relevant systematic reviews? 3. What alternatives are available when no relevant review can be found? PMID:20018114

The evaluation of complex clinical trial protocols: resources available to research ethics committees and the use of clinical trial registries--a case study.

PubMed

Homedes, Núria; Ugalde, Antonio

2015-06-01

To assess the potential role of clinical trial (CT) registries and other resources available to research ethics committees (RECs) in the evaluation of complex CT protocols in low-income and middle-income countries. Using a case study approach, the authors examined the decision-making process of a REC in Argentina and its efforts to use available resources to decide on a complex protocol. We also analysed the information in the USA and other CT registries and consulted 24 CT experts in seven countries. Information requested by the Argentinean REC from other national RECs and ethics' experts was not useful to verify the adequacy of the REC's decision whether or not to approve the CT. The responses from the national regulatory agency and the sponsor were not helpful either. The identification of international resources that could assist was beyond the REC's capability. The information in the USA and other CT registries is limited, and at times misleading; and its accuracy is not verified by register keepers. RECs have limited access to experts and institutions that could assist them in their deliberations. Sponsors do not always answer RECs' request for information to properly conduct the ethical and methodological assessment of CT protocols. The usefulness of the CT registries is curtailed by the lack of appropriate codes and by data errors. Information about reasons for rejection, withdrawal or suspension of the trial should be included in the registries. Establishing formal channels of communication among national and foreign RECs and with independent international reference centres could strengthen the ethical review of CT protocols. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Creating a bridge between data collection and program planning: a technical assistance model to maximize the use of HIV/AIDS surveillance and service utilization data for planning purposes.

PubMed

Logan, Jennifer A; Beatty, Maile; Woliver, Renee; Rubinstein, Eric P; Averbach, Abigail R

2005-12-01

Over time, improvements in HIV/AIDS surveillance and service utilization data have increased their usefulness for planning programs, targeting resources, and otherwise informing HIV/AIDS policy. However, community planning groups, service providers, and health department staff often have difficulty in interpreting and applying the wide array of data now available. We describe the development of the Bridging Model, a technical assistance model for overcoming barriers to the use of data for program planning. Through the use of an iterative feedback loop in the model, HIV/AIDS data products constantly are evolving to better inform the decision-making tasks of their multiple users. Implementation of this model has led to improved data quality and data products and to a greater willingness and ability among stakeholders to use the data for planning purposes.

Exploring cognitive bias in destination therapy left ventricular assist device decision making: A retrospective qualitative framework analysis.

PubMed

Magid, Molly; McIlvennan, Colleen K; Jones, Jaqueline; Nowels, Carolyn T; Allen, Larry A; Thompson, Jocelyn S; Matlock, Dan

2016-10-01

Cognitive biases are psychological influences, which cause humans to make decisions, which do not seemingly maximize utility. For people with heart failure, the left ventricular assist device (LVAD) is a surgically implantable device with complex tradeoffs. As such, it represents an excellent model within which to explore cognitive bias in a real-world decision. We conducted a framework analysis to examine for evidence of cognitive bias among people deciding whether or not to get an LVAD. The aim of this study was to explore the influence of cognitive bias on the LVAD decision-making process. We analyzed previously conducted interviews of patients who had either accepted or declined an LVAD using a deductive, predetermined framework of cognitive biases. We coded and analyzed the interviews using an inductive-deductive framework approach, which also allowed for other themes to emerge. We interviewed a total of 22 heart failure patients who had gone through destination therapy LVAD decision making (15 who had accepted the LVAD and 7 who had declined). All patients appeared influenced by state dependence, where both groups described high current state of suffering, but the groups differed in whether they believed LVAD would relieve suffering or not. We found evidence of cognitive bias that appeared to influence decision making in both patient groups, but groups differed in terms of which cognitive biases were present. Among accepters, we found evidence of anchoring bias, availability bias, optimism bias, and affective forecasting. Among decliners, we found evidence of errors in affective forecasting. Medical decision making is often a complicated and multifaceted process that includes cognitive bias as well as other influences. It is important for clinicians to recognize that patients can be affected by cognitive bias, so they can better understand and improve the decision-making process to ensure that patients are fully informed. Published by Elsevier Inc.

Education level, not health literacy, associated with information needs for patients with cancer.

PubMed

Matsuyama, Robin K; Wilson-Genderson, Maureen; Kuhn, Laura; Moghanaki, Drew; Vachhani, Hetal; Paasche-Orlow, Michael

2011-12-01

Cancer patients receiving adjuvant therapy encounter increasingly complex situations and decisions with each new procedure and therapy. To make informed decisions about care, they need to be able to access, process, and understand information. Individuals with limited health literacy may not be able to obtain or understand important information about their cancer and treatment. The rate of low health literacy has been shown to be higher among African Americans than among non-Hispanic Whites. This study examined the associations between race, health literacy, and self-reported needs for information about disease, diagnostic tests, treatments, physical care, and psychosocial resources. Measures assessing information needs were administered to 138 newly diagnosed cancer patients. Demographics were assessed by survey and health literacy was assessed with two commonly used measures: the Rapid Estimate Adult Literacy in Medicine (REALM) and the Short Test of Health Literacy in Adults (STOFHLA). Study findings indicate that educational attainment, rather than health literacy, is a significant predictor of information needs. Overcoming barriers to information needs may be less dependent on literacy considerations and more dependent on issues that divide across levels of educational attainment. Oncologists and hospital staff should be attentive to the fact that many patients require additional assistance to meet their information needs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Technical approaches to characterizing and cleaning up iron and steel mill sites under the brownfields initiative. Final report

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

NONE

EPA has developed this guide to provide decision-makers, such as city planners, private sector developers, and other involved in redeveloping brownfields, with a better understanding of the technical issues involved in assessing and cleaning up iron and steel mill sites so they can make the most informed decisions possible. This overview of the technical process involved in assessing and cleaning up brownfields sites can assist planners in making decisions at various stages of the project. An understanding of land use and industrial processes conducted in the past at a site can help the planner to conceptualize the site and identifymore » likely areas of contamination that may require cleanup. Numerous resources are suggested to facilitate characterization of the site and consideration of cleanup technologies.« less

Societal assessment overview

NASA Technical Reports Server (NTRS)

Bloomquist, C. E.

1980-01-01

The decision to proceed with SPS depends on a political determination that commitment of the economic, institutional, and social energies required for its implementation is a worthwhile investment. This determination is national (and international) in scope and is based on knowledge of the environmental and societal impacts of the SPS, its projected economics and technological risks, expressed through the influence of contending segments of society. To assist the decision makers, an assessment of societal issues associated with the SPS was undertaken as part of the Concept Development and Evaluation Program. Results of the assessment are reported. The primary societal assessment objectives are to determine if the societal ramifications of an SPS might significantly impede its development, and to establish an information base regarding these issues. Estimates regarding SPS impacts commensurate with its stage of development and the needs of the decision makers are provided.

Ability and Use of Comparative Effectiveness Research by P&T Committee Members and Support Staff: A 1-Year Follow-up.

PubMed

Augustine, Jill; Warholak, Terri L; Hines, Lisa E; Sun, Diana; Brown, Mary; Hurwitz, Jason; Taylor, Ann M; Brixner, Diana; Cobaugh, Daniel J; Schlaifer, Marissa; Malone, Daniel C

2016-06-01

In recent years, comparative effectiveness tools and methods have evolved to assist health care decision makers in identifying optimal therapies. In-person training programs on comparative effectiveness research may be helpful in understanding and applying this information. To provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program, in which participants were taught about CER designs and how to access available CER resources through the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program. A retrospective, cross-sectional questionnaire was developed and mailed to 2 groups of individuals: CER workshop attendees and interested nonattendees (expressing an interest in attending a workshop but did not attend for unknown reasons). The questionnaire asked respondents to indicate personal and organizational use of CER in the decision-making process. Participants were asked to indicate whether their knowledge, ability, and use of CER studies increased since participating in the program. Data were analyzed using nonparametric tests to compare the responses of attendees and nonattendees, as well as overall reliability of the instrument. A total of 164 respondents completed the questionnaire (63 attendees and 101 nonattendees; overall response rate = 44%). The majority of respondents were pharmacists (n = 157, 95.7%) and were affiliated with a hospital (n = 106, 64.6%). Proportions of attendees and nonattendees differed significantly in the use of EHC research reviews/reports (45% and 28%, respectively; P = 0.02) and EHC executive summaries of research reviews/reports (48% and 29%, respectively; P = 0.01). At 1-year follow-up, the majority of attendees reported an increase ("somewhat" or "very much") in knowledge of CER (91.5%), ability to use CER (83.0%), and use of CER studies (58.7%). Health professionals attending a continuing education CER program reported higher use of EHC CER materials compared with nonattendees. Additionally, attendees reported increased use of CER in clinical decision making. A continuing education program such as this may provide an effective avenue for introducing CER methods and resources to the P&T committee and clinical decision-making processes. This project was supported by grant number R18HS019220 from the Agency of Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency of Healthcare Research and Quality. Augustine has stock in Pfizer. The authors declared no other potential conflicts of interest associated with this study. Study concept and design were primarily contributed by Malone, along with Warholak, Hines, Brown, Hurwitz, and Taylor. Warholak, Hines, Brown, Hurwitz, and Taylor collected the data, assisted by Malone, Brixner, Cobaugh, and Schlaifer. Data interpretation was performed by Malone and Augustine, with assistance from the other authors. The manuscript was written primarily by Augustine, with assistance from Malone, Sun, Warholak, Hines, Brown, Hurwitz, and Taylor. Malone revised the manuscript, assisted by Warholak, Hines, Brown, Hurwitz, Taylor, Brixner, Cobaugh, and Schlaifer.

Enhancing the informed consent process in psychiatric outpatients with a brief computer-based method.

PubMed

Morán-Sánchez, Inés; Luna, Aurelio; Pérez-Cárceles, Maria D

2016-11-30

Informed consent is a key element of ethical clinical research. Those with mental disorders may be at risk for impaired consent capacity. Problems with procedures may also contribute to patient's ´difficulties in understanding consent forms. The present investigation explores if a brief technologically based information presentation of the informed consent process may enhance psychiatric patients understanding and satisfaction. In this longitudinal, within-participants comparison study, patients who initially were judged to lack capacity to make research decisions (n=41) and a control group (n=47) were followed up. Decisional capacity, willingness to participate and cognitive and clinical scores were assessed at baseline and after receiving the computer-assisted enhanced consent. With sufficient cueing, patients with impaired research-related decision-making capacity at baseline were able to display enough understanding of the consent form. Patient satisfaction and willingness to participate also increased at follow up. Implications of these results for clinical practice and medical research involving people with mental disorders are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Design and implementation of a simulation exercise for teaching confidentiality of patient information.

PubMed

Snyder, J R

1982-05-01

Allied health students, making the transition from a purely academic to a professional school setting, are suddenly faced with judgment decisions about disclosure of medical information. Obscure guidelines and new interpersonal relationships with other members of the health care team complicate this transition and pose a threat to confidentiality of patient information. This article describes the design and implementation of a simulation exercise to reinforce lecture guidelines specifying disclosure of medical information without risk to the patient or student. The simulation is comprised of 10 critical incidents calling for responses ranging from logical to judgmental. Although written primarily for medical technologists, with emphasis on limitations governing release of patient laboratory data, the simulation approach is presented here as a model for other allied health professions. The use of a latent image format provides learners with positive or negative reinforcement as they learn the consequences of their decisions. The simulation activity described is easily adapted to small group discussion or computer-assisted instruction. While the simulation appears to be an accurate representation of reality, peer and real-life pressures could not be totally simulated.

An exploratory study of relational, persuasive, and nonverbal communication in requests for tissue donation.

PubMed

Siminoff, Laura A; Traino, Heather M; Gordon, Nahida H

2011-10-01

This study explores the effects of tissue requesters' relational, persuasive, and nonverbal communication on families' final donation decisions. One thousand sixteen (N = 1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation.

An Exploratory Study of Relational, Persuasive, and Nonverbal Communication in Requests for Tissue Donation

PubMed Central

SIMINOFF, LAURA A.; TRAINO, HEATHER M.; GORDON, NAHIDA H.

2011-01-01

This study explores the effects of tissue requesters’ relational, persuasive, and nonverbal communication on families’ final donation decisions. One thousand sixteen (N=1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation. PMID:21512935

50 CFR 228.21 - Assistant Administrator's decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Assistant Administrator's decision. 228.21 Section 228.21 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS NOTICE AND HEARING ON SECTION 103(d) REGULATIONS § 228.21...

14 CFR 303.46 - Decision by the Assistant Secretary.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Decision by the Assistant Secretary. 303.46 Section 303.46 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL REGULATIONS REVIEW OF AIR CARRIER AGREEMENTS Procedures Upon Application or Review...

Intelligent system for topic survey in MEDLINE by keyword recommendation and learning text characteristics.

PubMed

Tanaka, M; Nakazono, S; Matsuno, H; Tsujimoto, H; Kitamura, Y; Miyano, S

2000-01-01

We have implemented a system for assisting experts in selecting MEDLINE records for database construction purposes. This system has two specific features: The first is a learning mechanism which extracts characteristics in the abstracts of MEDLINE records of interest as patterns. These patterns reflect selection decisions by experts and are used for screening the records. The second is a keyword recommendation system which assists and supplements experts' knowledge in unexpected cases. Combined with a conventional keyword-based information retrieval system, this system may provide an efficient and comfortable environment for MEDLINE record selection by experts. Some computational experiments are provided to prove that this idea is useful.

Intelligent Diagnostic Assistant for Complicated Skin Diseases through C5's Algorithm.

PubMed

Jeddi, Fatemeh Rangraz; Arabfard, Masoud; Kermany, Zahra Arab

2017-09-01

Intelligent Diagnostic Assistant can be used for complicated diagnosis of skin diseases, which are among the most common causes of disability. The aim of this study was to design and implement a computerized intelligent diagnostic assistant for complicated skin diseases through C5's Algorithm. An applied-developmental study was done in 2015. Knowledge base was developed based on interviews with dermatologists through questionnaires and checklists. Knowledge representation was obtained from the train data in the database using Excel Microsoft Office. Clementine Software and C5's Algorithms were applied to draw the decision tree. Analysis of test accuracy was performed based on rules extracted using inference chains. The rules extracted from the decision tree were entered into the CLIPS programming environment and the intelligent diagnostic assistant was designed then. The rules were defined using forward chaining inference technique and were entered into Clips programming environment as RULE. The accuracy and error rates obtained in the training phase from the decision tree were 99.56% and 0.44%, respectively. The accuracy of the decision tree was 98% and the error was 2% in the test phase. Intelligent diagnostic assistant can be used as a reliable system with high accuracy, sensitivity, specificity, and agreement.

Analysis of data mining classification by comparison of C4.5 and ID algorithms

NASA Astrophysics Data System (ADS)

Sudrajat, R.; Irianingsih, I.; Krisnawan, D.

2017-01-01

The rapid development of information technology, triggered by the intensive use of information technology. For example, data mining widely used in investment. Many techniques that can be used assisting in investment, the method that used for classification is decision tree. Decision tree has a variety of algorithms, such as C4.5 and ID3. Both algorithms can generate different models for similar data sets and different accuracy. C4.5 and ID3 algorithms with discrete data provide accuracy are 87.16% and 99.83% and C4.5 algorithm with numerical data is 89.69%. C4.5 and ID3 algorithms with discrete data provides 520 and 598 customers and C4.5 algorithm with numerical data is 546 customers. From the analysis of the both algorithm it can classified quite well because error rate less than 15%.

Residency selection process: description and annotated bibliography.

PubMed Central

Aaron, P R; Frye, T L

1979-01-01

Specialty and residency training choices of medical students will affect the quality, mode, and geographic location of their future practice; the importance of such choices should not be underestimated. Medical school librarians have largely ignored the opportunity to interact with both medical students and medical school officials in providing sources needed to assist these career decisions, and for the most part students and administrators have ignored the opportunity to utilize the medical library in this process. This article presents an overview of the processes and procedures in which third- and fourth-year medical students are involved in selecting specialty and residency training, and provides a detailed description of the resources which the medical student should consult in order to make thoughtful, informed career decisions. The article urges medical school advisers and medical librarians to work as partners in providing information on specialty and residency selection to medical students. PMID:385087

Randomized pilot study and qualitative evaluation of a clinical decision support system for brain tumour diagnosis based on SV ¹H MRS: evaluation as an additional information procedure for novice radiologists.

PubMed

Sáez, Carlos; Martí-Bonmatí, Luis; Alberich-Bayarri, Angel; Robles, Montserrat; García-Gómez, Juan M

2014-02-01

The results of a randomized pilot study and qualitative evaluation of the clinical decision support system Curiam BT are reported. We evaluated the system's feasibility and potential value as a radiological information procedure complementary to magnetic resonance (MR) imaging to assist novice radiologists in diagnosing brain tumours using MR spectroscopy (1.5 and 3.0T). Fifty-five cases were analysed at three hospitals according to four non-exclusive diagnostic questions. Our results show that Curiam BT improved the diagnostic accuracy in all the four questions. Additionally, we discuss the findings of the users' feedback about the system, and the further work to optimize it for real environments and to conduct a large clinical trial. © 2013 Published by Elsevier Ltd.

Identifying Opportunities for Decision Support Systems in Support of Regional Resource Use Planning: An Approach Through Soft Systems Methodology.

PubMed

Zhu; Dale

2000-10-01

/ Regional resource use planning relies on key regional stakeholder groups using and having equitable access to appropriate social, economic, and environmental information and assessment tools. Decision support systems (DSS) can improve stakeholder access to such information and analysis tools. Regional resource use planning, however, is a complex process involving multiple issues, multiple assessment criteria, multiple stakeholders, and multiple values. There is a need for an approach to DSS development that can assist in understanding and modeling complex problem situations in regional resource use so that areas where DSSs could provide effective support can be identified, and the user requirements can be well established. This paper presents an approach based on the soft systems methodology for identifying DSS opportunities for regional resource use planning, taking the Central Highlands Region of Queensland, Australia, as a case study.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

PubMed

Velickovski, Filip; Ceccaroni, Luigi; Roca, Josep; Burgos, Felip; Galdiz, Juan B; Marina, Nuria; Lluch-Ariet, Magí

2014-11-28

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

PubMed Central

2014-01-01

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems. PMID:25471545

Effects of a decision support intervention on decisional conflict associated with microsatellite instability testing.

PubMed

Hall, Michael J; Manne, Sharon L; Winkel, Gary; Chung, Daniel S; Weinberg, David S; Meropol, Neal J

2011-02-01

Decision support to facilitate informed consent is increasingly important for complicated medical tests. Here, we test a theoretical model of factors influencing decisional conflict in a study examining the effects of a decision support aid that was designed to assist patients at high risk for hereditary nonpolyposis colorectal cancer (CRC) deciding whether to pursue the microsatellite instability (MSI) test. Participants were 239 CRC patients at high familial risk for a genetic mutation who completed surveys before and after exposure to the intervention. Half of the sample was assigned to the CD-ROM aid and half received a brief description of the test. Structural equation modeling was employed to examine associations among the intervention, knowledge, pros and cons to having MSI testing, self-efficacy, preparedness, and decisional conflict. The goodness of fit for the model was acceptable [FIML, full information maximum likelihood, χ(2) (df = 280) = 392.24; P = 0.00]. As expected, the paths to decisional conflict were significant for postintervention pros of MSI testing (t = -2.43; P < 0.05), cons of MSI testing (t = 2.78; P < 0.05), and preparedness (t = -7.27; P < 0.01). The intervention impacted decisional conflict by increasing knowledge about the MSI test and knowledge exerted its effects on decisional conflict by increasing preparedness to make a decision about the test and by increases in perceived benefits of having the test. Increasing knowledge, preparedness, and perceived benefits of undergoing the MSI test facilitate informed decision making for this test. Understanding mechanisms underlying health decisions is critical for improving decisional support. Individuals with Lynch syndrome have an elevated lifetime risk of CRC. Risk of Lynch syndrome may be assessed with a tumor-based screening test (MSI testing or immunohistochemical tissue staining). ©2011 AACR.

Reasons for family involvement in elective surgical decision-making in Taiwan: a qualitative study.

PubMed

Lin, Mei-Ling; Huang, Chuen-Teng; Chen, Ching-Huey

2017-07-01

To inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. Making a patient the centre of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking. A qualitative study. In order to record and examine reasons for family involvement in adult patients' surgical decision-making, 12 different family members of 12 elective surgery patients were interviewed for collecting and analysing data. Three major reasons for family involvement emerged from the data analyses: (1) to share responsibility; (2) to ensure the correctness of medical information; and (3) to safeguard the patient's well-being. These findings also reveal that culture is not the only reason for family involvement. Making decision to undergo a surgery is a tough and stressful process for a patient. Family may provide the patient with timely psychological support to assist the patient to communicate with his or her physician(s) and other medical personnel to ensure their rights. It is also found that due to the imbalanced doctor-patient power relationship, a patient may be unable, unwilling to, or even dare not, tell the whole truth about his or her illness or feelings to the medical personnel. Thus, a patient would expect his or her family to undertake such a mission during the informed consent and decision-making processes. The results of this study may provide medical professionals with relevant insights into family involvement in adult patients' surgical decision-making. © 2016 John Wiley & Sons Ltd.

Provision and financing of assistive technology devices in Germany: a bureaucratic odyssey? The case of amyotrophic lateral sclerosis and Duchenne muscular dystrophy.

PubMed

Henschke, Cornelia

2012-05-01

The regulations for financing assistive technology devices (ATDs) are complex and fragmented and, thus, might influence adequate provision of these devices to people who need multiple ATDs. This study aims to explore and analyze patients' problems with the provision and financing of ATDs for the following two rare diseases: amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD). A survey was conducted by means of semi-standardized questionnaires addressing the issues of coverage decisions for ATDs and problems with provision of ATDs. Information was retrieved from ALS (n=19) and DMD (n=14) patients. Conducted interviews were transcribed verbatim and analyzed using qualitative content analysis. Respondents experienced difficulties with the provision and financing of ATDs. They underlined problems such as long approval processes and a serious bureaucratic burden, which induced inadequate provision of ATDs. Experiences of ALS and DMD respondents frequently were similar, especially regarding financing decisions and the process of decision making by sickness funds. The results suggest that difficulties in receiving and financing ATDs are common problems among ALS and DMD patients. There is a need for an interdisciplinary approach in the provision of ATDs and their financing, which should be coordinated by case managers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

What do public health officials expect from modelers during a response to an epidemic or outbreak?

NASA Astrophysics Data System (ADS)

Washington, Michael

Since 2009, the CDC has participated in emergency responses ranging from small domestic outbreaks involving a few hundred people, to international public health emergencies affecting millions of individuals from around the world. Each response required unique skills from the CDC'S Modeling Task Force to address public health officials' questions and to help them make informed decisions. This presentation will discuss the roll of the Modeling Task Forces in the CDC's Incident Management structure and some of the models used to assist officials in making decisions about the potential size of the public health crisis, how effective interventions could be, and what resources are required.

Genetic Testing as a Tool to Identify Horses with or at Risk for Ocular Disorders.

PubMed

Bellone, Rebecca R

2017-12-01

Advances in equine genetics and genomics resources have enabled the understanding of some inherited ocular disorders and ocular manifestations. These ocular disorders include congenital stationary night blindness, equine recurrent uveitis, multiple congenital ocular anomalies, and squamous cell carcinoma. Genetic testing can identify horses with or at risk for disease and thus can assist in clinical management. In addition, genetic testing can identify horses that are carriers and thus can inform breeding decisions. Use of genetic tests in management and breeding decisions should aid in reducing the incidence of these disorders and improving the outcomes for horses at highest risk. Copyright © 2017 Elsevier Inc. All rights reserved.

77 FR 40634 - Solicitation for a Cooperative Agreement: Pretrial Technical Assistance for Evidence-Based...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

...: Pretrial Technical Assistance for Evidence-Based Decision Making in Local Criminal Justice Systems AGENCY... NIC initiative, Evidence-Based Decision Making (EBDM) in Local Criminal Justice Systems. Work under... individual system planning activities. These change strategies are critical to meeting their system's harm...