Reducing Diagnostic Error with Computer-Based Clinical Decision Support

ERIC Educational Resources Information Center

Greenes, Robert A.

2009-01-01

Information technology approaches to delivering diagnostic clinical decision support (CDS) are the subject of the papers to follow in the proceedings. These will address the history of CDS and present day approaches (Miller), evaluation of diagnostic CDS methods (Friedman), and the role of clinical documentation in supporting diagnostic decision…

Superfund record of decision (EPA Region 3): Tyler Refrigeration Pit, Smyrna, DE, May 10, 1996

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

NONE

This decision document presents the Environmental Protection Agency`s selected remedial action for the Tyler Refrigeration Pit Site (Site) in Smyrna, Delaware. EPA has determined that no remedial action is necessary at the Site to ensure protection of human health and the environment.

A Perspective on Marketing Teacher Education.

ERIC Educational Resources Information Center

Turner, John E.

1990-01-01

This document presents a model for program planning and decision making for teacher education in marketing and discusses teacher education policy in the context of the model. The first section explains the document's background and perspective. The second section places marketing teacher education in the context of a larger marketing education…

Performance Assessment for Pump-and-Treat Closure or Transition

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

Truex, Michael J.; Johnson, Christian D.; Becker, Dave J.

2015-09-29

A structured performance assessment approach is useful to evaluate pump-and-treat (P&T) groundwater remediation, which has been applied at numerous sites. Consistent with the U.S. Environmental Protection Agency’s Groundwater Road Map, performance assessment during remedy implementation may be needed, and should consider remedy optimization, transition to alternative remedies, or remedy closure. In addition, a recent National Research Council study examined groundwater remediation at complex contaminated sites and concluded that it may be beneficial to evaluate remedy performance and the potential need for transition to alternative approaches at these sites. The intent of this document is to provide a structured approach formore » assessing P&T performance to support a decision to optimize, transition, or close a P&T remedy. The process presented in this document for gathering information and performing evaluations to support P&T remedy decisions includes use of decision elements to distinguish between potential outcomes of a remedy decision. Case studies are used to augment descriptions of decision elements and to illustrate each type of outcome identified in the performance assessment approach. The document provides references to resources for tools and other guidance relevant to conducting the P&T assessment.« less

Corrective Action Decision Document/Closure Report for Corrective Action Unit 569: Area 3 Yucca Flat Atmospheric Test Sites Nevada National Security Site, Nevada with ROTC 1, Revision 0

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

Sloop, Christy

2013-04-01

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 569: Area 3 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada. CAU 569 comprises the following nine corrective action sites (CASs): • 03-23-09, T-3 Contamination Area • 03-23-10, T-3A Contamination Area • 03-23-11, T-3B Contamination Area • 03-23-12, T-3S Contamination Area • 03-23-13, T-3T Contamination Area • 03-23-14, T-3V Contamination Area • 03-23-15, S-3G Contamination Area • 03-23-16, S-3H Contamination Area • 03-23-21, Pike Contamination Area The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supportingmore » the recommendation that no further corrective action is needed for CAU 569 based on the implementation of the corrective actions listed in Table ES-2.« less

12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

Code of Federal Regulations, 2010 CFR

2010-01-01

... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will: (a...

50 CFR 530.2 - Ensuring that environmental documents are actually considered in agency decision-making.

Code of Federal Regulations, 2010 CFR

2010-10-01

... actually considered in agency decision-making. 530.2 Section 530.2 Wildlife and Fisheries MARINE MAMMAL... documents are actually considered in agency decision-making. Section 1505.1 of the NEPA regulations contains requirements to ensure adequate consideration of environmental documents in agency decision-making. To...

Proceedings of the workshop "Development of biological decision support systems for resource managers": Denver, Colorado, October 27-29, 1998

USGS Publications Warehouse

Getter, James; D'Erchia, Terry D.; Root, Ralph; Getter, James; D'Erchia, Terry D.; Root, Ralph

1999-01-01

The format for this 3-day workshop (27-29 October 1998) included plenary presentations by USGS Biological Resources Division (BRD) and U.S. Fish and Wildlife Service per onnel who u e and develop decision support systems (DSS); breakout ses ions addressing DSS technical information aspect , outreach/ customer requirements, and future perspectives; and a DSS Steering Committee meeting to evaluate work hop goals and to provide guidance for fu ture efforts. Steering committee action item developed from workshop inputs were to ( I) develop a "DSS framework" document for u e in biological research. (2) develop a "proof of concept" DSS based upon the framework document, and (3) integrate decision support ystem into BRD program elements.

Superfund Record of Decision (EPA Region 9): San Fernando Valley Area 2, operable unit 2, Los Angeles County, CA, June 1993

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

Not Available

1993-06-01

This decision document presents the selected remedial action for the Glendale North Operable Unit, San Fernando Valley Area 2 Superfund site. The remedy involves groundwater extraction and treatment for the shallow aquifer system in the Glendale area of the San Fernando Valley.

Superfund Record of Decision (EPA Region 9): San Fernando Valley Area 2, operable unit 3, Los Angeles County, CA, June 1993

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

Not Available

1993-06-01

This decision document presents the selected remedial action for the Glendale South Operable Unit, San Fernando Valley Area 2 Superfund site. The remedy involves groundwater extraction and treatment for the shallow aquifer system in the Glendale area of the San Fernando Valley.

Government: The Decision-Making Process. A Resource Manual for Teachers and Students. Revised Edition.

ERIC Educational Resources Information Center

Khanlian, John F.; Wallin, Katherine L.

This guide for high school political science teachers focuses on political decision making. The program emphasizes experiential learning through utilizing community and state resources and implementing field study and internships for students. The document is presented in eight sections. The introduction includes a values survey and suggestions…

Santa Barbara City College: 1999-02 College Plan.

ERIC Educational Resources Information Center

Santa Barbara City Coll., CA.

This document presents Santa Barbara City College's 1999-2002 College Plan. It is intended to be used as the central organizing document for decision making, planning, and budgeting throughout the College during the 1999-2002 period. This plan is the result of thoughtful and substantive dialogue involving individuals and groups throughout the…

United States Air Force 611th Civil Engineer Squadron, Elmendorf AFB, Alaska. Final engineering evaluation/cost analysis: Petroleum, oil, and lubricants area, Galena Airport, Alaska

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

NONE

1996-02-05

This decision document presents the selected removal action for the Installation Restoration Program (IRP) site ST005, otherwise known as the POL Tank Farm, at Galena Airport, Alaska. This decision is based on the administrative record for this site, specifically the draft Remedial Investigation Report (March 1995) and the Treatability Study Report (January 1995) (PB95-225314). The information from these documents is summarized, along with an analysis of potential removal action alternatives in the Engineering Evaluation/Cost Analysis (EE/CA).

Superfund record of decision (EPA region 6): Longhorn Army Ammunition Plant, (No Further Action at LHAAP 13 and 14), Karnack, TX, February 14, 1996

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

NONE

1997-03-01

This decision document presents the selected no Further Action alternative for LHAAP 13 and 14, Longhorn Army Ammunition Plant (LHAAP), in Karnack, Texas. There are no actual or threatened releases of hazardous substances as a result of suspected previous activities from these sites that may present an imminent and substantial endangerment to public health, welfare, or the environment.

Enhancing User Customization through Novel Software Architecture for Utility Scale Solar Siting Software

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

Brant Peery; Sam Alessi; Randy Lee

2014-06-01

There is a need for a spatial decision support application that allows users to create customized metrics for comparing proposed locations of a new solar installation. This document discusses how PVMapper was designed to overcome the customization problem through the development of loosely coupled spatial and decision components in a JavaScript plugin architecture. This allows the user to easily add functionality and data to the system. The paper also explains how PVMapper provides the user with a dynamic and customizable decision tool that enables them to visually modify the formulas that are used in the decision algorithms that convert datamore » to comparable metrics. The technologies that make up the presentation and calculation software stack are outlined. This document also explains the architecture that allows the tool to grow through custom plugins created by the software users. Some discussion is given on the difficulties encountered while designing the system.« less

Superfund record of decision amendment (EPA Region 5): Moss-American (Kerr-McGee Oil Co.), Milwaukee, WI, September 30, 1998

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

NONE

The purpose of this decision document is to present an amendment to the Record of Decision (ROD) for the Moss-American Site, which is located in Milwaukee, Wisconsin. The ROD amendment for the Moss-American site has three principal components: (1) changes in soil treatment technology, (2) potential changes in cleanup standards, and (3) changes in cover design and requirements.

Participants' recall and understanding of genomic research and large-scale data sharing.

PubMed

Robinson, Jill Oliver; Slashinski, Melody J; Wang, Tao; Hilsenbeck, Susan G; McGuire, Amy L

2013-10-01

As genomic researchers are urged to openly share generated sequence data with other researchers, it is important to examine the utility of informed consent documents and processes, particularly as these relate to participants' engagement with and recall of the information presented to them, their objective or subjective understanding of the key elements of genomic research (e.g., data sharing), as well as how these factors influence or mediate the decisions they make. We conducted a randomized trial of three experimental informed consent documents (ICDs) with participants (n = 229) being recruited to genomic research studies; each document afforded varying control over breadth of release of genetic information. Recall and understanding, their impact on data sharing decisions, and comfort in decision making were assessed in a follow-up structured interview. Over 25% did not remember signing an ICD to participate in a genomic study, and the majority (54%) could not correctly identify with whom they had agreed to share their genomic data. However, participants felt that they understood enough to make an informed decision, and lack of recall did not impact final data sharing decisions or satisfaction with participation. These findings raise questions about the types of information participants need in order to provide valid informed consent, and whether subjective understanding and comfort with decision making are sufficient to satisfy the ethical principle of respect for persons.

[Written information for patients: From papers to documents].

PubMed

Cortés-Criado, M C

2014-01-01

There is a high variability in the level of information intended for patients, with different content, format and presentation. To determine the perceived safety of the patients treated at the Country Hospital of Melilla (HCML) and to assess the quality of the documents using criteria adapted to the «International Patient Decision Aid Standards» (IPDAS). Descriptive study of the documents given to patients by the HCML. They included questionnaires on perceived safety, classification of the documents, and the level of adherence to the IPDAS criteria. The Information given to patients during their stay in the HCML, their participation in decision-making, and the information about medication, did not exceed the average on the acceptance scale. Only 40 documents were studied (of the 131 collected), on being published in-house, and were classified, following the definitions of the RAE, into instructions (20), recommendations (14) and guidelines (6). Of these, only the 27.5% showed hospital logo. In the content analysis according to the IPDAS criteria, there was an overall adherence rate of 24.1% in instructions, 24.8% in recommendations, and 61.5% in guidelines. The perception of patient safety expressed in the questionnaire, and its assessment according IPDAS criteria, shows there may be a significant improvement within the organization. Furthermore, the quality of patient documentation provided can help decision making. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

40 CFR 300.700 - Activities by other persons.

Code of Federal Regulations, 2010 CFR

2010-07-01

... action is conducted in accordance with the preauthorization decision document, and costs are reasonable... preauthorization decision document. (8) For a claim to be awarded under section 111 of CERCLA, EPA must certify that the costs were necessary and consistent with the preauthorization decision document. (e) Section...

Superfund record of decision (EPA Region 4): Aberdeen Pesticide Dumps Site, Aberdeen, NC, October 1993

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

Not Available

1994-07-01

The decision document presents the selected remedial action for Operable Unit Three (OU3) of the Aberdeen Pesticide Dumps Site (the 'Site'), in Aberdeen, North Carolina. The remedy selected addresses groundwater, sediment, and surface water contamination and ecological concerns to eliminate or reduce the risks posed by the Site.

77 FR 22316 - Notification of a Public Teleconference of the Science Advisory Board Ecological Processes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

...) document, ``Integrating Ecological Assessment and Decision-Making at EPA, 2011 RAF Ecological Assessment... document, ``Integrating Ecological Assessment and Decision- Making at EPA, 2011 RAF Ecological Assessment... review comments on the EPA RAF draft document ``Integrating Ecological Assessment and Decision-Making at...

Superfund explanation of significant difference for the Record of Decision (EPA Region 10): Umatilla Army Depot (Lagoons), Hermiston, OR, September 30, 1997

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

NONE

1998-10-01

This document presents an Explanation of Significant Difference (ESD) from the Record of Decision (ROD) for the Umatilla Depot Activity (UMDA) Explosives Washout Lagoons Soils Operable Unit issued September 25, 1992 (PB93-964610). This ESD documents the significant differences to the selected remedy outlined in the ROD. In summary, the significant difference from the selected remedy in the ROD is the utilization of the treated soil as the organic component in the re-vegetation of several designated sites on the installation rather than backfilling the former Explosive Washout Lagoons with the compost.

Amatchmethod Based on Latent Semantic Analysis for Earthquakehazard Emergency Plan

NASA Astrophysics Data System (ADS)

Sun, D.; Zhao, S.; Zhang, Z.; Shi, X.

2017-09-01

The structure of the emergency plan on earthquake is complex, and it's difficult for decision maker to make a decision in a short time. To solve the problem, this paper presents a match method based on Latent Semantic Analysis (LSA). After the word segmentation preprocessing of emergency plan, we carry out keywords extraction according to the part-of-speech and the frequency of words. Then through LSA, we map the documents and query information to the semantic space, and calculate the correlation of documents and queries by the relation between vectors. The experiments results indicate that the LSA can improve the accuracy of emergency plan retrieval efficiently.

Superfund record of decision (EPA Region 10): Standard Steel and Metals Salvage Yard, (USDOT), Superfund Site, Anchorage, AK, July 16, 1996

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

NONE

1996-08-01

The decision document presents the selected remedial action for the Standard Steel and Metals Salvage Yard, in Anchorage, Alaska. This is the final remedial action for the site. The site was not divided into operable units. The Removal Action utilized treatment as a principle element for the principle sources.

Superfund record of decision (EPA Region 6): Southern Shipbuilding Corp., Slidell, LA, July 20, 1995

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

NONE

1996-03-01

This decision document presents the selected remedial action for the source control operable unit of the Southern Shipbuilding Corporation (SSC) site in Slidell, Louisiana. This remedy represents the source control operable unit which addresses remediation of highly contaminated sludge and soil, the marginally contaminated soil, and the graving dock sediments at the Southern Shipbuilding Corporation site.

Superfund record of decision (EPA Region 6): Longhorn Army Ammunition Plant, IHAAP 12 and 16 Landfills, Karnack, TX, September 27, 1995

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

NONE

1996-03-01

This decision document presents the selected Early Interim Remedial Action for the LHAAP 12 and 16 landfills, Longhorn Army Ammunition Plant (LHAAP), Karnack, Texas. The Record of Decision for the sites addresses an Early Interim Remedial Action. The selected remedy consists of a multilayer landfill cap section which includes the following components: Foundation soil layer, Sodium Bentonite Geocomposite Liner, Geosynthetic Membrane Liner, Final soil cover, and Perimeter berms and drainage swales.

No Further Action Decision Document for Site 8 at Alpena Combat Readiness Training Center, Alpena, Michigan.

DTIC Science & Technology

1998-04-01

INSTALLATION RESTORATION PROGRAM No FURTHER REMEDIAL ACTION PLANNED DECISION DOCUMENT FOR SITE 8 FINAL MICHIGAN AIR NATIONAL GUARD ALPENA ...COMBAT READINESS TRAINING CENTER ALPENA , MICHIGAN April 1998 Air National Guard Andrews AFB, Maryland fr r=.~r i^:r^f>^’ m% Approved for public...Document 4. TITLE AND SUBTITLE No Further Action Decision Document for Site 8 at Alpena CRTC, Alpena , MI. 6. AUTHOR(S) N/A 7. PERFORMING

Semantic Clinical Guideline Documents

PubMed Central

Eriksson, Henrik; Tu, Samson W.; Musen, Mark

2005-01-01

Decision-support systems based on clinical practice guidelines can support physicians and other health-care personnel in the process of following best practice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal manner, perform consistency checks, and use the guidelines directly in decision-support systems. Decision-support authors and guideline users require guidelines in human-readable formats in addition to computer-interpretable ones (e.g., for guideline review and quality assurance). We propose a new document-oriented information architecture that combines knowledge-representation models with electronic and paper documents. The approach integrates decision-support modes with standard document formats to create a combined clinical-guideline model that supports on-line viewing, printing, and decision support. PMID:16779037

Roadmap for the international, accelerator-based neutrino programme

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

Cao, J.; de Gouvêa, A.; Duchesneau, D.

In line with its terms of reference the ICFA Neutrino Panel has developed a roadmap for the international, accelerator-based neutrino programme. A "roadmap discussion document" was presented in May 2016 taking into account the peer-group-consultation described in the Panel's initial report. The "roadmap discussion document" was used to solicit feedback from the neutrino community---and more broadly, the particle- and astroparticle-physics communities---and the various stakeholders in the programme. The roadmap, the conclusions and recommendations presented in this document take into account the comments received following the publication of the roadmap discussion document. With its roadmap the Panel documents the approved objectivesmore » and milestones of the experiments that are presently in operation or under construction. Approval, construction and exploitation milestones are presented for experiments that are being considered for approval. The timetable proposed by the proponents is presented for experiments that are not yet being considered formally for approval. Based on this information, the evolution of the precision with which the critical parameters governinger the neutrino are known has been evaluated. Branch or decision points have been identified based on the anticipated evolution in precision. The branch or decision points have in turn been used to identify desirable timelines for the neutrino-nucleus cross section and hadro-production measurements that are required to maximise the integrated scientific output of the programme. The branch points have also been used to identify the timeline for the R&D required to take the programme beyond the horizon of the next generation of experiments. The theory and phenomenology programme, including nuclear theory, required to ensure that maximum benefit is derived from the experimental programme is also discussed.« less

Medical decision making: guide to improved CPT coding.

PubMed

Holt, Jim; Warsy, Ambreen; Wright, Paula

2010-04-01

The Current Procedural Terminology (CPT) coding system for office visits, which has been in use since 1995, has not been well studied, but it is generally agreed that the system contains much room for error. In fact, the available literature suggests that only slightly more than half of physicians will agree on the same CPT code for a given visit, and only 60% of professional coders will agree on the same code for a particular visit. In addition, the criteria used to assign a code are often related to the amount of written documentation. The goal of this study was to evaluate two novel methods to assess if the most appropriate CPT code is used: the level of medical decision making, or the sum of all problems mentioned by the patient during the visit. The authors-a professional coder, a residency faculty member, and a PGY-3 family medicine resident-reviewed 351 randomly selected visit notes from two residency programs in the Northeast Tennessee region for the level of documentation, the level of medical decision making, and the total number of problems addressed. The authors assigned appropriate CPT codes at each of those three levels. Substantial undercoding occurred at each of the three levels. Approximately 33% of visits were undercoded based on the written documentation. Approximately 50% of the visits were undercoded based on the level of documented medical decision making. Approximately 80% of the visits were undercoded based on the total number of problems which the patient presented during the visit. Interrater agreement was fair, and similar to that noted in other coding studies. Undercoding is not only common in a family medicine residency program but it also occurs at levels that would not be evident from a simple audit of the documentation on the visit note. Undercoding also occurs from not exploring problems mentioned by the patient and not documenting additional work that was performed. Family physicians may benefit from minor alterations in their documentation of office visit notes.

Superfund record of decision amendment (EPA Region 10): USAF Eielson Air Force Base, Operable Units 3, 4, and 5, Fairbanks North Star Borough, AK, September 29, 1998

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

NONE

This decision document presents the amended remedial action for Operable Units 3, 4, and 5 (OUs 3, 4, and 5) at Eielson Air Force Base (AFB). This decision is based on the Administrative Record for OU 3, 4, and 5, updated in July 1998, to include new information generated since the original Record of Decision was signed on 30 September 1995 (PB95-964618). This amendment applies to OU3 site DP44 (Battery Shop Leach Field Building), OU4 sites SS35 (Asphalt Mixing Area) and ST58 (Old Quartermaster Service Station), and OU5 sites LF03/FT09 (Current Inactive Base Landfill/Fire Training Area). Through new information, contaminantmore » levels than interpreted prior to signing the original ROD document. Proper enforcement of Institutional Controls (IC`s) at all sites will be effective in controlling and restricting access to contaminated media at the sites remediation goals are achieved.« less

Effectiveness guidance document (EGD) for acupuncture research - a consensus document for conducting trials

PubMed Central

2012-01-01

Background There is a need for more Comparative Effectiveness Research (CER) to strengthen the evidence base for clinical and policy decision-making. Effectiveness Guidance Documents (EGD) are targeted to clinical researchers. The aim of this EGD is to provide specific recommendations for the design of prospective acupuncture studies to support optimal use of resources for generating evidence that will inform stakeholder decision-making. Methods Document development based on multiple systematic consensus procedures (written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders including patients, clinicians and payers were involved. Results Recommendations focused mainly on randomized studies and were developed for the following areas: overall research strategy, treatment protocol, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD, based on an international consensus developed with multiple stakeholder involvement, provides the first systematic methodological guidance for future CER on acupuncture. PMID:22953730

20 CFR 404.950 - Presenting evidence at a hearing before an administrative law judge.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Presenting evidence at a hearing before an... Reopening of Determinations and Decisions Administrative Law Judge Hearing Procedures § 404.950 Presenting... location of the witnesses or documents with sufficient detail to find them; state the important facts that...

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.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada, Revision 0

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

Matthews, Patrick

2013-09-01

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada. CAU 105 comprises the following five corrective action sites (CASs): -02-23-04 Atmospheric Test Site - Whitney Closure In Place -02-23-05 Atmospheric Test Site T-2A Closure In Place -02-23-06 Atmospheric Test Site T-2B Clean Closure -02-23-08 Atmospheric Test Site T-2 Closure In Place -02-23-09 Atmospheric Test Site - Turk Closure In Place The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that nomore » further corrective action is needed for CAU 105 based on the implementation of the corrective actions. Corrective action investigation (CAI) activities were performed from October 22, 2012, through May 23, 2013, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices.« less

The Wildland Fire Decision Support System: Integrating science, technology, and fire management

Treesearch

Morgan Pence; Tom Zimmerman

2011-01-01

Federal agency policy requires documentation and analysis of all wildland fire response decisions. In the past, planning and decision documentation for fires were completed using multiple unconnected processes, yielding many limitations. In response, interagency fire management executives chartered the development of the Wildland Fire Decision Support System (WFDSS)....

Development Decision-Makers' Perspectives of Communication.

ERIC Educational Resources Information Center

Woods, John L.

Presented to a United Nations seminar on the role of information in the development of emerging nations, this document presents effective communication as the achievement of results--a change in attitude, practice, and knowledge. Elements of the SMCRE (sender-message-channel-receiver-effect) communications model are used in analyzing communication…

Superfund record of decision (EPA Region 3): Letterkenny Army Depot (PDO and SE Areas), Chambersburg, Franklin County, PA, September 30, 1998

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

NONE

1998-11-01

The decision document presents the selected remedial action for the Phase 1 Parcels at Letterkenny Army Depot (LEAD), Chambersburg, Pennsylvania. Based on consideration of he CERCLA requirements, the NCP, the detailed analysis of the alternatives using the nine criteria, and public and state comments, the Army and EPA have selected an institutional controls remedy for this Site.

National Incomes Policy and Manpower Problems. Proceedings of the Annual Research Conference in Industrial Relations (14th, Los Angeles, California, March 16, 1971).

ERIC Educational Resources Information Center

California Univ., Los Angeles. Inst. of Industrial Relations.

Two current economic dilemmas concern how to increase the supply of money without risking further inflation and how to influence wage-price decisions. The major purposes of the conference presented in this document were to define a national incomes policy, to explore alternative approaches to wage-price decisions, and to assess their implications…

Superfund Record of Decision (EPA Region 9): El Toro Marine Corps Air Station, Operable Units 2A and 3A (no action sites), El Toro, CA, September 29, 1997

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

NONE

This decision document presents the selected remedial action for Sites 4, 6, 9, 10, 13, 15, 19, 20, 21, 22, and 25 at MCAS El Toro in Orange County, California. The selected remedy for Sites, 4, 6, 9, 19, 13, 15, 19, 20, 21, 22, and 25 is no action.

Superfund record of decision (EPA Region 1): Tansitor Electronics, Inc., Bennington, VT, September 29, 1995

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

NONE

1996-03-01

This Decision Document presents the selected remedial action for the Tansitor Electronics, Inc. Superfund Site in Bennington, Vermont. This ROD sets forth the selected remedy for the Tansitor Electronics, Inc. Superfund Site, which includes management of migration components to obtain a comprehensive remedy. This ROD does not include any source control component because EPA`s risk assessment concluded that the surface and subsurface soils did not present an unacceptable risk either under current conditions or under a potential future residential scenario.

Superfund record of decision (EPA Region 3): Ohio River Park Site, Operable Unit 3, Neville Island, PA, September 17, 1998

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

NONE

1998-10-01

This Record of Decision (ROD) presents the selected remedial action plan for the Ohio River Park Superfund Site (the Site) in Allegheny County, Pennsylvania. The remedial action plan in this document is presented as the permanent remedy for controlling the groundwater at the Site. This remedy is comprised of: monitoring of natural attenuation processes to measure changes in contaminant concentrations in groundwater plume at the Site until the cleanup levels are achieved; deed restriction preventing residential use of groundwater at the Site.

Superfund record of decision (EPA Region 2): Hercules Incorporated (Gibbstown Plant), Solid Waste Disposal Area, Operable Unit 3, Greenwich Township, Gloucester County, NJ, January 22, 1966

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

NONE

1996-10-01

This decision document presents the selected remedial action for the Solid Waste Disposal Area (SWDA) - Operable Unit 3, Hercules Incorporated, Higgins Plant (hereinafter Hercules site or site), in Greenwhich Township, Gloucester County, New Jersey. The Record of Decision (ROD) addresses all contaminated media at the SWDA portion of the site including soil and ground water. The selected remedy is a modified version of the `In-Place Containment` remedy of the Porposed Plan.

Superfund Record of Decision Amendment (EPA Region 6): Texarkana Wood Preserving Co. , Texarkana, TX, March 13, 1998

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

Not Available

This decision document presents an amendment to the selected remedial action for the Texarkana Wood Preserving Co. Superfund Site. This amendment fundamentally changes the Record of Decision (ROD) executed by the Regional Administrator on September 25, 1990. This amended remedy will seal and contain soils contaminated with greater than 3 ppm (parts per million) benzo(a)pyrene equivalents, 2450 ppm total poly aromatic hydrocarbons (PAH), 20 ppb (parts per billion) as 2,3,7,8 TCDD equivalents and 150 ppm pentachlorophenol beneath a soil cap.

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION - TECHNOLOGY PROFILES

EPA Science Inventory

This document is intended as a reference guide for EPA Regional decision makers and others interested in technologies in the SITE Demonstration and Emerging Technologies programs. The Technologies are described in technology profiles, presented in alphabetical order by developer ...

SITE EMERGING TECHNOLOGY Program

EPA Science Inventory

This document is intended as a reference guide for EPA Regional decision makers and others interested in tchnologies in the SITE Demonstration and Technologies programs. The Technologies are described in technology profiles presented in alphabetical order by developer name and se...

Rural expressway intersection safety toolbox : desktop reference.

DOT National Transportation Integrated Search

2011-06-01

This document is intended to be a guide for planning-level decisions concerning safety : issues and subsequent potential improvements at rural expressway intersections. It is : NOT a design guide. It simply presents the gamut of safety treatment opti...

Evaluation of Nursing Documentation Completion of Stroke Patients in the Emergency Department: A Pre-Post Analysis Using Flowsheet Templates and Clinical Decision Support.

PubMed

Richardson, Karen J; Sengstack, Patricia; Doucette, Jeffrey N; Hammond, William E; Schertz, Matthew; Thompson, Julie; Johnson, Constance

2016-02-01

The primary aim of this performance improvement project was to determine whether the electronic health record implementation of stroke-specific nursing documentation flowsheet templates and clinical decision support alerts improved the nursing documentation of eligible stroke patients in seven stroke-certified emergency departments. Two system enhancements were introduced into the electronic record in an effort to improve nursing documentation: disease-specific documentation flowsheets and clinical decision support alerts. Using a pre-post design, project measures included six stroke management goals as defined by the National Institute of Neurological Disorders and Stroke and three clinical decision support measures based on entry of orders used to trigger documentation reminders for nursing: (1) the National Institutes of Health's Stroke Scale, (2) neurological checks, and (3) dysphagia screening. Data were reviewed 6 months prior (n = 2293) and 6 months following the intervention (n = 2588). Fisher exact test was used for statistical analysis. Statistical significance was found for documentation of five of the six stroke management goals, although effect sizes were small. Customizing flowsheets to meet the needs of nursing workflow showed improvement in the completion of documentation. The effects of the decision support alerts on the completeness of nursing documentation were not statistically significant (likely due to lack of order entry). For example, an order for the National Institutes of Health Stroke Scale was entered only 10.7% of the time, which meant no alert would fire for nursing in the postintervention group. Future work should focus on decision support alerts that trigger reminders for clinicians to place relevant orders for this population.

Superfund Record of Decision (EPA Region 8): Sand Creek Industrial Site, operable unit 5, Commerce City, CO, (amendment), September 1993

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

Not Available

This decision document is an amendment to the Record of Decision (ROD) signed September 28, 1990 (PB94-921479) and presents the new selected remedial action for cleanup of contaminated shallow soils at OU5 at the Sand Creek Industrial Superfund Site. OU5 is located immediately north of 52nd and Dahlia Street in Commerce City, Colorado. Based on new technical data and cost information obtained subsequent to the September 1990 ROD, EPA has reconsidered its decision to employ soil washing and incineration of the generated residuals as a source control measure for OU5.

Installation restoration program. Decision document for soil and groundwater at the storage area at the USMC Subleased Area, Site 3. 144th Fighter Wing, California Air National Guard, Fresno Air Terminal, California

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

NONE

1996-01-01

Decision Document for IRP Site No. 3 - Storage Area at the USMC Sublease Area, California Air National Guard, 144th Fighter Wing, Fresno Air Terminal, Fresno, California. This report documents the data, conclusion, and recommendation to support a No Further Remedial Action Planned decision at Site 3 under the IRP.

Traffic analysis toolbox volume XI : weather and traffic analysis, modeling and simulation.

DOT National Transportation Integrated Search

2010-12-01

This document presents a weather module for the traffic analysis tools program. It provides traffic engineers, transportation modelers and decisions makers with a guide that can incorporate weather impacts into transportation system analysis and mode...

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... integrated into the decision-making process. Because of the diversity of FEMA, it is not feasible to describe..., for integration of environmental considerations into the decision-making process. The Regional... document for the purpose of justifying the decision. Rather it is a concise document that sets forth the...

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... integrated into the decision-making process. Because of the diversity of FEMA, it is not feasible to describe..., for integration of environmental considerations into the decision-making process. The Regional... document for the purpose of justifying the decision. Rather it is a concise document that sets forth the...

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... integrated into the decision-making process. Because of the diversity of FEMA, it is not feasible to describe..., for integration of environmental considerations into the decision-making process. The Regional... document for the purpose of justifying the decision. Rather it is a concise document that sets forth the...

Superfund Record of Decision (EPA Region 4): BMI-Textron Site, Lake Park, FL, August 1994

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

Not Available

1994-09-01

This decision document presents the selected remedial action for the Basic Microelectronic, Incorporated (BMI)-Textron Site (BMI-Textron Site or the Site), in Lake Park, Florida. This remedy addresses the contaminated principal threat of ground water at the Site. This remedy addresses the principal threat remaining at the Site, by using existing institutional controls, and monitoring ground water contaminated with arsenic, cyanide, sodium and fluoride.

Glossary

MedlinePlus

... healthcare A document that designates the person you trust to make medical decisions on your behalf if ... healthcare: a document that designates the person you trust to make medical decisions on your behalf if ...

Management of the geriatric trauma patient at risk of death: therapy withdrawal decision making.

PubMed

Trunkey, D D; Cahn, R M; Lenfesty, B; Mullins, R

2000-01-01

The management of geriatric injured patients admitted to a trauma center includes the selective decision to provide comfort care only, including withdrawal of therapy, and a choice to not use full application of standard therapies. The decision makers in this process include multiple individuals in addition to the patient. Retrospective review of documentation by 2 blinded reviewers of the cohort of patients over a recent 5-year period (1993-1997). Trauma service of a level I trauma center. A convenience sample of patients aged 65 years and older who died, and whose medical record was available for review. Patients were categorized as having withdrawal of therapy, and documentation in the medical record of who made the assessment decisions and recommendations, and to what extent the processes of care were documented. Among 87 geriatric trauma patients who died, 47 had documentation interpreted as indicating a decision was made to withdraw therapy. In only a few circumstances was the patient capable of actively participating in these decisions. The other individuals involved in recommendations for withdrawal of therapy were, in order of prevalence, the treating trauma surgeon, family members (as proxy reporting the patient's preferences), or a second physician. Documentation regarding the end-of-life decisions was often fragmentary, and in some cases ambiguous. Copies of legal advance directives were rarely available in the medical record, and ethics committee participation was used only once. Withdrawal of therapy is a common event in the terminal care of geriatric injured patients. The process for reaching a decision regarding withdrawal of therapy is complex because in most circumstances patients' injuries preclude their full participation. Standards for documentation of essential information, including patients' preferences and decision-making ability, should be developed to improve the process and assist with recording these complicated decisions that often occur over several days of discussion.

36 CFR 219.14 - Decision document and planning records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... planning records. 219.14 Section 219.14 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF... records. (a) Decision document. The responsible official shall record approval of a new plan, plan... (§ 219.15); (4) The documentation of how the best available scientific information was used to inform...

36 CFR 219.14 - Decision document and planning records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... planning records. 219.14 Section 219.14 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF... records. (a) Decision document. The responsible official shall record approval of a new plan, plan... (§ 219.15); (4) The documentation of how the best available scientific information was used to inform...

Applying LD Documentation Guidelines at the Postsecondary Level: Decision Making with Sparse or Missing Data

ERIC Educational Resources Information Center

Banerjee, Manju; Madaus, Joseph W.; Gelbar, Nicholas

2015-01-01

A key issue in fostering transition to postsecondary education for students with disabilities is documentation verifying the nature of the disability and supporting the need for services and reasonable accommodations. Documentation guidelines assist postsecondary disability service providers in making decisions about eligibility and reasonable…

41 CFR 51-7.3 - Ensuring environmental documents are actually considered in agency determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... contains requirements to ensure adequate consideration of environmental documents in agency decision-making... environmental documents as a part of their decision-making: (1) Action: Request. (2) Start of NEPA process: Upon... Property Management Other Provisions Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO...

76 FR 49526 - Environmental Impact Statement; Saint Louis County, MN

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... environmental impacts of alternatives, including (1) No-build, (2) Purchasing title and possession of the.... The Scoping Document/Draft Scoping Decision Document is anticipated to be published in late 2011. A... Decision Document will be published after the public comment period has closed. A Draft EIS will be...

Naturalistic Decision Making in Power Grid Operations: Implications for Dispatcher Training and Usability Testing

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

Greitzer, Frank L.; Podmore, Robin

2008-11-17

The focus of the present study is on improved training approaches to accelerate learning and improved methods for analyzing effectiveness of tools within a high-fidelity power grid simulated environment. A theory-based model has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The theoretical foundation for the method is based on the concepts of situation awareness, the methods of cognitive task analysis, and the naturalistic decision making (NDM) approach of Recognition Primed Decision Making. The method has been systematically explored and refined as part of a capability demonstration ofmore » a high-fidelity real-time power system simulator under normal and emergency conditions. To examine NDM processes, we analyzed transcripts of operator-to-operator conversations during the simulated scenario to reveal and assess NDM-based performance criteria. The results of the analysis indicate that the proposed framework can be used constructively to map or assess the Situation Awareness Level of the operators at each point in the scenario. We can also identify the mental models and mental simulations that the operators employ at different points in the scenario. This report documents the method, describes elements of the model, and provides appendices that document the simulation scenario and the associated mental models used by operators in the scenario.« less

Corrective Action Decision Document/Closure Report for Corrective Action Unit 567: Miscellaneous Soil Sites - Nevada National Security Site, Nevada

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

Matthews, Patrick

2014-12-01

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 567: Miscellaneous Soil Sites, Nevada National Security Site, Nevada. The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that no further corrective action is needed for CAU 567 based on the implementation of the corrective actions. The corrective actions implemented at CAU 567 were developed based on an evaluation of analytical data from the CAI, the assumed presence of COCs at specific locations, and the detailed and comparative analysis of the CAAs. The CAAs weremore » selected on technical merit focusing on performance, reliability, feasibility, safety, and cost. The implemented corrective actions meet all requirements for the technical components evaluated. The CAAs meet all applicable federal and state regulations for closure of the site. Based on the implementation of these corrective actions, the DOE, National Nuclear Security Administration Nevada Field Office provides the following recommendations: • No further corrective actions are necessary for CAU 567. • The Nevada Division of Environmental Protection issue a Notice of Completion to the DOE, National Nuclear Security Administration Nevada Field Office for closure of CAU 567. • CAU 567 be moved from Appendix III to Appendix IV of the FFACO.« less

A systematic approach to baseline assessment of nursing documentation and enterprise-wide prioritization for electronic conversion.

PubMed

Dykes, Patricia C; Spurr, Cindy; Gallagher, Joan; Li, Qi; Ives Erickson, Jeanette

2006-01-01

An important challenge associated with making the transition from paper to electronic documentation systems is achieving consensus regarding priorities for electronic conversion across diverse groups. In our work we focus on applying a systematic approach to evaluating the baseline state of nursing documentation across a large healthcare system and establishing a unified vision for electronic conversion. A review of the current state of nursing documentation across PHS was conducted using structured tools. Data from this assessment was employed to facilitate an evidence-based approach to decision-making regarding conversion to electronic documentation at local and PHS levels. In this paper we present highlights of the assessment process and the outcomes of this multi-site collaboration.

Documenting Public Values for River Ecosystem Services

EPA Science Inventory

The value to society of environmental changes is difficult to assess, and thus challenging to include in environmental management decisions. This presentation will first provide an overview of how framing these values in an ecosystem services perspective can facilitate the proces...

Human Factors Guidelines for the Evaluation of the Locomotive Cab

DOT National Transportation Integrated Search

1995-09-01

This document presents human factors guidelines for the evaluation of the locomotive cab. These guidelines are part of : an effort to evaluate working conditions and safety in the locomotive cab. The guidelines will serve as a decision : making tool ...

Coral Reef Early Warning System (CREWS) RPC Experiment

NASA Technical Reports Server (NTRS)

Estep, Leland; Spruce, Joseph P.; Hall, Callie

2007-01-01

This viewgraph document reviews the background, objectives, methodology, validation, and present status of the Coral Reef Early Warning System (CREWS) Rapid Prototyping Capability (RPC) experiment. The potential NASA contribution to CREWS Decision Support Tool (DST) centers on remotely sensed imagery products.

Quality and quantity of information in summary basis of decision documents issued by health Canada.

PubMed

Habibi, Roojin; Lexchin, Joel

2014-01-01

Health Canada's Summary Basis of Decision (SBD) documents outline the clinical trial information that was considered in approving a new drug. We examined the ability of SBDs to inform clinician decision-making. We asked if SBDs answered three questions that clinicians might have prior to prescribing a new drug: 1) Do the characteristics of patients enrolled in trials match those of patients in their practice? 2) What are the details concerning the drug's risks and benefits? 3) What are the basic characteristics of trials? 14 items of clinical trial information were identified from all SBDs published on or before April 2012. Each item received a score of 2 (present), 1 (unclear) or 0 (absent). The unit of analysis was the individual SBD, and an overall SBD score was derived based on the sum of points for each item. Scores were expressed as a percentage of the maximum possible points, and then classified into five descriptive categories based on that score. Additionally, three overall 'component' scores were tallied for each SBD: "patient characteristics", "benefit/risk information" and "basic trial characteristics". 161 documents, spanning 456 trials, were analyzed. The majority (126/161) were rated as having information sometimes present (score of >33 to 66%). No SBDs had either no information on any item, or 100% of the information. Items in the patient characteristics component scored poorest (mean component score of 40.4%), while items corresponding to basic trial information were most frequently provided (mean component score of 71%). The significant omissions in the level of clinical trial information in SBDs provide little to aid clinicians in their decision-making. Clinicians' preferred source of information is scientific knowledge, but in Canada, access to such information is limited. Consequently, we believe that clinicians are being denied crucial tools for decision-making.

[Development, implementation, and analysis of a "collaborative decision-making for reasonable care" document in pediatric palliative care].

PubMed

Paoletti, M; Litnhouvongs, M-N; Tandonnet, J

2015-05-01

In France, a legal framework and guidelines state that decisions to limit treatments (DLT) require a collaborative decision meeting and a transcription of decisions in the patient's file. The do-not-attempt-resuscitation order involves the same decision-making process for children in palliative care. To fulfill the law's requirements and encourage communication within the teams, the Resource Team in Pediatric Palliative Care in Aquitaine created a document shared by all children's hospital units, tracing the decision-making process. This study analyzed the decision-making process, quality of information transmission, and most particularly the relevance of this new "collaborative decision-making for reasonable care" card. Retrospective study evaluating the implementation of a traceable document relating the DLT process. All the data sheets collected between January and December 2013 were analyzed. A total of 58 data sheets were completed between January and December 2013. We chose to collect the most relevant data to evaluate the relevance of the items to be completed and the transmission of the document, to draw up the patients' profile, and the contents of discussions with families. Of the 58 children for whom DLT was discussed, 41 data sheets were drawn up in the pediatric intensive care unit, seven in the oncology and hematology unit, five in the neonatology unit, four in the neurology unit, and one in the pneumology unit. For 30 children, one sheet was created, for 11 children, two sheets and for two children, three sheets were filled out. Thirty-nine decisions were made for withholding lifesaving treatment, 11 withdrawing treatment, and for five children, no limitation was set. Nine children survived after DLT. Of the 58 data sheets, only 31 discussions with families were related to the content of the data sheet. Of the 14 children transferred out of the unit with a completed data sheet, it was transmitted to the new unit for 11 children (79%). The number of data sheets collected in 1 year shows the value of this document. The participation of several pediatric specialities' referents in its creation, then its progressive presentation in the children's hospital units, were essential steps in introducing and establishing its use. Items describing the situation, management proposals, and adaptation of the children's supportive care were completed in the majority of cases. They correspond to a clinical description, the object of the discussion, and the daily caregiver's practices, respectively. On the other hand, discussions with families were related to the card's contents in only 53% of the cases. This can be explained by the time required to complete the DLT process. It is difficult for referring doctors to systematically, faithfully, and objectively transcribe discussions with parents. Although this process has been used for a long time in intensive care units, this document made possible an indispensable formalisation in the decision-making process. In other pediatric specialities, the sheet allowed introducing the palliative approach and was a starter and a tool for reflection on the do-not-attempt-resuscitation order, thus suggesting the need for anticipation in these situations. With the implementation of this new document, the DLT, data transmission, and continuity of care conditions were improved in the children's hospital units. Sharing this sheet with all professionals in charge of these children would support homogeneity and quality of management and care for children and their parents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Superfund Record of Decision Amendment (EPA Region 5): Springfield Township Dump, Davisburg, MI, June 10, 1998

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

NONE

This decision document presents the amendments to the remedial action for the Springfield Township Dump site, Oakland County, Michigan. The amended remedial action changes the selected method of addressing PCB-laden soils and also changes certain soil and groundwater cleanup standards previously selected in the 1990 Record of Decision (ROD) to reflect current state standards: The groundwater and soil vapor extraction and treatment systems and the arsenic and lead groundwater cleanup standards identified as part of the selected remedy in the 1990 ROD and in the 1993 Explanation of Significant Difference remain unchanged.

30 CFR 746.13 - Decision document and recommendation on mining plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Decision document and recommendation on mining plan. 746.13 Section 746.13 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR FEDERAL LANDS PROGRAM REVIEW AND APPROVAL OF MINING PLANS § 746.13 Decision...

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Superfund Record of Decision (EPA Region 4): Agriculture and Nutrition (Montgomery), Operable Unit 2, Montgomery, AL, September 28, 1998

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

NONE

This decision document presents the selected remedial action for the T.H. Agriculture and Nutrition (THAN) Site, Montgomery, Alabama. Operable Unit Two (OU2) encompasses the remediation of the contaminated soils and sediments on the Site, and also establishes the performance standards for the groundwater remedy. Upon reaching the cleanup standards for groundwater at an established point(s) of compliance, the groundwater pumping system will be shut down.

Superfund record of decision (EPA Region 4): T. H. Agriculture and Nutrition Site, operable unit 1, Montgomery, AL, April 17, 1995

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

NONE

1995-04-01

This decision document presents the selected interim remedial action for the T H Agriculture and Nutrition (THAN) Site, Montgomery, Alabama. This interim remedial action employs the use of extraction wells combined with a pump and treat system to prevent further migration of contaminated groundwater from the Site and to initiate groundwater restoration pending completion of the RI/FS and implementation of the final remedial action.

Superfund Record of Decision (EPA Region 6): Texarkana Wood Preserving Company, Operable Unit 2, Texarkana, TX, September 1993

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

Not Available

This decision document presents the selected remedial action for Operable Unit Two for the Texarkana Wood Preserving Company (TWPC) Superfund Site (Site) in Texarkana, Texas. This operable unit is the second of two operable units planned for the Site. Operable Unit Two involves remediation of the deeper ground water contaminated above the action levels in a limited area of the Silty Sand Zone around Monitoring Well-16.

The NASA scientific and technical information system: Its scope and coverage

NASA Technical Reports Server (NTRS)

1988-01-01

A general description of the subject areas covered in the NASA scientific and technical information system is presented. In addition, it establishes subject-based selection criteria for guiding decisions related to the addition of new documents to the NASA collection.

43 CFR 46.315 - How to format an environmental assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... planning, decision-making, and appropriate public participation. (b) An environmental assessment may be accompanied by any other planning or decision-making document. The portion of the document that analyzes the...

Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

PubMed

Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

2017-01-01

The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

Documenting the decision structure in software development

NASA Technical Reports Server (NTRS)

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

1990-01-01

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

Feasibility study on the use of groupware support for NASA source evaluation boards

NASA Technical Reports Server (NTRS)

Bishop, Peter C.; Yoes, Cissy

1991-01-01

Groupware is a class of computer based systems that support groups engaged in a common task (or goal) and that provide an interface to a shared environment. A potential application for groupware is the source evaluation board (SEB) process used in the procurement of government contracts. This study was undertaken to (1) identify parts of the SEB process which are candidates for groupware supports; and (2) identify tools which could be used to support the candidate process. Two processes of the SEB were identified as good candidates for groupware support: (1) document generation - a coordination and communication process required to present and document the findings of an SEB; and (2) group decision making - a highly analytical and integrative decision process requiring a clear and supportable outcome.

Software Tools for In-Situ Documentation of Built Heritage

NASA Astrophysics Data System (ADS)

Smars, P.

2013-07-01

The paper presents open source software tools developed by the author to facilitate in-situ documentation of architectural and archæological heritage. The design choices are exposed and related to a general issue in conservation and documentation: taking decisions about a valuable object under threat . The questions of level of objectivity is central to the three steps of this process. It is our belief that in-situ documentation has to be favoured in this demanding context, full of potential discoveries. The very powerful surveying techniques in rapid development nowadays enhance our vision but often tend to bring back a critical part of the documentation process to the office. The software presented facilitate a direct treatment of the data on the site. Emphasis is given to flexibility, interoperability and simplicity. Key features of the software are listed and illustrated with examples (3D model of Gothic vaults, analysis of the shape of a column, deformation of a wall, direct interaction with AutoCAD).

75 FR 18205 - Notice of Peer Review Meeting for the External Peer Review Drafts of Two Documents on Using...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... Role of Risk Analysis in Decision-Making AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... documents entitled, ``Using Probabilistic Methods to Enhance the Role of Risk Analysis in Decision- Making... Probabilistic Methods to Enhance the Role of Risk Analysis in Decision-Making, with Case Study Examples'' and...

Power, Authority and Decision Making in Teacher Education. Yearbook 1971.

ERIC Educational Resources Information Center

American Association of Colleges for Teacher Education, Washington, DC.

This document is a collection of reports of the American Association of Colleges for Teacher Education (AACTE) for 1971. The title of the document reflects much of the association's concern for that year and is close to the theme of the association's 1971 annual meeting, "Power and Decision Making in Teacher Education." The document is divided…

Effectiveness guidance document (EGD) for Chinese medicine trials: a consensus document

PubMed Central

2014-01-01

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for CM to inform stakeholder decision-making. Methods The Effectiveness Guidance Document (EGD) development was based on multiple consensus procedures (survey, written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders, including patients, clinicians, researchers and payers were involved in creating this document. Results Recommendations were developed for “using available data” and “future clinical studies”. The recommendations for future trials focus on randomized trials and cover the following areas: designing CER studies, treatments, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD provides the first systematic methodological guidance for future CER trials on CM and can be applied to single or multi-component treatments. While CONSORT statements provide guidelines for reporting studies, EGDs provide recommendations for the design of future studies and can contribute to a more strategic use of limited research resources, as well as greater consistency in trial design. PMID:24885146

Superfund record of decision (EPA Region 10): McCormick and Baxter Creosoting Company, Portland Plant, Portland, OR, March 29, 1996

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

NONE

1996-08-01

The decision document presents the selected final remedial actions for the McCormick and Baxter Creosoting Company, Portland Plant site (McCormick and Baxter or site) located in Portland, Oregon. The selected remedy is a series of remedial actions that address the principal threats at the site by treating the most highly contaminated soil, extracting nonaqueous phase liquid (NAPL) and treating contaminated groundwater, and capping the most highly contaminated sediment.

Superfund record of decision (EPA Region 6): Longhorn Army Ammunition Plant, Burning Ground Number 3, Karnack, TX, May 12, 1995

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

NONE

1996-03-01

This decision document presents the selected Early Interim Remedial Action for the Burning Ground No. 3 site (the site), Longhorn Army Ammunition Plant, in Karnack, Texas. The major components of the selected remedy include: extraction and Treatment of contaminated shallow groundwater using Organic Air Stripping and Off-gas Treatment and Metals precipitation, and Excavation and Treatment of Source Material using Low Temperature Thermal Desorption and Catalytic Oxidation for off-gas.

Final Record of Decision for the Defense Reutilization and Marketing Office Yard (AOC 32) and Petroleum, Oil, and Lubricants Storage Area (AOC 43A) Devens, Massachusetts.

DTIC Science & Technology

1998-02-01

decision document presents the U.S. Army’s (Army’s) selected remedial actions for AOCs 32 DRMO Yard, including Underground Storage Tank (UST) #13...of commencing the remedial action to ensure that the remedy at each AOC continues to provide adequate protection of human health and the environment... Devens , Massachusetts RAO remedial action objective RBC risk-based concentration RCRA Resource Conservation and Recovery Act RI remedial

Patients’ priorities for treatment decision making during periods of incapacity: quantitative survey

PubMed Central

RID, ANNETTE; WESLEY, ROBERT; PAVLICK, MARK; MAYNARD, SHARON; ROTH, KATALIN; WENDLER, DAVID

2017-01-01

Objective Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. Method We employed a self-administered, quantitative survey of patients in a tertiary care center. Results Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Significance of Results Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients’ treatment preferences. Clinicians should also discuss and document patients’ priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making. PMID:25273677

Patients' priorities for treatment decision making during periods of incapacity: quantitative survey.

PubMed

Rid, Annette; Wesley, Robert; Pavlick, Mark; Maynard, Sharon; Roth, Katalin; Wendler, David

2015-10-01

Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. We employed a self-administered, quantitative survey of patients in a tertiary care center. Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients' treatment preferences. Clinicians should also discuss and document patients' priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 252: Area 25 Engine Test Stand 1 Decontamination Pad, Nevada Test Site, Nevada

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

DOE /NV

This Corrective Action Decision Document/Closure Report (CADD/CR) has been prepared for Corrective Action Unit (CAU) 252: Area 25 Engine Test Stand-1 Decontamination Pad, in accordance with the Federal Facility Agreement and Consent Order (FFACO). Located at the Nevada Test Site in Nevada, CAU 252 consists of only one Corrective Action Site (25-07-04, Decontamination Pad). This CADD/CR identifies and rationalizes the U.S. Department of Energy, Nevada Operations Office's (DOE/NV's) recommendation that no corrective action is deemed necessary at CAU 252. The Corrective Action Decision Document and Closure Report have been combined into one report because the potential contaminants of concern weremore » either not detected during the corrective action investigation or were only present at naturally occurring concentrations. Based on the field results, neither corrective action or a corrective action plan is required at this site. A Notice of Completion to DOE/NV is being requested from the Nevada Division of Environmental Protection for closure of CAU 252, as well as a request that this site be moved from Appendix III to Appendix IV of the FFACO. Further, no use restrictions are required to be placed on this CAU.« less

Development of Cost Benefit Methodology for Scientific and Technical Information Communication and Application to Information Analysis Centers. Final Report.

ERIC Educational Resources Information Center

Mason, Robert M.; And Others

This document presents a research effort intended to improve the economic information available for formulating politics and making decisions related to Information Analysis Centers (IAC's) and IAC services. The project used a system of IAC information activities to analyze the functional aspects of IAC services, calculate the present value of net…

Corrective Action Decision Document/Closure Report for Corrective Action Unit 541: Small Boy Nevada National Security Site and Nevada Test and Training Range, Nevada, Revision 0 with ROTC-1

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

Kidman, Raymond; Matthews, Patrick

The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that no further corrective action is needed for CAU 541 based on the no further action alternative listed in Table ES-1.

25 CFR 1000.69 - How can a Tribe/Consortium obtain comments or selection documents received or utilized after OSG...

Code of Federal Regulations, 2010 CFR

2010-04-01

...-DETERMINATION AND EDUCATION ACT Other Financial Assistance for Planning and Negotiation Grants for Non-BIA... documents received or utilized after OSG has made a decision on a planning grant application? 1000.69... selection documents received or utilized after OSG has made a decision on a planning grant application? A...

Phytotechnology Technical and Regulatory Guidance Document

DTIC Science & Technology

2001-04-01

contaminated media is rather new. Throughout the development process of this document, we referred to the science as “ phytoremediation .” Recently...the media containing contaminants, we now refer to “phytotechnologies” as the overarching terminology, while using “ phytoremediation ” more...publication of the ITRC document, Phytoremediation Decision Tree. The decision tree was designed to allow potential users to take basic information

Beyond Rhetoric: Assuring a Child's Right to Two Parents. Presentations at the Children's Rights Council National Conference (7th, Bethesda, Maryland, April 28-May 2, 1993).

ERIC Educational Resources Information Center

National Council for Children's Rights, Washington, DC.

This document contains papers presented at the Seventh National Conference of the Children's Rights Council, also known as the National Council for Children's Rights. The papers presented were: (1) "Alternatives to the Adversarial Process for Resolution of Child Custody Cases" (Hugh McIsaac); (2) "New Decision Making Models in Child…

Accounting Principles and Financial Statements.

ERIC Educational Resources Information Center

Robinson, Daniel D.

1973-01-01

This document presents the background and analysis of the American Institute of Certified Public Accountants (AICPA) guide to auditing colleges and universities. Highlights include the approval of the market value option, the treatment of endowment gains, debt services as transfers, the decisions on pledges, the use of financial statements, the…

Improving Recruiting of the 6th Recruiting Brigade Through Statistical Analysis and Efficiency Measures

DTIC Science & Technology

2014-12-01

example of maximizing or minimizing decision variables within a model. Carol Stoker and Stephen Mehay present a comparative analysis of marketing and advertising strategies...strategy development process; documenting various recruiting, marketing , and advertising initiatives in each nation; and examining efforts to

A Bayesian Approach to Interactive Retrieval

ERIC Educational Resources Information Center

Tague, Jean M.

1973-01-01

A probabilistic model for interactive retrieval is presented. Bayesian statistical decision theory principles are applied: use of prior and sample information about the relationship of document descriptions to query relevance; maximization of expected value of a utility function, to the problem of optimally restructuring search strategies in an…

Choosing the route to traveler information systems deployment : decision factors for creating public-private business plans : an action guide

DOT National Transportation Integrated Search

1998-01-01

This document presents a guide designed to help public private partnerships in their efforts to provide Advanced Traveler Information Systems (ATIS) services. It first examines why ATIS can be useful in managing transportation networks and increasing...

The 1996 NAEP Technical Report.

ERIC Educational Resources Information Center

Allen, Nancy L.; Carlson, James E.; Zelenak, Christine A.

This report documents the design, administration, and data analysis procedure of the National Assessment of Education Progress (NAEP) for 1996. It indicates the technical decisions that were made and the rationale behind them. Detailed substantive findings are not presented in this report. These chapters provide technical information about the…

Superfund Record of Decision (EPA Region 7): Cornhusker Army Ammunition Plant, Operable Unit 2, Hall County, NE, September 30, 1998

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

NONE

1999-03-01

This Record of Decision (ROD) document presents the selected remedial action for the six areas of concern (AOCs) located at the Cornhusker Army Ammunition Plant (CHAAP) in Grand Island, Nebraska designated as OU2. The remedial action is chosen in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERLCA), as amended by the Superfund Amendments and Reauthorization Act (SARA) of 1986, and with the National Oil and Hazardous Substances Pollution Contingency Plan (NCP). The information supporting the decisions contained in the remedy is contained in the administrative record.

Evaluating the impact of an educational intervention on documentation of decision-making capacity in an emergency medical services system.

PubMed

Riley, Jennifer; Burgess, Rob; Schwartz, Brian

2004-07-01

To compare the documentation of decision-making capacity by advanced life support (ALS) providers and signature acquisition before, one month after, and one year after an educational intervention. The intervention comprised a one-and-a-half-hour module on assessment and documentation of decision-making capacity. Ambulance call reports were reviewed for all ALS calls occurring during three two-month periods, and refusals of transport were recorded. Provider compliance with documentation of decision-making capacity and signature acquisition were determined from a convenience sample of 75 reports from each period. Reviewers were blinded to study period. Twenty-percent double data entry was undertaken to evaluate accuracy. Ninety-five percent confidence intervals were calculated to compare frequencies of cancelled calls and documentation. From the emergency medical services database, 7,744 calls before the intervention, 7,444 immediately after, and 7,604 one year later were identified. Documentation rates in the second and third periods did not differ from that prior to the intervention (1.3% vs. 0.0% and 0.0% in subsequent periods), nor did the rates of signature acquisition differ (85.3% vs. 85.3% and 78.6%). The accuracy of data entry was 92.6%. However, the frequency of call refusals decreased significantly after the intervention (from 9.0% to 2.0% and 6.6% in the respective periods). An educational intervention resulted in no change in the rate of decision-making capacity documentation or signature acquisition by ALS providers for refusal of transport. There was a temporary increase in the number of transported patients.

Analyzing Decision Logs to Understand Decision Making in Serious Crime Investigations.

PubMed

Dando, Coral J; Ormerod, Thomas C

2017-12-01

Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments. Method A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results Analyses revealed diversity in documentation of decisions that did not correlate with case type and identified significant limitations of the decision log approach to supporting investigative decision making. Differences emerged between experienced and less experienced officers' decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential inquiry opened over phase of investigation. Conclusion The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision making to avoid confirmation and satisficing, which affect less experienced detectives. Application Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them.

Logic-Based Retrieval: Technology for Content-Oriented and Analytical Querying of Patent Data

NASA Astrophysics Data System (ADS)

Klampanos, Iraklis Angelos; Wu, Hengzhi; Roelleke, Thomas; Azzam, Hany

Patent searching is a complex retrieval task. An initial document search is only the starting point of a chain of searches and decisions that need to be made by patent searchers. Keyword-based retrieval is adequate for document searching, but it is not suitable for modelling comprehensive retrieval strategies. DB-like and logical approaches are the state-of-the-art techniques to model strategies, reasoning and decision making. In this paper we present the application of logical retrieval to patent searching. The two grand challenges are expressiveness and scalability, where high degree of expressiveness usually means a loss in scalability. In this paper we report how to maintain scalability while offering the expressiveness of logical retrieval required for solving patent search tasks. We present logical retrieval background, and how to model data-source selection and results' fusion. Moreover, we demonstrate the modelling of a retrieval strategy, a technique by which patent professionals are able to express, store and exchange their strategies and rationales when searching patents or when making decisions. An overview of the architecture and technical details complement the paper, while the evaluation reports preliminary results on how query processing times can be guaranteed, and how quality is affected by trading off responsiveness.

Impact of data transparency: Scientific publications

PubMed Central

Joshi, Mohit; Bhardwaj, Payal

2018-01-01

Data transparency has been an important aspect of medical research as it helps in enabling evidence-based decisions in medicine which leads to foster trust among the patients and research community alike. Currently, it is one of the key talking points owing to a number of initiatives taken by the pharmaceutical organizations, regulatory bodies, and the other decision enablers of the industry. Thanks to this, there are a number of ways by which a single piece of datum is available through multiple access points, namely, clinical trial disclosures (CTDs), clinical study reports (CSRs), plain language summaries, and scientific publications including abstracts, posters, and manuscripts, to name a few. This may pose a burden of documentation on the pharmaceutical organizations, demanding downsizing of medical writing documents. Since CTDs, CSRs, and other regulatory document are more or less template driven; there may not be much scope to interfere with their structure and submission timings. Scientific publications, on the other hand, provide the flexibility of presenting the clinical data that is typically not dependent on a particular format and timelines. The present paper discusses how the upcoming data transparency initiatives could affect the publication practices across the pharmaceutical industry and what could pharmaceutical companies do to get the maximum benefit out of the data transparency initiatives. PMID:29430415

Impact of data transparency: Scientific publications.

PubMed

Joshi, Mohit; Bhardwaj, Payal

2018-01-01

Data transparency has been an important aspect of medical research as it helps in enabling evidence-based decisions in medicine which leads to foster trust among the patients and research community alike. Currently, it is one of the key talking points owing to a number of initiatives taken by the pharmaceutical organizations, regulatory bodies, and the other decision enablers of the industry. Thanks to this, there are a number of ways by which a single piece of datum is available through multiple access points, namely, clinical trial disclosures (CTDs), clinical study reports (CSRs), plain language summaries, and scientific publications including abstracts, posters, and manuscripts, to name a few. This may pose a burden of documentation on the pharmaceutical organizations, demanding downsizing of medical writing documents. Since CTDs, CSRs, and other regulatory document are more or less template driven; there may not be much scope to interfere with their structure and submission timings. Scientific publications, on the other hand, provide the flexibility of presenting the clinical data that is typically not dependent on a particular format and timelines. The present paper discusses how the upcoming data transparency initiatives could affect the publication practices across the pharmaceutical industry and what could pharmaceutical companies do to get the maximum benefit out of the data transparency initiatives.

Acute asthma severity identification of expert system flow in emergency department

NASA Astrophysics Data System (ADS)

Sharif, Nurul Atikah Mohd; Ahmad, Norazura; Ahmad, Nazihah; Desa, Wan Laailatul Hanim Mat

2017-11-01

Integration of computerized system in healthcare management help in smoothening the documentation of patient records, highly accesses of knowledge and clinical practices guideline, and advice on decision making. Exploit the advancement of artificial intelligent such as fuzzy logic and rule-based reasoning may improve the management of emergency department in terms of uncertainty condition and medical practices adherence towards clinical guideline. This paper presenting details of the emergency department flow for acute asthma severity identification with the embedding of acute asthma severity identification expert system (AASIES). Currently, AASIES is still in preliminary stage of system validation. However, the implementation of AASIES in asthma bay management is hope can reduce the usage of paper for manual documentation and be a pioneer for the development of a more complex decision support system to smoothen the ED management and more systematic.

Professional Myopia: Job Satisfaction and the Management of Teachers.

ERIC Educational Resources Information Center

Mercer, David; Evans, Barbara

1991-01-01

Documents greater teacher attrition in the United Kingdom than previously realized and demands a halt to this trend. Urges increasing teacher managers' awareness of factors diminishing job satisfaction, an important factor influencing decisions to leave the profession. Presents three job satisfaction models used in business with possible…

Leaching Environmental Assessment Framework (LEAF) How-To Guide - Understanding the LEAF Approach and How and When to Use It

EPA Science Inventory

This document is intended to present the reader with important technical and decision-making information in a user-friendly format for implementation of the Leaching Environmental Assessment Framework (LEAF)test methods 1313, 1314, 1315, and 1316 for inorganic constituents. The ...

Shared Decision-Making and the Limits of Democratization: A Case Study of Site-Based Reform.

ERIC Educational Resources Information Center

Radnofsky, Mary L.; Spielmann, Guy

This paper presents findings of an ethnographic study of a school district's Staff Development, Supervision, and Evaluation Program (SDSEP). Data were gathered through interviews, observations, participant observation, analysis of kinesics and proxemics, semiotic analysis of discourse, unobtrusive measures, and analysis of official documents. The…

8 CFR 1244.10 - Decision by the director or Administrative Appeals Unit (AAU).

Code of Federal Regulations, 2010 CFR

2010-01-01

... Appeals Unit (AAU). 1244.10 Section 1244.10 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS TEMPORARY PROTECTED STATUS FOR NATIONALS OF DESIGNATED STATES... presently filed with the Immigration Court. (3) If a charging document has previously been filed or is...

A Custody Evaluation Model for Pre-School Children.

ERIC Educational Resources Information Center

Roseby, Vivienne

This document addresses the needs of mental health consultants involved in decision-making in custody disputes. A psycho-ecological model for assessing contexts of development in cases involving preschool children is presented, and the theoretical basis and rationale for the model are discussed. Issues, instruments, and findings of recent…

Mid-USA, Making Informed Decisions: Using Student Activities.

ERIC Educational Resources Information Center

Scovel, Donald A.; Nelson, Phillip J.

This document presents a series of learning activities focusing on the role of state government in American society. It is intended for senior or junior high school students. Six objectives are: to identify information sources about state government; to increase knowledge about its organization, processes, services, and costs; to compare these…

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

Tiradani, Tiradani,Anthony; Altunay, Mine; Dagenhart, David

The Decision Engine is a critical component of the HEP Cloud Facility. It provides the functionality of resource scheduling for disparate resource providers, including those which may have a cost or a restricted allocation of cycles. Along with the architecture, design, and requirements for the Decision Engine, this document will provide the rationale and explanations for various design decisions. In some cases, requirements and interfaces for a limited subset of external services will be included in this document. This document is intended to be a high level design. The design represented in this document is not complete and does notmore » break everything down in detail. The class structures and pseudo-code exist for example purposes to illustrate desired behaviors, and as such, should not be taken literally. The protocols and behaviors are the important items to take from this document. This project is still in prototyping mode so flaws and inconsistencies may exist and should be noted and treated as failures.« less

India: A Land of Contrasts. How to Develop Pro-Active Action Student Awareness and Understanding about the Third World in South Asia.

ERIC Educational Resources Information Center

Peters, Richard O.

This document presents a critical thinking/decision-making model to help students in grades K-12 understand East Indian culture. It is divided into three sections. Section 1 provides background information about India from the 15th century BC to the present. It briefly discusses religion, independence, political organization, social institutions,…

Superfund record of decision (EPA region 10): Idaho National Engineering Lab, (USDOE) Operable Unit 26 (Stationary Low-Power Reactor-1 and Boiling Water Reactor Experiment-I Burial Grounds), Idaho Falls, ID, December 1, 1995

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

NONE

1997-03-01

This document presents the selected remedial action for the Stationary Low-Power Reactor-1 (SL-1) burial ground, the Boiling Water Reactor Experiment-I (BORAX-I) burial ground, and 10 no action sites in Waste Area Group 5. Actual or threatened releases of hazardous substances from the SL-1 and BORAX-I burial grounds, if not addressed by implementing the response action selected in this Record of Decision, may present a current or potential threat to public health, welfare, or the environment. The 10 no action sites do not present a threat to human health or the environment.

50 CFR 23.33 - How is the decision made to issue or deny a request for a U.S. CITES document?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false How is the decision made to issue or deny..., PURCHASE, BARTER, EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) CONVENTION ON... Conditions § 23.33 How is the decision made to issue or deny a request for a U.S. CITES document? (a) Upon...

No Further Remedial Action Planned Decision Document for Site 3.

DTIC Science & Technology

1998-04-01

INSTALLATION RESTORATION PROGRAM No FURTHER REMEDIAL ACTION PLANNED DECISION DOCUMENT FOR SITE 3 FINAL MICHIGAN AIR NATIONAL GUARD ALPENA ...COMBAT READINESS TRAINING CENTER ALPENA , MICHIGAN April 1998 Air National Guard Andrews AFB, Maryland &nc QUALITY IMSmm«^ 19980519 204 XA REPORT...Document for Site 3 at Alpena CRTC, Alpena , MI. 6. AUTHOR(S) N/A 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Montgomery

Assessing Patient Participation in Health Policy Decision-Making in Cyprus

PubMed Central

Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

2016-01-01

Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus. PMID:27694659

Providing Global Change Information for Decision-Making: Capturing and Presenting Provenance

NASA Technical Reports Server (NTRS)

Ma, Xiaogang; Fox, Peter; Tilmes, Curt; Jacobs, Katherine; Waple, Anne

2014-01-01

Global change information demands access to data sources and well-documented provenance to provide evidence needed to build confidence in scientific conclusions and, in specific applications, to ensure the information's suitability for use in decision-making. A new generation of Web technology, the Semantic Web, provides tools for that purpose. The topic of global change covers changes in the global environment (including alterations in climate, land productivity, oceans or other water resources, atmospheric composition and or chemistry, and ecological systems) that may alter the capacity of the Earth to sustain life and support human systems. Data and findings associated with global change research are of great public, government, and academic concern and are used in policy and decision-making, which makes the provenance of global change information especially important. In addition, since different types of decisions benefit from different types of information, understanding how to capture and present the provenance of global change information is becoming more of an imperative in adaptive planning.

Bethesda Conference #36 and the European Society of Cardiology Consensus Recommendations revisited a comparison of U.S. and European criteria for eligibility and disqualification of competitive athletes with cardiovascular abnormalities.

PubMed

Pelliccia, Antonio; Zipes, Douglas P; Maron, Barry J

2008-12-09

Aspiration to reduce the risks of athletic field deaths prompted the American Heart Association and European Society of Cardiology (ESC) to establish consensus guidelines for eligibility/disqualification decisions in competitive athletes with cardiovascular abnormalities. Since 2005, the Bethesda Conference #36 and the ESC consensus documents have been relied upon by physicians from different parts of the world. The 2 consensus documents emanate from largely different cultural, social, and legal backgrounds existing in the U.S. and Europe and, although several recommendations are similar, in some instances the Bethesda Conference #36 and the ESC consensus documents suggest different approaches to disqualification decisions and implications for clinical practice, raising the possibility that confusion and discrepancies will contaminate the management of competitive athletes with cardiovascular disease. In the present article, the differences between the 2 documents are critically viewed, with special attention to genetic cardiovascular diseases relevant to sudden death in young athletes, through the prism of different cultural backgrounds, societal attitudes, and also perceptions regarding exposure to legal liability in the U.S. and Europe. In conclusion, it seems appropriate at some time to consider assembling updated recommendations for sports eligibility/disqualification that assimilate both the U.S. and European perspectives, with the aspiration of creating a unique and authoritative document applicable to the global sports medicine community.

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

NASA Technical Reports Server (NTRS)

Forthofer, M. J.

1981-01-01

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

Challenges of implementing collaborative models of decision making with trans-identified patients.

PubMed

Dewey, Jodie M

2015-10-01

Factors health providers face during the doctor-patient encounter both impede and assist the development of collaborative models of treatment. I investigated decision making among medical and therapeutic professionals who work with trans-identified patients to understand factors that might impede or facilitate the adoption of the collaborative decision-making model in their clinical work. Following a grounded theory approach, I collected and analysed data from semi-structured interviews with 10 U.S. physicians and 10 U.S. mental health professionals. Doctors and therapists often desire collaboration with their patients but experience dilemmas in treating the trans-identified patients. Dilemmas include lack of formal education, little to no institutional support and inconsistent understanding and application of the main documents used by professionals treating trans-patients. Providers face considerable risk in providing unconventional treatments due to the lack of institutional and academic support relating to the treatment for trans-people, and the varied interpretation and application of the diagnostic and treatment documents used in treating trans-people. To address this risk, the relationship with the patient becomes crucial. However, trust, a component required for collaboration, is thwarted when the patients feel obliged to present in ways aligned with these documents in order to receive desired treatments. When trust cannot be established, medical and mental health providers can and do delay or deny treatments, resulting in the imbalance of power between patient and provider. The documents created to assist in treatment actually thwart professional desire to work collaboratively with patients. © 2013 John Wiley & Sons Ltd.

A ward round proforma improves documentation and communication.

PubMed

Alazzawi, Sulaiman; Silk, Zacharia; Saha, Urmila U; Auplish, Sunil; Masterson, Sean

2016-12-02

This article present the results of an audit cycle which evaluated the quality of inpatient ward round documentation in a busy district general hospital before and after the implementation of a standardized proforma which was specifically designed for trauma and orthopaedic patients. In each cycle, 20 case notes were examined and the data analysed to examine three main areas: Diagnosis, management and/or discharge plan Objective assessments including neurovascular status, weight-bearing status, surgical wound review, observations, results of investigations and decision from the daily trauma meeting Logistics of the documentation such as legibility, date and time, name and grade of the doctor and contact number. This audit demonstrated that using a ward round proforma can significantly enhance the quality of documentation and improve communication between multidisciplinary team members.

49 CFR 219.901 - Retention of alcohol testing records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... test results; and (2) A copy of the annual report summarizing the results of its alcohol misuse... connection with decisions to administer reasonable suspicion alcohol tests. (iv) Documents generated in connection with decisions on post-accident testing. (v) Documents verifying the existence of a medical...

15 CFR 764.5 - Voluntary self-disclosure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... retained by the person making the disclosure until OEE requests them, or until a final decision on the disclosed information has been made. After a final decision, the documents should be maintained in... account and supporting documentation. If the person making the disclosure believes otherwise, a request...

Preventive Detention of Juveniles. Hearing before the Subcommittee on Juvenile Justice of the Committee on the Judiciary. United States Senate, Ninety-Eighth Congress, Second Session. Oversight Hearing to Review the Recent Supreme Court Decision Relating to the Pretrial Detention of Juvenile Offenders. Serial No. J-98-145.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

This document contains prepared statements and witness testimony from the Congressional hearing on the pretrial detention of juveniles. The opening statement of Senator Arlen Specter, subcommittee chairman, is presented, focusing on the concerns arising from the Supreme Court decision in the case of Schall versus Martin (New York) which supports…

Superfund Record of Decision (EPA Region 6): Longhorn Army Ammunition Plant, Group 1 Sites, Karnack, TX, January 23, 1998

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

NONE

1998-10-01

This decision document presents the selected No Further Action alternative for Group 1 Sites, Longhorn Army Ammunition Plant (LHAAP), In Karnack, Texas. The public comment period for the Group 1 Sites No Further Action Proposed Plan ended August 20, 1997. During the public comment period, the Army received four comments. These comments were in regards to future excising of the facility property, PCB`s (no PCB`s found), off-site sampling, and the area`s regional water supply.

Superfund record of decision (EPA Region 3): US Defense General Supply Center (DLA), operable unit 3, Chesterfield County, Richmond, VA, September 29, 1995

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

NONE

This decision document presents the selected remedial action for the National Guard Source Area (NGA), Operable Unit (OU3) at the Defense General Supply Center (DGSC) in Richmond, Virginia. Operable Unit 3 addresses the contaminated soils at the National Guard . The selected alternative requires that institutional controls, including access restriction, property transfer restriction, and preconstruction assessment, be implemented or continued at the site. Also, contaminated soils posing human health risks will be excavated and disposed of.

Superfund Record of Decision (EPA Region 3): Allegany Ballistics Laboratory (USNavy), Operable Unit 1, Mineral, WV, February 12, 1997

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

NONE

1998-01-01

This decision document presents the selected remedial action for Site 5 Landfill Contents and Surface Soil at the Allegany Ballistics Laboratory (ABL), Rocket Center, West Virginia. The major components of the selected remedy are: Deed notation along with property use and limited access restrictions; Installation of a composite CAP-GCL and FMC; Installation of a drainage layer utilizing a geonet; Installation of a passive landfill gas (LFG) venting system; Revegetation of the capped area; Installation of perimeter drainage system; and Post-closure requirements.

Superfund record of decision (EPA Region 3): Stanley Kessler Superfund Site, King of Prussia, PA, September 1994

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

Not Available

1994-09-29

This decision document presents the final selected remedial action for the Stanley Kessler Superfund Site (the Site). The selected remedy for the Site will restore contaminated ground water to its beneficial use by cleaning up the ground water to background levels as established by EPA or the appropriate Maximum Contaminant Levels or non-zero Maximum Contaminant Level Goals established under the Federal Safe Drinking Water Act whichever is more stringent. The selected remedy is the only planned action for the Site.

Superfund record of decision (EPA Region 9): Mather Air Force Base, Landfill Operable Unit, Sacramento County, CA, August 3, 1995

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

NONE

This decision document presents the selected remedial actions for the Landfill OU Sites, at the inactive Mather AFB, Sacramento County, California. The Installation Restoration Program (IRP) sites which comprise the Landfill OU at the inactive Mather AFB include: Site 1 - Runway Overrun Landfill; Site 2 - `8150` Area Landfill; Site 3 - Northeast Perimeter Landfill No. 1; Site 4 - Northeast Perimeter Landfill No. 2; Site 5 - Northeast Perimeter Landfill No. 3; and Site 6 - Firing Range Landfill Sites.

Editorial Commentary: Got Evidence? What We Really Need Is an Algorithm for Treating Symptomatic Bipartite Patella.

PubMed

Fithian, Donald C

2018-05-01

Bipartite patella is an uncommon but potentially troublesome problem for young athletes. Numerous uncontrolled retrospective studies have reported good results after various treatments. What is needed are studies that will guide workup and support treatment decisions based on the condition of the cartilage surfaces of the fragment, presence of pseudoarthrosis, and size and location of the fragment. To support decisions, we need prospective comparative studies, either randomized or, at least, prospective cohort studies that identify patients at the time of presentation, document key decision points, and follow patients to successful resolution of symptoms. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Natural language generation in health care.

PubMed

Cawsey, A J; Webber, B L; Jones, R B

1997-01-01

Good communication is vital in health care, both among health care professionals, and between health care professionals and their patients. And well-written documents, describing and/or explaining the information in structured databases may be easier to comprehend, more edifying, and even more convincing than the structured data, even when presented in tabular or graphic form. Documents may be automatically generated from structured data, using techniques from the field of natural language generation. These techniques are concerned with how the content, organization and language used in a document can be dynamically selected, depending on the audience and context. They have been used to generate health education materials, explanations and critiques in decision support systems, and medical reports and progress notes.

50 CFR 23.33 - How is the decision made to issue or deny a request for a U.S. CITES document?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false How is the decision made to issue or deny... INTERNATIONAL TRADE IN ENDANGERED SPECIES OF WILD FAUNA AND FLORA (CITES) Application Procedures, Criteria, and Conditions § 23.33 How is the decision made to issue or deny a request for a U.S. CITES document? (a) Upon...

50 CFR 23.33 - How is the decision made to issue or deny a request for a U.S. CITES document?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false How is the decision made to issue or deny... INTERNATIONAL TRADE IN ENDANGERED SPECIES OF WILD FAUNA AND FLORA (CITES) Application Procedures, Criteria, and Conditions § 23.33 How is the decision made to issue or deny a request for a U.S. CITES document? (a) Upon...

50 CFR 23.33 - How is the decision made to issue or deny a request for a U.S. CITES document?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false How is the decision made to issue or deny... INTERNATIONAL TRADE IN ENDANGERED SPECIES OF WILD FAUNA AND FLORA (CITES) Application Procedures, Criteria, and Conditions § 23.33 How is the decision made to issue or deny a request for a U.S. CITES document? (a) Upon...

50 CFR 23.33 - How is the decision made to issue or deny a request for a U.S. CITES document?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false How is the decision made to issue or deny... INTERNATIONAL TRADE IN ENDANGERED SPECIES OF WILD FAUNA AND FLORA (CITES) Application Procedures, Criteria, and Conditions § 23.33 How is the decision made to issue or deny a request for a U.S. CITES document? (a) Upon...

Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support

PubMed Central

2014-01-01

Background Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. Methods We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Results Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). Conclusions CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care. PMID:24645674

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

PubMed

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed to determine if it results in improved care.

Toward Sustainable Communities: Resources for Citizens and Their Governments. Revised and Updated.

ERIC Educational Resources Information Center

Roseland, Mark

Many of the most critical global environmental issues are rooted in local, day-to-day problems. Local decisions about such issues benefit all citizens globally. This book attempts to identify and document the current range of initiatives toward developing sustainable communities. Dozens of tools, initiatives, and resources are presented,…

Sourcing in Professional Education: Do Text Factors Make Any Difference?

ERIC Educational Resources Information Center

Bråten, Ivar; Strømsø, Helge I.; Andreassen, Rune

2016-01-01

The present study investigated the extent to which the text factors of source salience and emphasis on risk might influence readers' attention to and use of source information when reading single documents to make behavioral decisions on controversial health-related issues. Participants (n = 259), who were attending different bachelor-level…

Energy Design Guidelines for High Performance Schools: Temperate and Humid Climates.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Office of Energy Efficiency and Renewable Energy.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

Energy Design Guidelines for High Performance Schools: Hot and Humid Climates.

ERIC Educational Resources Information Center

National Renewable Energy Lab. (DOE), Golden, CO.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

Energy Design Guidelines for High Performance Schools: Cool and Humid Climates.

ERIC Educational Resources Information Center

National Renewable Energy Lab. (DOE), Golden, CO.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

Energy Design Guidelines for High Performance Schools: Temperate and Mixed Climates.

ERIC Educational Resources Information Center

National Renewable Energy Lab. (DOE), Golden, CO.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

Energy Design Guidelines for High Performance Schools: Cool and Dry Climates.

ERIC Educational Resources Information Center

National Renewable Energy Lab. (DOE), Golden, CO.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

Energy Design Guidelines for High Performance Schools: Cold and Humid Climates.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Office of Energy Efficiency and Renewable Energy.

The U.S. Department of Energy's EnergySmart Schools provides school boards, administrators, and design staff with guidance to help them make informed decisions about energy and environmental issues important to school systems and communities. The design guidelines presented in this document outline high performance principles for the new or…

17 CFR 10.102 - Review of initial decisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the appeal with respect to the issues presented, and the reasons therefor, and citations to supporting... answering brief generally shall follow the same style as prescribed for the appeal brief but may omit a... reference citations to the record contained in its brief or in any other document. If an appellee deems it...

Transparency and Documentation in Simulations of Infectious Disease Outbreaks: Towards Evidence-Based Public Health Decisions and Communications

NASA Astrophysics Data System (ADS)

Ekberg, Joakim; Timpka, Toomas; Morin, Magnus; Jenvald, Johan; Nyce, James M.; Gursky, Elin A.; Eriksson, Henrik

Computer simulations have emerged as important tools in the preparation for outbreaks of infectious disease. To support the collaborative planning and responding to the outbreaks, reports from simulations need to be transparent (accessible) with regard to the underlying parametric settings. This paper presents a design for generation of simulation reports where the background settings used in the simulation models are automatically visualized. We extended the ontology-management system Protégé to tag different settings into categories, and included these in report generation in parallel to the simulation outcomes. The report generator takes advantage of an XSLT specification and collects the documentation of the particular simulation settings into abridged XMLs including also summarized results. We conclude that even though inclusion of critical background settings in reports may not increase the accuracy of infectious disease simulations, it can prevent misunderstandings and less than optimal public health decisions.

Toxicology research for precautionary decision-making and the role of Human & Experimental Toxicology.

PubMed

Grandjean, P

2015-12-01

A key aim of toxicology is the prevention of adverse effects due to toxic hazards. Therefore, the dissemination of toxicology research findings must confront two important challenges: one being the lack of information on the vast majority of potentially toxic industrial chemicals and the other being the strict criteria for scientific proof usually required for decision-making in regard to prevention. The present study ascertains the coverage of environmental chemicals in four volumes of Human & Experimental Toxicology and the presentation and interpretation of research findings in published articles. Links in SciFinder showed that the 530 articles published in four selected volumes between 1984 and 2014 primarily dealt with metals (126 links) and other toxicants that have received substantial attention in the past. Thirteen compounds identified by US authorities in 2006 as high-priority substances, for which toxicology documentation is badly needed, were not covered in the journal issues at all. When reviewing published articles, reliance on p values was standard, and non-significant findings were often called 'negative.' This tradition may contribute to the perceived need to extend existing research on toxic hazards that have already been well characterized. Several sources of bias towards the null hypothesis can affect toxicology research, but are generally not considered, thus adding to the current inclination to avoid false positive findings. In this regard, toxicology is particularly prone to bias because of the known paucity of false positives and, in particular, the existence of a vast number of toxic hazards which by default are considered innocuous due to lack of documentation. The Precautionary Principle could inspire decision-making on the basis of incomplete documentation and should stimulate a change in toxicology traditions and in toxicology research publication. © The Author(s) 2015.

The use of fingerprints available on the web in false identity documents: Analysis from a forensic intelligence perspective.

PubMed

Girelli, Carlos Magno Alves

2016-05-01

Fingerprints present in false identity documents were found on the web. In some cases, laterally reversed (mirrored) images of a same fingerprint were observed in different documents. In the present work, 100 fingerprints images downloaded from the web, as well as their reversals obtained by image editing, were compared between themselves and against the database of the Brazilian Federal Police AFIS, in order to better understand trends about this kind of forgery in Brazil. Some image editing effects were observed in the analyzed fingerprints: addition of artifacts (such as watermarks), image rotation, image stylization, lateral reversal and tonal reversal. Discussion about lateral reversals' detection is presented in this article, as well as suggestion to reduce errors due to missed HIT decisions between reversed fingerprints. The present work aims to highlight the importance of the fingerprints' analysis when performing document examination, especially when only copies of documents are available, something very common in Brazil. Besides the intrinsic features of the fingermarks considered in three levels of details by ACE-V methodology, some visual features of the fingerprints images can be helpful to identify sources of forgeries and modus operandi, such as: limits and image contours, fails in the friction ridges caused by excess or lack of inking and presence of watermarks and artifacts arising from the background. Based on the agreement of such features in fingerprints present in different identity documents and also on the analysis of the time and location where the documents were seized, it is possible to highlight potential links between apparently unconnected crimes. Therefore, fingerprints have potential to reduce linkage blindness and the present work suggests the analysis of fingerprints when profiling false identity documents, as well as the inclusion of fingerprints features in the profile of the documents. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evidence for top-down control of eye movements during visual decision making.

PubMed

Glaholt, Mackenzie G; Wu, Mei-Chun; Reingold, Eyal M

2010-05-01

Participants' eye movements were monitored while they viewed displays containing 6 exemplars from one of several categories of everyday items (belts, sunglasses, shirts, shoes), with a column of 3 items presented on the left and another column of 3 items presented on the right side of the display. Participants were either required to choose which of the two sets of 3 items was the most expensive (2-AFC) or which of the 6 items was the most expensive (6-AFC). Importantly, the stimulus display, and the relevant stimulus dimension, were held constant across conditions. Consistent with the hypothesis of top-down control of eye movements during visual decision making, we documented greater selectivity in the processing of stimulus information in the 6-AFC than the 2-AFC decision. In addition, strong spatial biases in looking behavior were demonstrated, but these biases were largely insensitive to the instructional manipulation, and did not substantially influence participants' choices.

Historical Roots of the Spatial, Temporal, and Diversity Scales of Agricultural Decision-Making in Sierra de Santa Marta, Los Tuxtlas

NASA Astrophysics Data System (ADS)

Negrete-Yankelevich, Simoneta; Porter-Bolland, Luciana; Blanco-Rosas, José Luis; Barois, Isabelle

2013-07-01

Land degradation is a serious problem in tropical mountainous areas. Market prices, technological development, and population growth are often invoked as the prime causes. Using historical agrarian documents, literature sources, and historical population data, we (1) provide quantitative and qualitative evidence that the land degradation present at Sierra de Santa Marta (Los Tuxtlas, Mexico) has involved a historical reduction in the temporal, spatial, and diversity scales, in which individual farmers make management decisions, and has resulted in decreased maize productivity; and (2) analyze how these three scalar changes can be linked to policy, population growth, and agrarian history. We conclude that the historical reduction in the scales of land use decision-making and practices constitutes a present threat to indigenous agricultural heritage. The long-term viability of agriculture requires that initiatives consider incentives for co-responsibility with an initial focus on self-sufficiency.

Historical roots of the spatial, temporal, and diversity scales of agricultural decision-making in sierra de santa marta, los tuxtlas.

PubMed

Negrete-Yankelevich, Simoneta; Porter-Bolland, Luciana; Blanco-Rosas, José Luis; Barois, Isabelle

2013-07-01

Land degradation is a serious problem in tropical mountainous areas. Market prices, technological development, and population growth are often invoked as the prime causes. Using historical agrarian documents, literature sources, and historical population data, we (1) provide quantitative and qualitative evidence that the land degradation present at Sierra de Santa Marta (Los Tuxtlas, Mexico) has involved a historical reduction in the temporal, spatial, and diversity scales, in which individual farmers make management decisions, and has resulted in decreased maize productivity; and (2) analyze how these three scalar changes can be linked to policy, population growth, and agrarian history. We conclude that the historical reduction in the scales of land use decision-making and practices constitutes a present threat to indigenous agricultural heritage. The long-term viability of agriculture requires that initiatives consider incentives for co-responsibility with an initial focus on self-sufficiency.

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

Matthews, Patrick K.

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 550: Smoky Contamination Area, Nevada National Security Site, Nevada. CAU 550 includes 19 corrective action sites (CASs), which consist of one weapons-related atmospheric test (Smoky), three safety experiments (Ceres, Oberon, Titania), and 15 debris sites (Table ES-1). The CASs were sorted into the following study groups based on release potential and technical similarities: • Study Group 1, Atmospheric Test • Study Group 2, Safety Experiments • Study Group 3, Washes • Study Group 4, Debris The purpose of this document is to provide justificationmore » and documentation supporting the conclusion that no further corrective action is needed for CAU 550 based on implementation of the corrective actions listed in Table ES-1. Corrective action investigation (CAI) activities were performed between August 2012 and October 2013 as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 550: Smoky Contamination Area; and in accordance with the Soils Activity Quality Assurance Plan. The approach for the CAI was to investigate and make data quality objective (DQO) decisions based on the types of releases present. The purpose of the CAI was to fulfill data needs as defined during the DQO process. The CAU 550 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated the dataset is complete and acceptable for use in fulfilling the DQO data needs.« less

The Effect of Structured Decision-Making Techniques and Gender on Student Reaction and Quality of Written Documents.

ERIC Educational Resources Information Center

Neal, Joan; Echternacht, Lonnie

1995-01-01

Experimental groups used four decision-making techniques--reverse brainstorming (RS), dialectical inquiry (DI), devil's advocacy (DA), and consensus--in evaluating writing assignments. Control group produced a better quality document. Student reaction to negative features of RS, DI, and DA were not significant. (SK)

Report: Administrative Leave Decisions for EPA Employee Disciplinary Actions Should Be Better Documented, and Parameters on Use of Such Leave Should Be Established

EPA Pesticide Factsheets

Report #16-P-0036, November 9, 2015. EPA’s use of extended administrative leave can result in unnecessary and excessive payroll costs, and lack of documentation and justification can lead others to second guess the agency’s decisions.

Corrective Action Decision Document for Corrective Action Unit 340: Pesticide Release sites, Nevada Test Site, Nevada

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

DOE /NV

This Corrective Action Decision Document has been prepared for Corrective Action Unit 340, the NTS Pesticide Release Sites, in accordance with the Federal Facility Agreement and Consent Order of 1996 (FFACO, 1996). Corrective Action Unit 340 is located at the Nevada Test Site, Nevada, and is comprised of the following Corrective Action Sites: 23-21-01, Area 23 Quonset Hut 800 Pesticide Release Ditch; 23-18-03, Area 23 Skid Huts Pesticide Storage; and 15-18-02, Area 15 Quonset Hut 15-11 Pesticide Storage. The purpose of this Corrective Action Decision Document is to identify and provide a rationale for the selection of a recommended correctivemore » action alternative for each Corrective Action Site. The scope of this Corrective Action Decision Document consists of the following tasks: Develop corrective action objectives; Identify corrective action alternative screening criteria; Develop corrective action alternatives; Perform detailed and comparative evaluations of the corrective action alternatives in relation to the corrective action objectives and screening criteria; and Recommend and justify a preferred corrective action alternative for each Corrective Action Site.« less

Superfund record of decision amendment (EPA Region 3): Tyson Dump Superfund Site, Upper Merion Township, Montgomergy County, PA, July 20, 1996

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

NONE

1996-08-01

The Record of Decision Amendment (`ROD Amendment`) modifies the selected remedy described in the Revised Record of Decision for the Tyson`s Superfund Site (Site) issued by the U.S. Environmental Protection Agency (EPA) on March 31, 1988 (1988 Revised ROD - PB89-233894). In the 1988 Revised ROD, EPA selected a soil vapor extraction (SVE) remedy for lagoon area soils. The SVE system has removed approximately 200,000 pounds of volatile organic compounds (VOCs) from the lagoon area soils. Although several enhancements and modifications have been employed to improve performance, the SVE system will not achieve the cleanup standards specified in the 1988more » Revised ROD. The decision document presents the selected remedial action for the lagoon area soils at the Tyson`s Site.« less

Toward the Geoscience Paper of the Future: Best practices for documenting and sharing research from data to software to provenance

NASA Astrophysics Data System (ADS)

Gil, Yolanda; David, Cédric H.; Demir, Ibrahim; Essawy, Bakinam T.; Fulweiler, Robinson W.; Goodall, Jonathan L.; Karlstrom, Leif; Lee, Huikyo; Mills, Heath J.; Oh, Ji-Hyun; Pierce, Suzanne A.; Pope, Allen; Tzeng, Mimi W.; Villamizar, Sandra R.; Yu, Xuan

2016-10-01

Geoscientists now live in a world rich with digital data and methods, and their computational research cannot be fully captured in traditional publications. The Geoscience Paper of the Future (GPF) presents an approach to fully document, share, and cite all their research products including data, software, and computational provenance. This article proposes best practices for GPF authors to make data, software, and methods openly accessible, citable, and well documented. The publication of digital objects empowers scientists to manage their research products as valuable scientific assets in an open and transparent way that enables broader access by other scientists, students, decision makers, and the public. Improving documentation and dissemination of research will accelerate the pace of scientific discovery by improving the ability of others to build upon published work.

Data Presentation and Visualization (DPV) Interface Control Document

NASA Technical Reports Server (NTRS)

Mazzone, Rebecca A.; Conroy, Michael P.

2015-01-01

Data Presentation and Visualization (DPV) is a subset of the modeling and simulation (M&S) capabilities at Kennedy Space Center (KSC) that endeavors to address the challenges of how to present and share simulation output for analysts, stakeholders, decision makers, and other interested parties. DPV activities focus on the development and provision of visualization tools to meet the objectives identified above, as well as providing supporting tools and capabilities required to make its visualization products available and accessible across NASA.

Assessing Patient Participation in Health Policy Decision-Making in Cyprus.

PubMed

Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

2016-06-20

Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients' involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus. © 2016 by Kerman University of Medical Sciences.

24 CFR 5.502 - Requirements concerning documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Requirements concerning documents... § 5.502 Requirements concerning documents. For any notice or document (decision, declaration, consent... regulations for requirements concerning communications with persons with disabilities.) ...

Providing Greater Protection for Environmental Audits: A Proposal for a Self-Evaluative Privilege

DTIC Science & Technology

1993-04-01

make the government more accountable to the people. It also intended to encourage governmental responsibility. FOIA provides, in part, that any person ...document is exempt.84 Pre- decisional documents lose their exempt status if the documents are incorporated by reference in the agency’s final decision .85 E...the employee making the communication, of whatever rank he may be, is in a position to control or even to take a substantial part in a decision about

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.

"The Right of Every Child": The Story of the Washington, D.C. Program of School Integration.

ERIC Educational Resources Information Center

American Friends Service Committee, Washington, DC.

Described in this 1955 document is the initiation of school integration in the District of Columbia immediately following the 1954 Supreme Court school desegregation decision. The report presents information about the desegregation process in terms of pupil assignment and extent of interracial classes, teacher and administrator integration, parent…

The University of Mississippi and the Meredith Case. (Includes "Another Mississippi Story").

ERIC Educational Resources Information Center

Williams, J.D.

The document is the report of the chancellor of the University of Mississippi about the university's role in the case of James Meredith. Presented is the history of the case from the university's viewpoint--Meredith's initial application for admission, the subsequent legal suit and appeals, the U.S. Supreme Court decision ordering his admission,…

The Physician's Role in Prevention. Adolescent Alcoholism: Recognizing, Intervening, and Treating Series No. 2.

ERIC Educational Resources Information Center

Fisher, Joseph V.; Krol, Ronald A.

This document is one of seven publications contained in a series of materials for physicians on recognizing, intervening with, and treating adolescent alcoholism. The materials in this unit of study offer guidelines to help physicians make responsible and informed decisions about their roles with adolescent patients. Materials are presented which…

Time for Decisions: Visualizing the Future. Proceedings of the Annual NEAIR Conference (39th, Bethesda, Maryland, November 3-6, 2012)

ERIC Educational Resources Information Center

Carson, Cristi, Ed.

2012-01-01

The NEAIR (North East Association for Institutional Research) 2012 Conference Proceedings is a compilation of papers presented at the Bethesda, Maryland conference. Papers in this document include: (1) Can a Marketing Campaign Increase Response Rates to Online Course Evaluations? (Kimberly Puhala); (2) Developing Community College Peer…

Putting It All Together: A Model for Parish Educational Policymaking. Second Edition.

ERIC Educational Resources Information Center

Harper, Mary-Angela

The rationale of shared responsibility by the hierarchy and the laity for directing Catholic school and non-school religious educational programs is clearly present in the Vatican Council II documents, which state that members of the laity should be involved in all decisions affecting their lives and that appropriate structures should be…

Superfund record of decision (EPA Region 9): Mather Air Force Base, Soil and Groundwater operable units, Sacramento, CA, June 21, 1996

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

NONE

The decision document presents the selected remedial actions for the Soil Operable Unit (OU) Sites and Groundwater OU Plumes, at the formerly active Mather Air Force Base (AFB), Sacramento County, California. The purpose of the Record of Decision (ROD) is to decide the appropriate level of remediation necessary to protect human health and the environment, and determine what requirements are applicable or relevant and appropriate requirements (ARARs) based on the groundwater beneficial use designation and site-specific conditions. The ROD has been divided into seven sections which specifically address the range of selected remedial actions for the Soil OU sites andmore » Groundwater OU plumes.« less

Addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 321: Area 22 Weather Station Fuel Storage Nevada Test Site, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the August 2001, Corrective Action Decision Document / Closure Report for Corrective Action Unit 321: Area 22 Weather Station Fuel Storage as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. The approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modificationmore » document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 22-99-05, Fuel Storage Area. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

36 CFR 220.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... environmental impact statement (EIS) or environmental assessment (EA). Decision notice. A concise written record... ENVIRONMENTAL POLICY ACT (NEPA) COMPLIANCE § 220.3 Definitions. The following definitions supplement, by adding... about natural resource systems is sometimes uncertain. Decision document. A record of decision, decision...

Superfund Record of Decision (EPA Region 4): Milan Army Ammunition Plant, Milan, TN, March 11, 1998

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

NONE

1998-09-01

This decision document presents the selected action for the Salvage Yard, Former Ammunition Burnout Area (ABA), and Sanitary Landfill at MLAAP, located in Gibson and Carroll Counties, TN. This ROD addresses the final response action planned for the Salvage Yard, Former ABA, and Sanitary Landfill, including soil and groundwater. NFA is the selected remedy for soil and groundwater at the Salvage Yard, Former ABA, and Sanitary landfill. The selected remedy manages the risk to acceptable levels for both human health and the environment and is the final action planned.

Proceeding Under Title VI of the Civil Rights Act of 1964; Initial Decision in the Matter of Chicago Public School District #299 and Illinois Office of Education and City of Chicago, Illinois; Docket No. S-120. Administrative Proceedings in the Department of Health, Education and Welfare, National Science Foundation, Department of Housing and Urban Development.

ERIC Educational Resources Information Center

Office for Civil Rights (DHEW), Washington, DC.

This document presents the initial decision concerning a federal compliance review of the Chicago Public School District #299, the Illinois Office of Education, and the City of Chicago, Illinois. These proceedings try to determine if the school district under consideration was complying with Title VI of the 1964 Civil Rights Act. Violations of…

Superfund record of decision (EPA Region 3): US Defense General Supply Center, Operable Unit 9, Chesterfield County, VA, September 1993

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

Not Available

1993-09-01

The decision document presents the selected interim remedial action for Operable Unit 9 (OU9) at the Defense General Supply Center (DGSC) in Chesterfield County, Virginia near Richmond. OU9 pertains to groundwater beneath Area 50, the Open Storage Area (OSA), and the Naitonal Guard Area (NGA). This operable unit is the third of nine operable units that are currently being addressed at the DGSC. OU9 addresses interim treatment and containment of groundwater in the upper and lower aquifers beneath Area 50, the OSA, and the NGA.

Sound data management as a foundation for natural resources management and science

USGS Publications Warehouse

Burley, Thomas E.

2012-01-01

Effective decision making is closely related to the quality and completeness of available data and information. Data management helps to ensure data quality in any discipline and supports decision making. Managing data as a long-term scientific asset helps to ensure that data will be usable beyond the original intended application. Emerging issues in water-resources management and climate variability require the ability to analyze change in the conditions of natural resources over time. The availability of quality, well-managed, and documented data from the past and present helps support this requirement.

Superfund record of decision (EPA Region 5): Skinner Landfill, West Chester, OH, June 1993

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

Not Available

1993-06-04

The decision document presents the selected final remedial action for the Skinner Landfill site in West Chester, Ohio. The remedy is the second and final of two operable units for this site. The first operable unit addressed immediate site concerns, through the construction of a fence around the contaminated area, and by offering an alternate supply of drinking water to the potentially affected users of groundwater. This final operable unit addresses potential future migration of site contaminants into the groundwater and will limit the potential for direct exposure of site contaminants to humans through source control measures.

Facsimile Transmission of Microforms.

DTIC Science & Technology

1983-12-30

display terminals, high speed printers, conventional facsimile receivers, and/or graphics COM recorders. Microforms designed for storage, retrieval...author and Whould not be construed as an official Department of the Army position, policy, or decision, unless so designated by other documentation...beconstrued as an official Department of the Army position, policy, or decision, unless so designated by other documentation. ,, -- UNCLASSIFIED SECURITY

Data for Renewable Energy Planning, Policy, and Investment

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

Cox, Sarah L

Reliable, robust, and validated data are critical for informed planning, policy development, and investment in the clean energy sector. The Renewable Energy (RE) Explorer was developed to support data-driven renewable energy analysis that can inform key renewable energy decisions globally. This document presents the types of geospatial and other data at the core of renewable energy analysis and decision making. Individual data sets used to inform decisions vary in relation to spatial and temporal resolution, quality, and overall usefulness. From Data to Decisions, a complementary geospatial data and analysis decision guide, provides an in-depth view of these and other considerationsmore » to enable data-driven planning, policymaking, and investment. Data support a wide variety of renewable energy analyses and decisions, including technical and economic potential assessment, renewable energy zone analysis, grid integration, risk and resiliency identification, electrification, and distributed solar photovoltaic potential. This fact sheet provides information on the types of data that are important for renewable energy decision making using the RE Data Explorer or similar types of geospatial analysis tools.« less

The Application of Recognition-Primed Decision Theory to Decisions Made in an Outdoor Education Context

ERIC Educational Resources Information Center

Boyes, Mike; Potter, Tom

2015-01-01

This research examined the decisions that highly experienced outdoor leaders made on backpacking expeditions conducted by a tertiary institution in the Southern Alps of New Zealand. The purpose of the research was to document decision problems and explore them as Recognition-Primed Decisions (RPD) within naturalistic decision making (NDM)…

Building Stakeholder Trust: Defensible Government Decisions - 13110

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

Franklin, Victor A.

Administrative decisions must be grounded in reasonable expectations, founded on sound principles, and bounded by societal norms. Without these first principles, attaining and retaining public trust is a Herculean task. Decisions made by governmental administrators must be both transparent and defensible: without the former the agency will lose the public's trust and support (possibly prompting a legal challenge to the decision) and without the latter the decision may fail to withstand judicial scrutiny. This presentation and accompanying paper delves into the process by which governmental decisions can achieve both defensibility and openness through building stakeholder trust with transparency. Achieving andmore » maintaining stakeholder trust is crucial, especially in the environs of nuclear waste management. Proving confidence, stability, and security to the surrounding citizenry as well as those throughout the country is the goal of governmental nuclear waste remediation. Guiding administrative decision-making processes and maintaining a broad bandwidth of communication are of incalculable importance to all those charged with serving the public, but are especially essential to those whose decisional impacts will be felt for millennia. A strong, clear, and concise administrative record documenting discrete decisions and overarching policy choices is the strongest defense to a decisional challenge. However, this can be accomplished using transparency as the fundamental building block. This documentation allows the decision-makers to demonstrate the synthesis of legal and technical challenges and fortifies the ground from which challenges will be defended when necessary. Further, administrative actions which capture the public's interest and captivate that interest throughout the process will result in a better-informed, more deeply-involved, and more heavily-invested group of interested parties. Management of information, involvement, and investment on the front-end of the process reaps rewards far more efficiently than attempts to assuage and mitigate the concerns of those parties after the fact and there are a number of tools Savannah River Remediation (SRR) has deployed that render transparency an ally in this context. The makers, applicators, and beneficiaries of policies and decisions will all benefit from strong administrative records which document decisional choices in an open and transparent manner and from timely, up-front management of concerns of interested parties. The strongest defense to decisional challenges is an ability to demonstrate the basis of the decision and the reason(s) that the decision was chosen over other alternatives. Providing a sound basis for defending challenges rather than avoiding or fighting over them allows the deciding entity the greatest opportunity to produce value for its customer. Often, a transparent process that invites public participation and is open for public review and comment will thwart challenge genesis. An entity that has to devote resources to defending its choices obviously cannot utilize those resources to further its mission. (authors)« less

Mapping Process to Pattern in the Landscape Change of the Amazonian Frontier

NASA Technical Reports Server (NTRS)

Walker, Robert

2003-01-01

Changes in land use and land cover are dynamic processes reflecting a sequence of decisions made by individual land managers. In developing economies, these decisions may be embedded in the evolution of individual households, as is often the case in indigenous areas and agricultural frontiers. One goal of the present article is to address the land use and land-cover decisions of colonist farmers in the Amazon Basin as a function, in part, of household characteristics. Another goal is to generalize the issue of tropical deforestation into a broader discussion on forest dynamics. The extent of secondary forest in tropical areas has been well documented in South America and Africa. Agricultural-plot abandonment often occurs in tandem with primary forest clearance and as part of the same decision-making calculus. Consequently, tropical deforestation and forest succession are not independent processes in the landscape. This article presents a framework that integrates them into a model of forest dynamics at household level, and in so doing provides an account of the spatial pattern of deforestation that has been observed in the Amazon's colonization frontiers.

36 CFR 1010.13 - Trust decision-making procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental document (i.e., the EA, finding of no significant impact, EIS, or notice of intent), in addition... environmental factors. (b) The Trust shall consider in its decision-making process only decision alternatives...

Identifying and characterising health policy and system-relevant documents in Uganda: a scoping review to develop a framework for the development of a one-stop shop.

PubMed

Mutatina, Boniface; Basaza, Robert; Obuku, Ekwaro; Lavis, John N; Sewankambo, Nelson

2017-02-06

Health policymakers in low- and middle-income countries continue to face difficulties in accessing and using research evidence for decision-making. This study aimed to identify and provide a refined categorisation of the policy documents necessary for building the content of a one-stop shop for documents relevant to health policy and systems in Uganda. The on-line resource is to facilitate timely access to well-packaged evidence for decision-making. We conducted a scoping review of Uganda-specific, health policy, and systems-relevant documents produced between 2000 and 2014. Our methods borrowed heavily from the 2005 Arksey and O'Malley approach for scoping reviews and involved five steps, which that include identification of the research question; identification of relevant documents; screening and selection of the documents; charting of the data; and collating, summarising and reporting results. We searched for the documents from websites of relevant government institutions, non-governmental organisations, health professional councils and associations, religious medical bureaus and research networks. We presented the review findings as numerical analyses of the volume and nature of documents and trends over time in the form of tables and charts. We identified a total of 265 documents including policies, strategies, plans, guidelines, rapid response summaries, evidence briefs for policy, and dialogue reports. The top three clusters of national priority areas addressed in the documents were governance, coordination, monitoring and evaluation (28%); disease prevention, mitigation, and control (23%); and health education, promotion, environmental health and nutrition (15%). The least addressed were curative, palliative care, rehabilitative services and health infrastructure, each addressed in three documents (1%), and early childhood development in one document. The volume of documents increased over the past 15 years; however, the distribution of the different document types over time has not been uniform. The review findings are necessary for mobilising and packaging the local policy-relevant documents in Uganda in a one-stop shop; where policymakers could easily access them to address pressing questions about the health system and interventions. The different types of available documents and the national priority areas covered provide a good basis for building and organising the content in a meaningful way for the resource.

EPA Superfund Records of Decision (RODs) for Region 7: Iowa, Kansas, Missouri, and Nebraska

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 10: Alaska, Idaho, Oregon, and Washington

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

Evaluating a Clinical Decision Support Interface for End-of-Life Nurse Care.

PubMed

Febretti, Alessandro; Stifter, Janet; Keenan, Gail M; Lopez, Karen D; Johnson, Andrew; Wilkie, Diana J

2014-01-01

Clinical Decision Support Systems (CDSS) are tools that assist healthcare personnel in the decision-making process for patient care. Although CDSSs have been successfully deployed in the clinical setting to assist physicians, few CDSS have been targeted at professional nurses, the largest group of health providers. We present our experience in designing and testing a CDSS interface embedded within a nurse care planning and documentation tool. We developed four prototypes based on different CDSS feature designs, and tested them in simulated end-of-life patient handoff sessions with a group of 40 nurse clinicians. We show how our prototypes directed nurses towards an optimal care decision that was rarely performed in unassisted practice. We also discuss the effect of CDSS layout and interface navigation in a nurse's acceptance of suggested actions. These findings provide insights into effective nursing CDSS design that are generalizable to care scenarios different than end-of-life.

77 FR 20688 - 29th Meeting: RTCA Special Committee 206, Aeronautical Information and Meteorological Data Link...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

.... SC-206 Related Work in SESAR--Progress Status. Discuss previously proposed TOR changes and DO-252 Revision. [cir] Discuss TOR changes for the June PMC meeting. PMC decision on OSED document. ConUse FRAC... dates. Decision to approve the ConUse document for release to the PMC. Agree upon TOR changes for June...

Issues in Peer Review of the Scientific Basis for Regulatory Decisions.

ERIC Educational Resources Information Center

American Chemical Society, Washington, DC.

This document is intended to provide a discussion of the issues that need to be addressed in the development of peer review guidelines, the options for addressing the issues, and a range of views about such options. The document focuses on peer review with regard to regulatory decisions and contains major sections which deal with: (1) what should…

Global Grid Telemedicine System: Expert Consult Manager

DTIC Science & Technology

2000-10-01

Department of the Army position, policy or decision unless so designated by other documentation. DTIC QUALITY iw^^rxi 20010122 014 REPORT DOCUMENTATION...processes and personnel for collecting, processing, storing, disseminating and managing information on demand to warfighters, policy makers, and...to be responsive to and incorporate current and future policy decisions. (7) Be continuously aware, along with Network and Bandwidth managers, of

Alternative control technology document for bakery oven emissions. Final report

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

Sanford, C.W.

The document was produced in response to a request by the baking industry for Federal guidance to assist in providing a more uniform information base for State decision-making with regard to control of bakery oven emissions. The information in the document pertains to bakeries that produce yeast-leavened bread, rolls, buns, and similar products but not crackers, sweet goods, or baked foodstuffs that are not yeast leavened. Information on the baking processes, equipment, operating parameters, potential emissions from baking, and potential emission control options are presented. Catalytic and regenerative oxidation are identified as the most appropriate existing control technologies applicable tomore » VOC emissions from bakery ovens. Cost analyses for catalytic and regenerative oxidation are included. A predictive formula for use in estimating oven emissions has been derived from source tests done in junction with the development of the document. Its use and applicability are described.« less

Guideline Adherence Regarding the Use of Expensive Drugs in Daily Practice: The Examples of Trastuzumab in Breast Cancer and Bortezomib in Multiple Myeloma.

PubMed

Boons, Christel C L M; Wagner, Cordula; Hugtenburg, Jacqueline G

2016-01-01

The present study was designed to obtain insights into guideline adherence regarding the use of expensive drugs in The Netherlands in daily practice and into the patients' perspective on the decision-making process. A retrospective review of medical charts regarding the use of trastuzumab in early and metastatic breast cancer (EBC/MBC) and bortezomib in multiple myeloma (MM) was conducted. Prescription according to clinical practice guidelines was assessed. The review was supplemented with patient interviews. Of 702 adjuvant-treated EBC patients, 97% had a documented human epidermal growth factor receptor 2 (HER2) testing (23% HER2 positive). 92% (147/160) of the HER2-positive EBC patients were treated with trastuzumab. Of 594 MBC patients, 81% had a documented HER2 testing (19% HER2 positive). 82% (75/91) of the HER2-positive MBC patients were treated with trastuzumab. Of 68 MM patients, 50% were treated with bortezomib. Reasons not to treat were consistent with the guidelines. Patients were generally satisfied with the decision-making process; improvements in patient education were suggested (e.g., repeating the information given, adding information on side effects). Guidelines were generally well followed with respect to trastuzumab and bortezomib, indicating that funding did not influence the treatment decisions of physicians. In view of the growing numbers of both cancer patients and expensive new anticancer drugs, and increasing budget constraints, it is unclear whether the present-day policies will guarantee a similar level of guideline adherence. Patient involvement in decision-making could be increased by improving the patient education on treatment. © 2016 S. Karger GmbH, Freiburg.

Goals of patient care system change with video-based education increases rates of advance cardiopulmonary resuscitation decision-making and discussions in hospitalised rehabilitation patients.

PubMed

Johnson, Claire E; Chong, Jeffrey C; Wilkinson, Anne; Hayes, Barbara; Tait, Sonia; Waldron, Nicholas

2017-07-01

Advance cardiopulmonary resuscitation (CPR) discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. A pre-post study tested two interventions: (i) standard ward-based education forums with CPR content; and (ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and a structured video-based workshop; against usual practice (i.e. no formal training). Participants were a random sample of patients in a hospital rehabilitation unit. The outcomes were the proportion of patients documented as: (i) not for resuscitation (NFR); and (ii) eligible for rapid response team (RRT) calls, and rates of documented discussions with the patient, family and carer. When compared with usual practice, patients were more likely to be documented as NFR following the two-pronged intervention (adjusted odds ratio (aOR): 6.4, 95% confidence interval (CI): 3.0; 13.6). Documentation of discussions with patients was also more likely (aOR: 3.3, 95% CI:1.8; 6.2). Characteristics of patients documented NFR were similar between the phases, but were more likely for RRT calls following Phase 3 (P 0.03). An increase in advance CPR decisions occurred following GoPC system change with education. This appears safe as NFR patients had the same level of frailty between phases but were more likely to be eligible for RRT review. Increased documentation of discussions suggests routine use of the GoPC form may improve communication with patients about their care. © 2017 Royal Australasian College of Physicians.

Towpaths to Oblivion. The Middlesex Canal and the Coming of the Railroad 1792-1853.

ERIC Educational Resources Information Center

Holmes, Cary W.

This narrative history of the Middlesex Canal from 1792-1853 is designed to be used with "Canal," a role-playing, decision-making game found in SO 011 886. Economic, social, and political factors related to planning, building, and implementing the canal are considered. The document is presented in three parts. Part I states reasons for…

Shuttle Transportation System Case-Study Development

NASA Technical Reports Server (NTRS)

Ransom, Khadijah

2012-01-01

A case-study collection was developed for NASA's Space Shuttle Program. Using lessons learned and documented by NASA KSC engineers, analysts, and contractors, decades of information related to processing and launching the Space Shuttle was gathered into a single database. The goal was to provide educators with an alternative means to teach real-world engineering processes and to enhance critical thinking, decision making, and problem solving skills. Suggested formats were created to assist both external educators and internal NASA employees to develop and contribute their own case-study reports to share with other educators and students. Via group project, class discussion, or open-ended research format, students will be introduced to the unique decision making process related to Shuttle missions and development. Teaching notes, images, and related documents will be made accessible to the public for presentation of Space Shuttle reports. Lessons investigated included the engine cutoff (ECO) sensor anomaly which occurred during mission STS-114. Students will be presented with general mission infom1ation as well as an explanation of ECO sensors. The project will conclude with the design of a website that allows for distribution of information to the public as well as case-study report submissions from other educators online.

How IRBs View and Make Decisions About Consent Forms

PubMed Central

Klitzman, Robert L.

2013-01-01

IRBs have been criticized for long and complicated consent forms, but how IRBs make decisions about these issues hasn’t been examined. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%), and 13 members and administrators. IRBs confront challenges and dilemmas regarding these documents: what and how much these forms should include (e.g., how “perfect” forms should be). While IRBs generally seek to decrease the length and complexity, institutions and industry funders often want these forms to be legal documents. IRBs may also “nitpick” these documents without realizing the costs. This study, the first to explore how IRBs view and make decisions about consent forms, suggests underlying tensions, ambiguities, and subjectivities that have important implications for future policy, practice, education, and research. PMID:23485667

36 CFR 220.4 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... agency decisionmaking by: (1) Completing the environmental document review before making a decision on...(s) before rendering a decision on the proposal; and (5) Making a decision encompassed within the... preparing to make a decision on one or more alternative means of accomplishing that goal and the effects can...

Difficult decisions: Migration from Small Island Developing States under climate change

NASA Astrophysics Data System (ADS)

Kelman, Ilan

2015-04-01

The impacts of climate change on Small Island Developing States (SIDS) are leading to discussions regarding decision-making about the potential need to migrate. Despite the situation being well-documented, with many SIDS aiming to raise the topic to prominence and to take action for themselves, limited support and interest has been forthcoming from external sources. This paper presents, analyzes, and critiques a decision-making flowchart to support actions for SIDS dealing with climate change-linked migration. The flowchart contributes to identifying the pertinent topics to consider and the potential support needed to implement decision-making. The flowchart has significant limitations and there are topics which it cannot resolve. On-the-ground considerations include who decides, finances, implements, monitors, and enforces each decision. Additionally, views within communities differ, hence mechanisms are needed for dealing with differences, while issues to address include moral and legal blame for any climate change-linked migration, the ultimate goal of the decision-making process, the wider role of migration in SIDS communities and the right to judge decision-making and decisions. The conclusions summarize the paper, emphasizing the importance of considering contexts beyond climate change and multiple SIDS voices.

Documenting Employee Conduct

ERIC Educational Resources Information Center

Dalton, Jason

2009-01-01

One of the best ways for a child care program to lose an employment-related lawsuit is failure to document the performance of its employees. Documentation of an employee's performance can provide evidence of an employment-related decision such as discipline, promotion, or discharge. When properly implemented, documentation of employee performance…

Three Dimensional Modeling via Photographs for Documentation of a Village Bath

NASA Astrophysics Data System (ADS)

Balta, H. B.; Hamamcioglu-Turan, M.; Ocali, O.

2013-07-01

The aim of this study is supporting the conceptual discussions of architectural restoration with three dimensional modeling of monuments based on photogrammetric survey. In this study, a 16th century village bath in Ulamış, Seferihisar, and Izmir is modeled for documentation. Ulamış is one of the historical villages within which Turkish population first settled in the region of Seferihisar - Urla. The methodology was tested on an antique monument; a bath with a cubical form. Within the limits of this study, only the exterior of the bath was modeled. The presentation scale for the bath was determined as 1 / 50, considering the necessities of designing structural interventions and architectural ones within the scope of a restoration project. The three dimensional model produced is a realistic document presenting the present situation of the ruin. Traditional plan, elevation and perspective drawings may be produced from the model, in addition to the realistic textured renderings and wireframe representations. The model developed in this study provides opportunity for presenting photorealistic details of historical morphologies in scale. Compared to conventional drawings, the renders based on the 3d models provide an opportunity for conceiving architectural details such as color, material and texture. From these documents, relatively more detailed restitution hypothesis can be developed and intervention decisions can be taken. Finally, the principles derived from the case study can be used for 3d documentation of historical structures with irregular surfaces.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 274: Septic Systems, Nevada Test Site, Nevada, Rev. No.: 0

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

Grant Evenson

2006-09-01

This Corrective Action Decision Document/Closure Report has been prepared for Corrective Action Unit 274, Septic Systems, Nevada Test Site (NTS), Nevada in accordance with the ''Federal Facility Agreement and Consent Order'' (1996). Corrective Action Unit (CAU) 274 is comprised of five corrective action sites (CASs): (1) CAS 03-02-01, WX-6 ETS Building Septic System; (2) CAS 06-02-01, Cesspool; (3) CAS 09-01-01, Spill Site; (4) CAS 09-05-01, Leaching Pit; and (5) CAS 20-05-01, Septic System. The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the closure of CAU 274 with no further corrective action. Tomore » achieve this, corrective action investigation (CAI) activities were performed from November 14 through December 17, 2005 as set forth in the CAU 274 Corrective Action Investigation Plan. The purpose of the CAI was to fulfill the following data needs as defined during the data quality objective (DQO) process: (1) Determine whether contaminants of concern (COCs) are present. (2) If contaminants of concern are present, determine their nature and extent. (3) Provide sufficient information and data to complete appropriate corrective actions. The CAU 274 dataset from the investigation results was evaluated based on the data quality indicator parameters. This evaluation demonstrated the quality and acceptability of the dataset for use in fulfilling the DQO data needs. Analytes detected during the CAI were evaluated against final action levels (FALs) established in this document. No analytes were detected at concentrations exceeding the FALs. No COCs have been released to the soil at CAU 274, and corrective action is not required. Therefore, the DQO data needs were met, and it was determined that no corrective action based on risk to human receptors is necessary for the site. All FALs were calculated using the industrial site worker scenario except for benzo(a)pyrene, which was calculated based on the occasional use scenario. Benzo(a)pyrene was detected above the preliminary action level at CAS 20-05-01; however, it was not identified as a COC because the concentration was below the FAL. As a best management practice and to ensure that future site workers are not exposed to this site contaminant for more than this decision-basis exposure duration, an administrative use restriction was established around the leachfield at CAS 20-05-01. In addition, the removal of the septic tanks and septic tank contents at CASs 03-02-01, 06-02-01, and 20-05-01 was performed.« less

Designing a Hydro-Economic Collaborative Computer Decision Support System: Approaches, Best Practices, Lessons Learned, and Future Trends

NASA Astrophysics Data System (ADS)

Rosenberg, D. E.

2008-12-01

Designing and implementing a hydro-economic computer model to support or facilitate collaborative decision making among multiple stakeholders or users can be challenging and daunting. Collaborative modeling is distinguished and more difficult than non-collaborative efforts because of a large number of users with different backgrounds, disagreement or conflict among stakeholders regarding problem definitions, modeling roles, and analysis methods, plus evolving ideas of model scope and scale and needs for information and analysis as stakeholders interact, use the model, and learn about the underlying water system. This presentation reviews the lifecycle for collaborative model making and identifies some key design decisions that stakeholders and model developers must make to develop robust and trusted, verifiable and transparent, integrated and flexible, and ultimately useful models. It advances some best practices to implement and program these decisions. Among these best practices are 1) modular development of data- aware input, storage, manipulation, results recording and presentation components plus ways to couple and link to other models and tools, 2) explicitly structure both input data and the meta data that describes data sources, who acquired it, gaps, and modifications or translations made to put the data in a form usable by the model, 3) provide in-line documentation on model inputs, assumptions, calculations, and results plus ways for stakeholders to document their own model use and share results with others, and 4) flexibly program with graphical object-oriented properties and elements that allow users or the model maintainers to easily see and modify the spatial, temporal, or analysis scope as the collaborative process moves forward. We draw on examples of these best practices from the existing literature, the author's prior work, and some new applications just underway. The presentation concludes by identifying some future directions for collaborative modeling including geo-spatial display and analysis, real-time operations, and internet-based tools plus the design and programming needed to implement these capabilities.

Incorporating individual health-protective decisions into disease transmission models: a mathematical framework.

PubMed

Durham, David P; Casman, Elizabeth A

2012-03-07

It is anticipated that the next generation of computational epidemic models will simulate both infectious disease transmission and dynamic human behaviour change. Individual agents within a simulation will not only infect one another, but will also have situational awareness and a decision algorithm that enables them to modify their behaviour. This paper develops such a model of behavioural response, presenting a mathematical interpretation of a well-known psychological model of individual decision making, the health belief model, suitable for incorporation within an agent-based disease-transmission model. We formalize the health belief model and demonstrate its application in modelling the prevalence of facemask use observed over the course of the 2003 Hong Kong SARS epidemic, a well-documented example of behaviour change in response to a disease outbreak.

Incorporating individual health-protective decisions into disease transmission models: a mathematical framework

PubMed Central

Durham, David P.; Casman, Elizabeth A.

2012-01-01

It is anticipated that the next generation of computational epidemic models will simulate both infectious disease transmission and dynamic human behaviour change. Individual agents within a simulation will not only infect one another, but will also have situational awareness and a decision algorithm that enables them to modify their behaviour. This paper develops such a model of behavioural response, presenting a mathematical interpretation of a well-known psychological model of individual decision making, the health belief model, suitable for incorporation within an agent-based disease-transmission model. We formalize the health belief model and demonstrate its application in modelling the prevalence of facemask use observed over the course of the 2003 Hong Kong SARS epidemic, a well-documented example of behaviour change in response to a disease outbreak. PMID:21775324

Advanced decision support for winter road maintenance

DOT National Transportation Integrated Search

2008-01-01

This document provides an overview of the Federal Highway Administration's winter Maintenance Decision Support System (MDSS). The MDSS is a decision support tool that has the ability to provide weather predictions focused toward the road surface. The...

An Overview of R in Health Decision Sciences.

PubMed

Jalal, Hawre; Pechlivanoglou, Petros; Krijkamp, Eline; Alarid-Escudero, Fernando; Enns, Eva; Hunink, M G Myriam

2017-10-01

As the complexity of health decision science applications increases, high-level programming languages are increasingly adopted for statistical analyses and numerical computations. These programming languages facilitate sophisticated modeling, model documentation, and analysis reproducibility. Among the high-level programming languages, the statistical programming framework R is gaining increased recognition. R is freely available, cross-platform compatible, and open source. A large community of users who have generated an extensive collection of well-documented packages and functions supports it. These functions facilitate applications of health decision science methodology as well as the visualization and communication of results. Although R's popularity is increasing among health decision scientists, methodological extensions of R in the field of decision analysis remain isolated. The purpose of this article is to provide an overview of existing R functionality that is applicable to the various stages of decision analysis, including model design, input parameter estimation, and analysis of model outputs.

Quality Document Examples (Record of Decision of the Year Contest)

EPA Pesticide Factsheets

This page provides document examples with clear documentation that are consistent with the Superfund Program's policy and regulations. The examples provided here are the winners of the Superfund ROD of the Year Contest (1999-2004)

An Introspective Critique of Past, Present, and Future USGS Decision Support

NASA Astrophysics Data System (ADS)

Neff, B. P.; Pavlick, M.

2017-12-01

In response to increasing scrutiny of publicly funded science, the Water Mission Area of USGS is shifting its approach for informing decisions that affect the country. Historically, USGS has focused on providing sound science on cutting edge, societally relevant issues with the expectation that decision makers will take action on this information. In practice, scientists often do not understand or focus on the needs of decision makers and decision makers often cannot or do not utilize information produced by scientists. The Water Mission Area of USGS has recognized that it can better serve the taxpayer by delivering information more relevant to decision making in a form more conducive to its use. To this end, the Water Mission Area of USGS is seeking greater integration with the decision making process to better inform what information it produces. In addition, recognizing that the transfer of scientific knowledge to decision making is fundamentally a social process, USGS is embracing the use of social science to better inform how it delivers scientific information and facilitates its use. This study utilizes qualitative methods to document the evolution of decision support at USGS and provide a rationale for a shift in direction. Challenges to implementation are identified and collaborative opportunities to improve decision making are discussed.

Communication pitfalls of traditional history and physical write-up documentation

PubMed Central

Brown, Jeffrey L

2017-01-01

Background An unofficial standardized “write-up” outline is commonly used for documenting history and physical examinations, giving oral presentations, and teaching clinical skills. Despite general acceptance, there is an apparent discrepancy between the way clinical encounters are conducted and how they are documented. Methods Fifteen medical school websites were randomly selected from search-engine generated lists. One example of a history and physical write-up from each of six sites, one teaching outline from each of nine additional sites, and recommendations for documentation made in two commonly used textbooks were compared for similarities and differences. Results Except for minor variations in documenting background information, all sampled materials utilized the same standardized format. When the examiners’ early perceptions of the patients’ degree of illness or level of distress were described, they were categorized as “general appearance” within the physical findings. Contrary to clinical practice, none of the examples or recommendations documented these early perceptions before chief concerns and history were presented. Discussion An examiner’s initial perceptions of a patient’s affect, degree of illness, and level of distress can influence the content of the history, triage decisions, and prioritization of likely diagnoses. When chief concerns and history are shared without benefit of this information, erroneous assumptions and miscommunications can result. Conclusion This survey confirms common use of a standardized outline for documenting, communicating, and teaching history-taking and physical examination protocol. The present outline shares early observations out of clinical sequence and may provide inadequate context for accurate interpretation of chief concerns and history. Corrective actions include modifying the documentation sequence to conform to clinical practice and teaching contextual methodology for sharing patient information. PMID:28096709

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

Zining, Jin, E-mail: jinzn@pkusz.edu.cn

The article explores the practices of Environmental Impact Assessment (EIA) Law in China's courts by examining 107 judicial decisions. Each of the 107 judicial decisions has been analyzed to determine the time/location of the decision, what type of EIA document was referred to, what specific claim was made by the plaintiffs, and what the court's ruling was on the case. The results indicate that: unlike in Germany or Japan, all kinds of EIA decisions made by environment protect bureaus (EPBs) in China were widely taken as justiciable, and China's courts generally allowed local residents to have standing and thus challengemore » the EPBs' decisions made during the EIA process. On the other hand, the research also shows the EPBs overwhelmingly prevailed in those EIA lawsuits. It is also found that China's reviewing judges were highly self-restrained, giving obvious deference to the technocrat with the substantial contents of EIA documents. Also, the concept of “flaw” was created when it came to procedural issues. These two factors, among others, were both helping the EPBs' prevailing successes. - Highlights: • 107 judicial decisions referring to China's EIA law are examined. • The justiciability of EPB's EIA decisions were taken for granted. • The defenders overwhelmingly prevailed in those EIA lawsuits. • The reviewing judges were highly self-restrained, defering to the technocrat with the EIA documents. • A functional concept, “flaw”, was created by reviewing judges when it came to procedural issues.« less

The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

PubMed

Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

2016-09-01

Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

Human Judgment and Decision Making: Models and Applications.

ERIC Educational Resources Information Center

Loke, Wing Hong

This document notes that researchers study the processes involved in judgment and decision making and prescribe theories and models that reflect the behavior of the decision makers. It addresses the various models that are used to represent judgment and decision making, with particular interest in models that more accurately represent human…

Stereotype threat affects financial decision making.

PubMed

Carr, Priyanka B; Steele, Claude M

2010-10-01

The research presented in this article provides the first evidence that one's decision making can be influenced by concerns about stereotypes and the devaluation of one's identity. Many studies document gender differences in decision making, and often attribute these differences to innate and stable factors, such as biological and hormonal differences. In three studies, we found that stereotype threat affected decision making and led to gender differences in loss-aversion and risk-aversion behaviors. In Study 1, women subjected to stereotype threat in academic and business settings were more loss averse than both men and women who were not facing the threat of being viewed in light of negative stereotypes. We found no gender differences in loss-aversion behavior in the absence of stereotype threat. In Studies 2a and 2b, we found the same pattern of effects for risk-aversion behavior that we had observed for loss-aversion behavior. In addition, in Study 2b, ego depletion mediated the effects of stereotype threat on women's decision making. These results suggest that individuals' decision making can be influenced by stereotype concerns.

Superfund record of decision amendment (EPA Region 5): Arrowhead Refinery Company, Hermantown, MN, February 9, 1994

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

NONE

This decision document amends the selected remedial action for the Arrowhead Refinery Superfund Site (Arrowhead). This AROD does not make `fundamental changes` to the groundwater remedy selected in the ROD. Therefore, this AROD does not constitute an amendment of the groundwater remedy. However, this AROD does document minor differences in the groundwater remedy which the Agency intends to implement.

Reconstructing the Prostate Cancer Transcriptional Regulatory Network

DTIC Science & Technology

2010-07-01

the Medical Scientist Training Program. The funders had no role in study design , data collection and analysis , decision to publish, or preparation of...reverse analysis , building a cell line subtype classifier to classify 86 breast tumors (from the original Stanford/Norway study defining the five tumor...Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public

25 CFR 162.588 - What happens if BIA does not meet a deadline for issuing a decision on a lease document?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false What happens if BIA does not meet a deadline for issuing a decision on a lease document? 162.588 Section 162.588 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Lease...

25 CFR 162.588 - What happens if BIA does not meet a deadline for issuing a decision on a lease document?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false What happens if BIA does not meet a deadline for issuing a decision on a lease document? 162.588 Section 162.588 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Lease...

10 CFR 95.37 - Classification and preparation of documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... classification decisions. (c) Markings required on face of documents. (1) For derivative classification of... to a document must be placed in a conspicuous fashion in letters at the top and bottom of the outside... on the face of the document: Reproduction or Further Dissemination Requires Approval of If any...

10 CFR 95.37 - Classification and preparation of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... classification decisions. (c) Markings required on face of documents. (1) For derivative classification of... to a document must be placed in a conspicuous fashion in letters at the top and bottom of the outside... on the face of the document: Reproduction or Further Dissemination Requires Approval of If any...

Pedagogical Documentation as a Lens for Examining Equality in Early Childhood Education

ERIC Educational Resources Information Center

Paananen, Maiju; Lipponen, Lasse

2018-01-01

In this paper, we consider pedagogical quality particularly as equal opportunities for participating in decision-making in preschool. Relying on Ferraris' [2013. "Documentality: Why it is necessary to leave traces." New York: Fordham University Press] theory of Documentality, we demonstrate how pedagogical documentation can contribute to…

Measuring Non-Market Values for Hydropower Production and Water Storage on the Colorado River: A White Paper Investigation

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

Lowry, Thomas Stephen; Chermak, Janie M.; Brookshire, David S.

This study presents a conceptual framework for capturing the spatial and temporal aspects of non-market dimensions of value (DOV) and how they vary as the result of policy changes for hydropower generation and developed water uses. The foundation of this project is a literature review that reveals that focused, sector specific valuations are no longer adequate if the goal is to provide decision makers with a complete understanding of their decisions. Rather, estimates of non-market values for informing decisions regarding dam operations and/or other water management alternatives must consider the entire spectrum of market and non-market values, and the tradeoffsmore » (both positive and negative) between those values over time and space, while considering shifting preferences in an uncertain environment. This document describes the history and reasoning for these conclusions and presents a conceptual framework for understanding non-market values as a function of changes to hydropower operations and water resources management.« less

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

Screening Algorithm to Guide Decisions on Whether to Conduct a Health Impact Assessment

EPA Pesticide Factsheets

Provides a visual aid in the form of a decision algorithm that helps guide discussions about whether to proceed with an HIA. The algorithm can help structure, standardize, and document the decision process.

Superfund record of decision (EPA Region 4): Alabama Army Ammunition Plant, Area B soils operable unit, Childersburg, AL, November 14, 1995

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

NONE

1996-03-01

This decision document presents the selected remedial action for the contaminated soils and sediments in Study Areas, 6, 7, and 21, and the Industrial Sewer System (ISS) in Study Areas 6, 7, and 10 within Area B at the Alabama Army Ammunition Plant (ALAAP), Childersburg, Alabama. The Area B Soils Operable Unit addresses the principal threats from soils and sediments in Study Areas 6, 7, and 21, and underground industrial sewer lines in Study Areas 6, 7, and 10. The soils and sediments and the industrial sewer lines are contaminated with explosives and lead.

Superfund record of decision (EPA Region 4): Paducah Gaseous Diffusion Plant (USDOE), Operable Unit 15, Paducah, KY, August 10, 1998

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

NONE

1998-12-01

This decision document presents the remedial action for the Solid Waste Management Unit (SWMU) 91 of the Waste Area Group (WAG) 27 at the Paducah Gaseous Diffusion Plant (PGDP) near Paducah, Kentucky. The primary objective of this remedial action is to reduce the level of TCE-contaminated soil thereby reducing the potential future concentrations in ground water that could pose a threat to human health and the environment at the POE (i.e., the DOE property boundary). The potential for migration of the contamination from the soil of the off-site aquifer is the concern associated with the SWMU.

Planning documents: a business planning strategy.

PubMed

Kaehrle, P A

2000-06-01

Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

Do People Experience Cognitive Biases while Searching for Information?

PubMed Central

Lau, Annie Y.S.; Coiera, Enrico W.

2007-01-01

Objective To test whether individuals experience cognitive biases whilst searching using information retrieval systems. Biases investigated are anchoring, order, exposure and reinforcement. Design A retrospective analysis and a prospective experiment were conducted to investigate whether cognitive biases affect the way that documentary evidence is interpreted while searching online. The retrospective analysis was conducted on the search and decision behaviors of 75 clinicians (44 doctors, 31 nurses), answering questions for 8 clinical scenarios within 80 minutes in a controlled setting. The prospective study was conducted on 227 undergraduate students, who used the same search engine to answer two of six randomly assigned consumer health questions. Measurements Frequencies of correct answers pre- and post- search, and confidence in answers were collected. The impact of reading a document on the final decision was measured by the population likelihood ratio (LR) of the frequency of reading the document and the frequency of obtaining a correct answer. Documents with a LR > 1 were most likely to be associated with a correct answer, and those with a LR < 1 were most likely to be associated with an incorrect answer to a question. Agreement between a subject and the evidence they read was estimated by a concurrence rate, which measured the frequency that subjects’ answers agreed with the likelihood ratios of a group of documents, normalized for document order, time exposure or reinforcement through repeated access. Serial position curves were plotted for the relationship between subjects’ pre-search confidence, document order, the number of times and length of time a document was accessed, and concurrence with post-search answers. Chi-square analyses tested for the presence of biases, and the Kolmogorov-Smirnov test checked for equality of distribution of evidence in the comparison populations. Results A person’s prior belief (anchoring) has a significant impact on their post-search answer (retrospective: P < 0.001; prospective: P < 0.001). Documents accessed at different positions in a search session (order effect [retrospective: P = 0.76; prospective: P = 0.026]), and documents processed for different lengths of time (exposure effect [retrospective: P = 0.27; prospective: P = 0.0081]) also influenced decision post-search more than expected in the prospective experiment but not in the retrospective analysis. Reinforcement through repeated exposure to a document did not yield statistical differences in decision outcome post-search (retrospective: P = 0.31; prospective: P = 0.81). Conclusion People may experience anchoring, exposure and order biases while searching for information, and these biases may influence the quality of decision making during and after the use of information retrieval systems. PMID:17600097

Applying language technology to nursing documents: pros and cons with a focus on ethics.

PubMed

Suominen, Hanna; Lehtikunnas, Tuija; Back, Barbro; Karsten, Helena; Salakoski, Tapio; Salanterä, Sanna

2007-10-01

The present study discusses ethics in building and using applications based on natural language processing in electronic nursing documentation. Specifically, we first focus on the question of how patient confidentiality can be ensured in developing language technology for the nursing documentation domain. Then, we identify and theoretically analyze the ethical outcomes which arise when using natural language processing to support clinical judgement and decision-making. In total, we put forward and justify 10 claims related to ethics in applying language technology to nursing documents. A review of recent scientific articles related to ethics in electronic patient records or in the utilization of large databases was conducted. Then, the results were compared with ethical guidelines for nurses and the Finnish legislation covering health care and processing of personal data. Finally, the practical experiences of the authors in applying the methods of natural language processing to nursing documents were appended. Patient records supplemented with natural language processing capabilities may help nurses give better, more efficient and more individualized care for their patients. In addition, language technology may facilitate patients' possibility to receive truthful information about their health and improve the nature of narratives. Because of these benefits, research about the use of language technology in narratives should be encouraged. In contrast, privacy-sensitive health care documentation brings specific ethical concerns and difficulties to the natural language processing of nursing documents. Therefore, when developing natural language processing tools, patient confidentiality must be ensured. While using the tools, health care personnel should always be responsible for the clinical judgement and decision-making. One should also consider that the use of language technology in nursing narratives may threaten patients' rights by using documentation collected for other purposes. Applying language technology to nursing documents may, on the one hand, contribute to the quality of care, but, on the other hand, threaten patient confidentiality. As an overall conclusion, natural language processing of nursing documents holds the promise of great benefits if the potential risks are taken into consideration.

An Electronic Nursing Patient Care Plan Helps in Clinical Decision Support.

PubMed

Wong, C M; Wu, S Y; Ting, W H; Ho, K H; Tong, L H; Cheung, N T

2015-01-01

Information technology can help to improve health care delivery. The utilisation of informatics principle enhances the quality of nursing practices through improved communication, documentation and efficiency. The Nursing Profession constitutes 34% of the total workforce in the Hong Kong Hospital Authority (HA) and includes 21,000 nurses in 2012. To enhance the quality of care and patient safety in both hospitals and community care setting, it is essential that an integrated electronic decision support system for nurses is designed to track documentation and support care or service including observations, decisions, actions and outcomes throughout the care process at each point-of-care. The Patient Care Plan project was set up to achieve these objectives. The Project adheres to strict documentation information architecture to ensure data sharing is freely available. Preliminary results showed very promising improvement in clinical care.

Corrective Action Decision Document/Corrective Action Plan for Corrective Action Unit 97: Yucca Flat/Climax Mine Nevada National Security Site, Nevada, Revision 1

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

Farnham, Irene

This corrective action decision document (CADD)/corrective action plan (CAP) has been prepared for Corrective Action Unit (CAU) 97, Yucca Flat/Climax Mine, Nevada National Security Site (NNSS), Nevada. The Yucca Flat/Climax Mine CAU is located in the northeastern portion of the NNSS and comprises 720 corrective action sites. A total of 747 underground nuclear detonations took place within this CAU between 1957 and 1992 and resulted in the release of radionuclides (RNs) in the subsurface in the vicinity of the test cavities. The CADD portion describes the Yucca Flat/Climax Mine CAU data-collection and modeling activities completed during the corrective action investigationmore » (CAI) stage, presents the corrective action objectives, and describes the actions recommended to meet the objectives. The CAP portion describes the corrective action implementation plan. The CAP presents CAU regulatory boundary objectives and initial use-restriction boundaries identified and negotiated by DOE and the Nevada Division of Environmental Protection (NDEP). The CAP also presents the model evaluation process designed to build confidence that the groundwater flow and contaminant transport modeling results can be used for the regulatory decisions required for CAU closure. The UGTA strategy assumes that active remediation of subsurface RN contamination is not feasible with current technology. As a result, the corrective action is based on a combination of characterization and modeling studies, monitoring, and institutional controls. The strategy is implemented through a four-stage approach that comprises the following: (1) corrective action investigation plan (CAIP), (2) CAI, (3) CADD/CAP, and (4) closure report (CR) stages.« less

Reduced use of occult bacteremia blood screens by emergency medicine physicians using immunization registry for children presenting with fever without a source.

PubMed

Zeretzke, Cristina M; McIntosh, Mark S; Kalynych, Colleen J; Wylie, Todd; Lott, Michelle; Wood, David

2012-07-01

This study examined whether utilization of the Florida State Health Online Tracking System (SHOTS) immunization registry to determine Haemophilus influenzae type B and heptavalent pneumococcal conjugate (PCV7) vaccine status impacts the protocolized decision to perform a screening blood draw for occult bacteremia (OB) in young children. A convenience sample of children 6 to 24 months of age presenting to the pediatric emergency department with fever of greater than 39°C without a source was enrolled. Physicians were trained to use the SHOTS immunization registry and reviewed the emergency department's fever protocol. A "preregistry" workup plan was documented for each patient based on clinical history, immunization status before accessing SHOTS, and physical examination. A "postregistry" workup plan was then documented based on the SHOTS record. Demographic and registry data were recorded. Preregistry workup plans indicated OB screening blood draws for 100% (n = 91; 95% confidence interval [CI], 96-100) of patients with unconfirmed immunization status. Of those 91 children, 58% (n = 53; 95% CI, 55-61) were documented in SHOTS as having received their primary conjugate vaccine series at ages 2, 4, and 6 months. Registry access reduced the percentage of screening blood draws from 100% (n = 91) to 42% (n = 38; 95% CI, 37-53; P < 0.001). The state immunization registry is an adjunctive tool to caregiver recall, which can be used by emergency medicine practitioners to confirm completion of the primary conjugate vaccine series before making the decision to perform blood screens for OB in children aged 6 to 24 months who present with fever without a source.

Responding to Nonwords in the Lexical Decision Task: Insights from the English Lexicon Project

PubMed Central

Yap, Melvin J.; Sibley, Daragh E.; Balota, David A.; Ratcliff, Roger; Rueckl, Jay

2014-01-01

Researchers have extensively documented how various statistical properties of words (e.g., word-frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, since a better specification of the mechanisms driving nonword responses may provide valuable insights into early lexical processes. In the present study, item-level and participant-level analyses were conducted on the trial-level lexical decision data for almost 37,000 nonwords in the English Lexicon Project in order to identify the influence of different psycholinguistic variables on nonword lexical decision performance, and to explore individual differences in how participants respond to nonwords. Item-level regression analyses reveal that nonword response time was positively correlated with number of letters, number of orthographic neighbors, number of affixes, and baseword number of syllables, and negatively correlated with Levenshtein orthographic distance and baseword frequency. Participant-level analyses also point to within- and between-session stability in nonword responses across distinct sets of items, and intriguingly reveal that higher vocabulary knowledge is associated with less sensitivity to some dimensions (e.g., number of letters) but more sensitivity to others (e.g., baseword frequency). The present findings provide well-specified and interesting new constraints for informing models of word recognition and lexical decision. PMID:25329078

Design for Life. Abortion. A Student's Lesson Plan [and] A Teacher's Lesson Plan [and] A Lawyer's Lesson Plan.

ERIC Educational Resources Information Center

Howard, Estelle; And Others

One of a series of secondary level teaching units presenting case studies with pro and con analyses of particular legal problems, the document consists of a student's lesson plan, a teacher's lesson plan, and a lawyer's lesson plan for a unit on abortion. The lessons are designed to expose students to the Supreme Court's decision concerning…

Differences in Presenting Advance Directives in the Chart, in the Minimum Data Set, and through the Staffs Perceptions

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Libin, Alexander; Lipson, Steven

2003-01-01

Purpose: Decisions concerning end-of-life care depend on information contained in advance directives that are documented in residents' charts in the nursing home. The availability of that information depends on the quality of the chart and on the location of the information in the chart. No research was found that compared directives by the manner…

Development Goals and Strategies for Children in the 1990s. A UNICEF Policy Review. Executive Board Decision 1990-2.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

This document presents proposals for goals and strategies for children and development in the 1990s that were approved by the UNICEF Executive Board in April, 1990. The paper proposes that developing human capabilities and meeting basic human needs should be the focus of the UNICEF contribution to the fourth United Nations developmental decade.…

Alternatives Generation and Analysis for Heat Removal from High Level Waste Tanks

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

WILLIS, W.L.

This document addresses the preferred combination of design and operational configurations to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. An interim decision for the preferred method to remove the heat from the high-level waste tanks during waste feed delivery operations is presented herein.

Preliminary design data package, appendix C. [hybrid electric vehicles

NASA Technical Reports Server (NTRS)

1979-01-01

The data and documentation required to define the preliminary design of a near term hybrid vehicle and to quantify its operational characteristics are presented together with the assumptions and rationale behind the design decisions. Aspects discussed include development requirements for the propulsion system, the chassis system, the body, and the vehicle systems. Particular emphasis is given to the controls, the heat engine, and the batteries.

Analysis of Stakeholder-Defined Needs in Northeast U.S. Coastal Communities to Determine Gaps in Research Informing Coastal Resilience Planning

NASA Astrophysics Data System (ADS)

Molino, G. D.; Kenney, M. A.; Sutton-Grier, A.; Penn, K.

2017-12-01

The impacts of climate change on our coastlines are increasing pressure on communities, ecosystems, infrastructure, and state-to-local economies in the northeastern United States (U.S.). As a result of current or imminent risk of acute and chronic hazards, local, state and regional entities have taken steps to identify and address vulnerabilities to climate change. Decisions to increase coastal infrastructure resilience and grey, green, and cultural infrastructure solutions requires physical, natural, and social science that is useful for decision-making and effective science translation mechanisms. Despite the desire to conduct or fund science that meets the needs of communities, there has been no comprehensive analysis to determine stakeholder-defined research needs. To address this gap, this study conducts a stakeholder needs analysis in northeast U.S. coastal communities to determine gaps in information and translation processes supporting coastal resilience planning. Documents were sourced from local, state, and regional organizations in both the public and private sectors, using the northeast region defined by the third National Climate Assessment. Modeled after Dilling et al. (2015), a deductive coding schema was developed that categorized documents using specific search terms such as "Location and condition of infrastructure" and "Proactive planning". A qualitative document analysis was then executed using NVivo to formally identify patterns and themes present in stakeholder surveys, workshop proceedings, and reports. Initial stakeholder priorities centered around incorporation of climate science into planning and decision making regarding vulnerabilities of infrastructure, enhanced emergency planning and response, and communication of key information.

Developing an Advanced Environment for Collaborative Computing

NASA Technical Reports Server (NTRS)

Becerra-Fernandez, Irma; Stewart, Helen; DelAlto, Martha; DelAlto, Martha; Knight, Chris

1999-01-01

Knowledge management in general tries to organize and make available important know-how, whenever and where ever is needed. Today, organizations rely on decision-makers to produce "mission critical" decisions that am based on inputs from multiple domains. The ideal decision-maker has a profound understanding of specific domains that influence the decision-making process coupled with the experience that allows them to act quickly and decisively on the information. In addition, learning companies benefit by not repeating costly mistakes, and by reducing time-to-market in Research & Development projects. Group-decision making tools can help companies make better decisions by capturing the knowledge from groups of experts. Furthermore, companies that capture their customers preferences can improve their customer service, which translates to larger profits. Therefore collaborative computing provides a common communication space, improves sharing of knowledge, provides a mechanism for real-time feedback on the tasks being performed, helps to optimize processes, and results in a centralized knowledge warehouse. This paper presents the research directions. of a project which seeks to augment an advanced collaborative web-based environment called Postdoc, with workflow capabilities. Postdoc is a "government-off-the-shelf" document management software developed at NASA-Ames Research Center (ARC).

28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., written orders, and decisions. 68.3 Section 68.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED... DOCUMENT FRAUD § 68.3 Service of complaint, notice of hearing, written orders, and decisions. (a) Service of complaint, notice of hearing, written orders, and decisions shall be made by the Office of the...

28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., written orders, and decisions. 68.3 Section 68.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED... DOCUMENT FRAUD § 68.3 Service of complaint, notice of hearing, written orders, and decisions. (a) Service of complaint, notice of hearing, written orders, and decisions shall be made by the Office of the...

28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., written orders, and decisions. 68.3 Section 68.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED... DOCUMENT FRAUD § 68.3 Service of complaint, notice of hearing, written orders, and decisions. (a) Service of complaint, notice of hearing, written orders, and decisions shall be made by the Office of the...

28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., written orders, and decisions. 68.3 Section 68.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED... DOCUMENT FRAUD § 68.3 Service of complaint, notice of hearing, written orders, and decisions. (a) Service of complaint, notice of hearing, written orders, and decisions shall be made by the Office of the...

Surface transportation weather decision support requirements : operational concept description : advanced-integrated decision support using weather information for surface transportation decisions makers : draft version 2.0

DOT National Transportation Integrated Search

2000-07-14

This is a draft document for the Surface Transportation Weather Decision Support Requirements (STWDSR) project. The STWDSR project is being conducted for the FHWAs Office of Transportation Operations (HOTO) Road Weather Management Program by Mitre...

8 CFR 103.9 - Availability of decisions and interpretive material under the Freedom of Information Act.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Availability of decisions and interpretive... of decisions and interpretive material under the Freedom of Information Act. (a) Precedent decisions. There may be purchased from the Superintendent of Documents, U.S. Government Printing Office, Washington...

Installation Restoration Program Decision Document. Site 15. Alpena Combat Readiness Training Center, Michigan Air National Guard, Alpena County Regional Airport, Alpena, Michigan.

DTIC Science & Technology

1996-05-01

This Decision Document (DD) supports the no further action alternative for Site 15 - Oiled Roads at the Alpena Combat Readiness Training Center (CRTC...in Alpena , Michigan. The purpose of the DD is to summarize the existing data for the site and describe the Air National Guard’s rational for selecting the no further action alternative.

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.

25 CFR 162.569 - Will BIA require an appeal bond for an appeal of a decision on a WSR lease document?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Will BIA require an appeal bond for an appeal of a decision on a WSR lease document? 162.569 Section 162.569 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Lease Approval § 162...

25 CFR 162.569 - Will BIA require an appeal bond for an appeal of a decision on a WSR lease document?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Will BIA require an appeal bond for an appeal of a decision on a WSR lease document? 162.569 Section 162.569 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Lease Approval § 162...

Reconstructing the Prostate Cancer Transcriptional Regulatory Network

DTIC Science & Technology

2010-09-01

funders had no role in study design , data collection and analysis , decision to publish, or preparation of the manuscript. Competing Interests: The authors...basal-like or ERBB2 tumors (despite that none were ERBB2-positive). We also carried out the reverse analysis , building a cell line subtype classifier to...Department of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No

Mental Health Nursing, Mechanical Restraint Measures and Patients’ Legal Rights

PubMed Central

Birkeland, Soren; Gildberg, Frederik A.

2016-01-01

Coercive mechanical restraint (MR) in psychiatry constitutes the perhaps most extensive exception from the common health law requirement for involving patients in health care decisions and achieving their informed consent prior to treatment. Coercive measures and particularly MR seriously collide with patient autonomy principles, pose a particular challenge to psychiatric patients’ legal rights, and put intensified demands on health professional performance. Legal rights principles require rationale for coercive measure use be thoroughly considered and rigorously documented. This article presents an in-principle Danish Psychiatric Complaint Board decision concerning MR use initiated by untrained staff. The case illustrates that, judicially, weight must be put on the patient perspective on course of happenings and especially when health professional documentation is scant, patients’ rights call for taking notice of patient evaluations. Consequently, if it comes out that psychiatric staff failed to pay appropriate consideration for the patient’s mental state, perspective, and expressions, patient response deviations are to be judicially interpreted in this light potentially rendering MR use illegitimated. While specification of law criteria might possibly improve law use and promote patients’ rights, education of psychiatry professionals must address the need for, as far as possible, paying due regard to meeting patient perspectives and participation principles as well as formal law and documentation requirements. PMID:27123152

36 CFR 1010.4 - NEPA Compliance Coordinator.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Develop procedures within the Trust's planning and decision-making processes to ensure that environmental... and documentation of the environmental aspects of the Trust's planning and decision-making processes... decisions of the NEPA Compliance Coordinator in accordance with the Trust's regulations and procedures. (b...

Gold Run Pass - Div. of Mining, Land, and Water

Science.gov Websites

issuing a Final Findings of Fact and Decision for the renewal of the Gold Run Pass Mine permits. Documents : Final Findings and Decision(PDF)(Posted 9/2/2016) Public Notice of Final Findings and Decision (PDF

Comparison of not for resuscitation (NFR) forms across five Victorian health services.

PubMed

Levinson, M; Mills, A; Hutchinson, A M; Heriot, G; Stephenson, G; Gellie, A

2014-07-01

Within Australian hospitals, cardiac and respiratory arrests result in a resuscitation attempt unless the patient is documented as not for resuscitation. To examine the consistency of policies and documentation for withholding in-hospital resuscitation across health services. An observational, qualitative review of hospital policy and documentation was conducted in June 2013 in three public and two private sector hospitals in metropolitan Melbourne. Not for resuscitation (NFR) forms were evaluated for physical characteristics, content, authorisation and decision-making. Hospital policies were coded for alerts, definition of futility and burden of treatment and management of discussions and dissent. There was a lack of standardisation, with each site using its own unique NFR form and accompanying site-specific policies. Differences were found in who could authorise the decision, what was included on the form, the role of patients and families, and how discussions were managed and dissent resolved. Futility and burden of treatment were not defined independently. These inconsistencies across sites contribute to a lack of clarity regarding the decision to withhold resuscitation, and have implications for staff employed across multiple hospitals. NFR forms should be reviewed and standardised so as to be clear, uniform and consistent with the legislative framework. We propose a two-stage process of documentation. Stage 1 facilitates discussion of patient-specific goals of care and consideration of limitations of treatment. Stage 2 serves to communicate a NFR order. Decisions to withhold resuscitation are inherently complex but could be aided by separating the decision-making process from the communication of the decision, resulting in improved end-of-life care. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Superfund record of decision (EPA Region 3): William Dick Lagoons, West Caln Township, Chester County, PA, March 1993

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

Not Available

1993-03-31

This decision document presents the selected remedial action for Operable Unit 3 of the William Dick Lagoons Site (Site), in West Caln Township, Pennsylvania. The remedy described in this Record of Decision is for Operable Unit 3 at the Site. The remedy selected for Operable Unit 3 will reduce the concentrations of hazardous substances in the Site soils so that leaching of contaminants into the groundwater will be minimized. Reduction of the volatile organic compounds and semi-volatile organic compounds in the soils is necessary in order the groundwater will not continue to be impacted above acceptable levels. In addition, themore » installation of a vegetative soil cover or multi-layer cap will prevent the surrounding community from exposure to Site-related contaminants through inhalation, ingestion, and dermal contact.« less

Key Decision Record Creation and Approval Module

NASA Technical Reports Server (NTRS)

Hebert, Barrt; Messer, Elizabeth A.; Albasini, Colby; Le, Thang; ORourke, William, Sr.; Stiglets, Tim; Strain, Ted

2012-01-01

Retaining good key decision records is critical to ensuring the success of a project or operation. Having adequately documented decisions with supporting documents and rationale can greatly reduce the amount of rework or reinvention over a project's, vehicle's, or facility's lifecycle. Stennis Space Center developed and uses a software tool that automates the Key Decision Record (KDR) process for its engineering and test projects. It provides the ability for a user to log key decisions that are made during the course of a project. By customizing Parametric Technology Corporation's (PTC) Windchill product, the team was able to log all information about a decision, and electronically route that information for approval. Customizing the Windchill product allowed the team to directly connect these decisions to the engineering data that it might affect and notify data owners of the decision. The user interface was created in JSP and Javascript, within the OOTB (Out of the Box) Windchill product, allowing users to create KDRs. Not only does this interface allow users to create and track KDRs, but it also plugs directly into the OOTB ability to associate these decision records with other relevant engineering data such as drawings, designs, models, requirements, or specifications

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

PubMed Central

2013-01-01

In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids. PMID:24624947

LEEDS Decision Tools for E-Craft

DTIC Science & Technology

2011-02-15

currently valid 0MB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 15-Feb-2011 2. REPORT TYPE Final... RIT has received no feedback regarding which system monitoring would be most beneficial to MSB. TASKS 1. Decision support research Data/analysis...project, a Project Initiation Document (PID) was written by RIT and submitted to MSB for its approval. This document is attached in Appendix A. It

Self-Aligned, Extremely High Frequency III-V Metal-Oxide-Semiconductor Field-Effect Transistors on Rigid and Flexible Substrates

DTIC Science & Technology

2012-06-29

resistances, respectively, and gd is the output conductance. The reduced parasitic capacitances and resistances provided by the self-aligned T-gate design ...Department of the Army position, policy or decision, unless so designated by other documentation. 12. DISTRIBUTION AVAILIBILITY STATEMENT Approved for...position, policy or decision, unless so designated by other documentation. Approved for public release; distribution is unlimited. ... 59654.5-MS-DRP Self

Terahertz Photovoltaic Detection of Cyclotron Resonance in the Regime of Radiation-Induced Magnetoresistance Oscillations

DTIC Science & Technology

2013-06-17

should not contrued as an official Department of the Army position, policy or decision, unless so designated by other documentation. 9. SPONSORING...construed as an official Department of the Army position, policy or decision, unless so designated by other documentation. ... PHYSICAL REVIEW B 87, 245308...oscillations in the diagonal magnetoresistance, Rxx , of the 2DES at cryogenic temperatures, T , with oscillatory nodes near integral and half- integral

Rise and Fall of Decentralized School Governance--Decision-Making Practices in Georgia

ERIC Educational Resources Information Center

Gorgodze, Sophia

2016-01-01

The current study investigates educational decision-making in the former Soviet Republic of Georgia. The focus is on decisions concerning issues of school governance decentralization/recentralization in the period of 2003-2012. The research draws on in-depth interviews with over 20 top decision-makers, and an extensive review of legal documents,…

43 CFR 46.20 - How to use this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

....4501505.2 (b) The Responsible Official will ensure that the decision making process for proposals subject to this part includes appropriate NEPA review. (c) During the decision making process for each... the relevant environmental document. The Responsible Official's decision may combine elements of...

36 CFR 228.102 - Leasing analyses and decisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... decisions. 228.102 Section 228.102 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE MINERALS Oil and Gas Resources Leasing § 228.102 Leasing analyses and decisions. (a) Compliance... further planning in Executive Communication 1504, Ninety-Sixth Congress (House Document No. 96-119...

24 CFR 55.27 - Documentation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FLOODPLAIN MANAGEMENT Procedures for Making Determinations on Floodplain Management § 55.27 Documentation. (a... outside the floodplain, but within the local housing market area, the local public utility service area..., documentation of compliance with this part must be included as a part of the record of decision (or...

Physician as partner or salesman? Shared decision-making in real-time encounters.

PubMed

Karnieli-Miller, Orit; Eisikovits, Zvi

2009-07-01

The results of recent research have led to the increased advocacy of shared decision-making regarding medical treatment. Nonetheless, only a limited number of studies have focused on the process of decision-making in real-time encounters. The present paper aims to document and analyze this process. Specifically, we assess whether these decisions are the result of partnership or of persuasive tactics based on power and hierarchical relationships. We will describe and analyze different strategies used by pediatric gastroenterologists in breaking bad news encounters, as well as their consequences. The analysis is based on a multi-method, multi-participant phenomenological study on breaking bad news to adolescents and their families regarding a chronic illness. It included 17 units of analysis (actual encounters and 52 interviews with physicians, parents and adolescents). Data were collected from three hospitals in Northern Israel using observations and audiotapes of diagnosis disclosure encounters and audio-taped interviews with all participants. The analysis identified eight different presentation tactics used in actual encounters during which physicians made various use of language, syntax and different sources of power to persuade patients to agree with their preferred treatment choice. The tactics included various ways of presenting the illness, treatment and side effects; providing examples from other success or failure stories; sharing the decision only concerning technicalities; and using plurals and authority. The findings suggest that shared decision-making may be advocated as a philosophical tenet or a value, but it is not necessarily implemented in actual communication with patients. Rather, treatment decisions tend to be unilaterally made, and a variety of persuasive approaches are used to ensure agreement with the physician's recommendation. The discussion is focused on the complexity of sharing a decision, especially in the initial bad news encounter; and the potentially harmful implications on building a trusting relationship between the physician and the family when a decision is not shared.

Informed consent: not just for procedures anymore.

PubMed

Feld, Andrew D

2004-06-01

The ethical and legal requirement to obtain informed consent prior to performing a procedure or administering a treatment derives from the concept of personal (patient) autonomy. The competent patient, after receiving appropriate disclosure of the material risks of the procedure or treatment, understanding those risks, the benefits, and the alternative approaches, makes a voluntary and uncoerced informed decision to proceed. This article will present a general overview of the modern concept of informed consent as a process (mutual communication) rather than an event (document signing). The historical evolution of this concept and the legal rulings that have shaped the requirements of informed consent will be cited. The benefits of informed decision making as a communication and risk management tool are presented. This review is intended as general information, and not as legal advice, which should be sought from a health-care attorney.

Using Perilog to Explore "Decision Making at NASA"

NASA Technical Reports Server (NTRS)

McGreevy, Michael W.

2005-01-01

Perilog, a context intensive text mining system, is used as a discovery tool to explore topics and concerns in "Decision Making at NASA," chapter 6 of the Columbia Accident Investigation Board (CAIB) Report, Volume I. Two examples illustrate how Perilog can be used to discover highly significant safety-related information in the text without prior knowledge of the contents of the document. A third example illustrates how "if-then" statements found by Perilog can be used in logical analysis of decision making. In addition, in order to serve as a guide for future work, the technical details of preparing a PDF document for input to Perilog are included in an appendix.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada, Revision 1

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

Matthews, Patrick

2014-01-01

The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that no further corrective action is needed for CAU 105 based on the implementation of the corrective actions. Corrective action investigation (CAI) activities were performed from October 22, 2012, through May 23, 2013, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices.

Proceedings of the Second Joint Technology Workshop on Neural Networks and Fuzzy Logic, volume 2

NASA Technical Reports Server (NTRS)

Lea, Robert N. (Editor); Villarreal, James A. (Editor)

1991-01-01

Documented here are papers presented at the Neural Networks and Fuzzy Logic Workshop sponsored by NASA and the University of Texas, Houston. Topics addressed included adaptive systems, learning algorithms, network architectures, vision, robotics, neurobiological connections, speech recognition and synthesis, fuzzy set theory and application, control and dynamics processing, space applications, fuzzy logic and neural network computers, approximate reasoning, and multiobject decision making.

Genetic Networks Activated by Blast Injury to the Eye

DTIC Science & Technology

2013-08-01

SUPPLEMENTARY NOTES 14. ABSTRACT Purpose: The present research project is designed to define the overall change in gene expression in the eye...Memphis TN, 38163 REPORT DATE: August 2013 TYPE OF REPORT: Annual Summary PREPARED FOR: U.S. Army Medical Research and Materiel Command...author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation

Decision Making: An Imperative for Language Learning; Highlights of the Annual Language Arts Conference of Memphis State University (7th, Memphis, June 12-14, 1974).

ERIC Educational Resources Information Center

Rakes, Thomas A., Ed.; Brotherton, Sophia, Ed.

This document presents nine papers which were originally prepared for the 1974 Annual Language Arts Conference at Memphis State University. Included are: "Proxemics" by Dale F. Baltus; "Reading and Study Skill Hints for Intermediate and Secondary Teachers" by Stuart W. Bray; "A Reading Game License" by Flora C. Fowler; "Teach Kids to Think" by…

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…

Village of Arlington Heights et al. v. Metropolitan Housing Development Corp. et al. Certiorari to the United States Court of Appeals for the Seventh Circuit. Syllabus.

ERIC Educational Resources Information Center

Supreme Court of the U. S., Washington, DC.

This document presents the Supreme Court decision in the law suit between the Village of Arlington Heights, Illinois, and the Metropolitan Housing Development Corporation (MHDC). MHDC, a nonprofit developer contracted to purchase a tract within the boundaries of the Village of Arlington Heights, Illinois in order to build racially integrated low…

World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia.

PubMed

Santesso, Nancy; Schünemann, Holger; Blumenthal, Paul; De Vuyst, Hugo; Gage, Julia; Garcia, Francisco; Jeronimo, Jose; Lu, Ricky; Luciani, Silvana; Quek, Swee C; Awad, Tahany; Broutet, Nathalie

2012-08-01

In 2008, cervical cancer was responsible for 275000 deaths, of which approximately 88% occurred in low- and middle-income countries. In 2009, the World Health Organization (WHO) committed to updating recommendations for use of cryotherapy for cervical intraepithelial neoplasia (CIN). We followed the WHO Handbook for Guidelines Development to develop present guidelines. An expert panel was established, which included clinicians, researchers, program directors, and methodologists. An independent group conducted systematic reviews and produced evidence summaries following the GRADE approach. GRADE evidence profiles were created for 16 key questions about the effects of cryotherapy in the presence of histologically confirmed CIN compared with no treatment and with loop electrosurgical excision procedure, as well as the use of different cryotherapy techniques. We identified a small number of randomized controlled trials or independently controlled observational studies. Surrogate outcomes were reported when evidence about outcomes critical to decision making were not available. The panel made 14 recommendations and documented factors that determined the strength and direction of the recommendations in decision tables. The present document summarizes new evidence-based WHO recommendations about the use of cryotherapy in women with histologically confirmed CIN for low-, middle-, and high-income countries. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

EPA superfund Records of Decision (RODs) for region 3: New Jersey, New York, Puerto Rico, and Virgin Islands. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 7: Iowa, Kansas, Missouri, and Nebraska. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 3: Delaware, Washington DC, Maryland, Pennsylvania, and Virginia. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 1: Connecticut, Maine, Massachussetts, New Hampshire, Rhode Island, and Vermont

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 3: Delaware, Washington DC, Maryland, Pennsylvania, and Virginia

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 1: Connecticut, Maine, Massachussetts, New Hampshire, Rhode Island, and Vermont. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA superfund Records of Decision (RODs) for region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming. Irregular report

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

NONE

1998-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 2: New Jersey, New York, Puerto Rico, and Virgin Islands

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

EPA Superfund Records of Decision (RODs) for Region 9: Arizona, California, Hawaii, Nevada, American Samoa, and Guam

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

NONE

1999-03-01

The purpose of an EPA Record of Decision is to evaluate a Superfund Site with the goal of protecting human health and the environment while ensuring consistency of evaluations in contamination and clean-up of all Superfund sites. The ROD is a public document signed by the appropriate Regional Administrator which details cleanup, cost estimates, and EPA`s responsiveness to the public comment summary. The ROD may be litigated, thus it is important to have all current updates to the signed EPA decision. The ROD may be amended with an Amendment or supplemented by an Explanation of Significant Difference (ESD). A Superfundmore » Site may have multiple RODs, as each Superfund Site may be further redefined as Operable Units and Events. This allows EPA`s decisions to evolve as new technology presents itself. Average clean-up time for a Superfund Site can range from 12 to 100 years.« less

Progressive Learning of Topic Modeling Parameters: A Visual Analytics Framework.

PubMed

El-Assady, Mennatallah; Sevastjanova, Rita; Sperrle, Fabian; Keim, Daniel; Collins, Christopher

2018-01-01

Topic modeling algorithms are widely used to analyze the thematic composition of text corpora but remain difficult to interpret and adjust. Addressing these limitations, we present a modular visual analytics framework, tackling the understandability and adaptability of topic models through a user-driven reinforcement learning process which does not require a deep understanding of the underlying topic modeling algorithms. Given a document corpus, our approach initializes two algorithm configurations based on a parameter space analysis that enhances document separability. We abstract the model complexity in an interactive visual workspace for exploring the automatic matching results of two models, investigating topic summaries, analyzing parameter distributions, and reviewing documents. The main contribution of our work is an iterative decision-making technique in which users provide a document-based relevance feedback that allows the framework to converge to a user-endorsed topic distribution. We also report feedback from a two-stage study which shows that our technique results in topic model quality improvements on two independent measures.

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... decision-making process. Because of the diversity of FEMA, it is not feasible to describe in this part the... shall provide further guidance, commensurate with their programs and organization, for integration of... the decision. Rather it is a concise document that sets forth the decision and describes the...

75 FR 1615 - Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-12

... DEPARTMENT OF ENERGY Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition...-Level Waste and Facilities Disposition Final Environmental Impact Statement. This document corrects an... Record of Decision: Idaho High-Level Waste and Facilities [[Page 1616

Environmental services coupled to food products and brands: food companies interests and on-farm accounting.

PubMed

Kempa, Daniela

2013-09-01

Much research has been carried out on governmental support of agri environmental measures (AEM). However, little is known about demands on and incentives from the commercial market for environmental contributions of the farmers. The factors farm structures, level of remuneration and legal framework have been thoroughly investigated. However, demands of the food industry for environmentally friendly goods(1) and their effects on farmers' decisions have not yet been analyzed. Leading companies in the food industry have observed an increasing consumer awareness and, due to higher competition, see an additional need to communicate environmental benefits which result from either organic production methods or agri-environmental measures. To address this research deficit, two case studies were carried out. The first case study is a survey aimed at the industrial food producers' demands with regards to the environmental performance of supplying farms. Concurrently, within a second survey farmers were questioned to find out what conditions are required to implement agri-environmental measures beyond cross compliance and document their environmental performance. This article presents the outcomes of the first case study. The results show that food companies have an interest in the documentation of environmental benefits of supplying farms for their marketing strategies. Provision of support by finance or contract-design is also seen as appropriate tool to promote an environmentally friendly production. In turn the food producers' demand and support for documented environmental services can have a positive influence on farmers' decisions for implementation and documentation of these services. Thus, the surveys provide essential findings for further development of documentation strategies for environmental benefits within the supply chain. Copyright © 2012 Elsevier Ltd. All rights reserved.

Negotiating the Digital Library: Document Delivery.

ERIC Educational Resources Information Center

Jacobs, Neil; Morris, Anne

1999-01-01

The eLib-funded FIDDO (Focused Investigation of Document Delivery Options) project provides library managers/others with information to support policy decisions. Senior libraries were interviewed about the future of document delivery and interviews were analyzed with the support of NUD*IST (Nonnumerical Unstructured Data by Indexing, Searching and…

[Involving patients, the insured and the general public in healthcare decision making].

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2016-01-01

No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria. Copyright © 2015. Published by Elsevier GmbH.

From Narratives to Numbers: Data Work and Patient-Generated Health Data in Consultations.

PubMed

Lindroth, Tomas; Islind, Anna Sigridur; Steineck, Gunnar; Lundin, Johan

2018-01-01

This article presents preliminary findings on how the introduction of patient-generated health data (PGHD) triggers changes during patient-nurse consultations. This article builds on a two-year case study, examining the work practice at a cancer rehabilitation clinic at a Swedish Hospital using PGHD. The study focuses on how nurses' use data, gathered by patients with a mobile phone app, during consultations. The use of PGHD introduce a change in the translation work, the work of turning rich patient descriptions and transform them into data, during the consultation for documentation and clinical decision-making. This change affects precision, questions asked and the use of visualizations as well as the patient-nurse decision making.

Web-based document and content management with off-the-shelf software

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

Schuster, J

1999-03-18

This, then, is the current status of the project: Since we made the switch to Intradoc, we are now treating the project as a document and image management system. In reality, it could be considered a document and content management system since we can manage almost any file input to the system such as video or audio. At present, however, we are concentrating on images. As mentioned above, my CRADA funding was only targeted at including thumbnails of images in Intradoc. We still had to modify Intradoc so that it would compress images submitted to the system. All processing ofmore » files submitted to Intradoc is handled in what is called the Document Refinery. Even though MrSID created thumbnails in the process of compressing an image, work needed to be done to somehow build this capability into the Document Refinery. Therefore we made the decision to contract the Intradoc Engineering Team to perform this custom development work. To make Intradoc even more capable of handling images, we have also contracted for customization of the Document Refinery to accept Adobe PhotoShop and Illustrator file in their native format.« less

43 CFR 30.101 - What definitions do I need to know?

Code of Federal Regulations, 2010 CFR

2010-10-01

....S.C. 450f or 458cc. Attorney decision maker (ADM) means an attorney with OHA who conducts a summary proceeding and renders a decision that is subject to de novo review by an administrative law judge or Indian... person who is deceased. Decision or order (or decision and order) means: (1) A written document issued by...

The effects of the application of SIMPRO on the completeness and time efficiency of nursing documentation in the outpatient instalation at Dompet Dhuafa Hospital Parung

NASA Astrophysics Data System (ADS)

Dwisatyadini, M.; Hariyati, R. T. S.; Afifah, E.

2018-03-01

Nursing documentation is clinical information that has a vital role in nursing services. The nursing process includes assessment, diagnosis, intervention, implementation, and evaluation. The purpose of this study was to determine the effects of the application of SIMPRO on the completeness and the efficiency of nursing documentation in the outpatient installation at Dompet Dhuafa Hospital Parung. This study used quantitative method with pre experimental (pre and posttest without control group) design. The mean of the documentation completeness marks before the application of SIMPRO was 1.87 (SD 0.922), and after SIMPRO was applied increased to 3.61 (0.588). This increase indicated an improvement of the nursing documentation completeness after the implementation of SIMPRO. The mean of time needed by nurses in documenting the nursing care before the application of SIMPRO was 476.13 seconds (SD 78.896). The mean of documenting time decreased more than a half after the application of SIMPRO which was 202.52 seconds (SD 196.723). SIMPRO made a nurse easier to take a decision analysis and decision support system to nursing care plan and documentation.

Incentivizing shared decision making in the USA--where are we now?

PubMed

Durand, Marie-Anne; Barr, Paul J; Walsh, Thom; Elwyn, Glyn

2015-06-01

The Affordable Care Act raised significant interest in the process of shared decision making, the role of patient decision aids, and incentivizing their utilization. However, it has not been clear how best to put incentives into practice, and how the implementation of shared decision making and the use of patient decision aids would be measured. Our goal was to review developments and proposals put forward. We performed a qualitative document analysis following a pragmatic search of Medline, Google, Google Scholar, Business Source Complete (Ebscohost), and LexisNexis from 2009-2013 using the following key words: "Patient Protection and Affordable Care Act", "Decision Making", "Affordable Care Act", "Shared Decision Making", "measurement", "incentives", and "payment." We observed a lack of clarity about how to measure shared decision making, about how best to reward the use of patient decisions aids, and therefore how best to incentivize the process. Many documents clearly imply that providing and disseminating patient decision aids might be equivalent to shared decision making. However, there is little evidence that these tools, when used by patients in advance of clinical encounters, lead to significant change in patient-provider communication. The assessment of shared decision making for performance management remains challenging. Efforts to incentivize shared decision making are at risk of being limited to the promotion of patient decision aids, passing over the opportunity to influence the communication processes between patients and providers. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 4345 - A Method To Assess Climate-Relevant Decisions: Application in the Chesapeake Bay

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9257-2] A Method To Assess Climate-Relevant Decisions... external peer review workshop to review the external review draft document titled, ``A Method to Assess.../peerreview/register-chesapeake.htm . The draft ``A Method to Assess Climate-Relevant Decisions: Application...

7 CFR 283.10 - Consent decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Consent decision. 283.10 Section 283.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... of the document. Such decision shall be final and shall take effect 30 days after the date of the...

7 CFR 283.10 - Consent decision.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Consent decision. 283.10 Section 283.10 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... of the document. Such decision shall be final and shall take effect 30 days after the date of the...

32 CFR 651.26 - Record of decision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Record of decision. 651.26 Section 651.26 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Records and Documents § 651.26 Record of decision. The Record...

77 FR 4319 - Notification of Two Public Teleconferences of the Science Advisory Board Ecological Processes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

..., ``Integrating Ecological Assessment and Decision-Making at EPA, 2011 RAF Ecological Assessment Action Plan... the EPA Risk Assessment Forum (RAF) document, ``Integrating Ecological Assessment and Decision-Making... Ecological Risk Assessment in Environmental Decision-Making'' (EPA-SAB-08-002), the EPA Risk Assessment Forum...

43 CFR 4.201 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... means a person who is deceased. Decision or order (or decision and order) means: (1) A written document issued by a judge making determinations as to heirs, wills, devisees, and the claims of creditors, and ordering distribution of trust or restricted land or trust personalty; (2) The decision issued by an...

32 CFR 989.11 - Combining EIAP with other documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation. (a) The EPF combines environmental analysis with other related documentation when practicable (40 CFR 1506.4) following the procedures prescribed by the CEQ regulations and this part. (b) The EPF must... the EIAP. Prior to making a decision to proceed, the EPF must analyze the environmental impacts that...

Predicting Document Retrieval System Performance: An Expected Precision Measure.

ERIC Educational Resources Information Center

Losee, Robert M., Jr.

1987-01-01

Describes an expected precision (EP) measure designed to predict document retrieval performance. Highlights include decision theoretic models; precision and recall as measures of system performance; EP graphs; relevance feedback; and computing the retrieval status value of a document for two models, the Binary Independent Model and the Two Poisson…

End-of-life decisions in Dutch neonatal intensive care units.

PubMed

Verhagen, A A Eduard; Dorscheidt, Jozef H H M; Engels, Bernadette; Hubben, Joep H; Sauer, Pieter J

2009-10-01

To clarify the practice of end-of-life decision making in severely ill newborns. Retrospective descriptive study with face-to-face interviews. The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006. All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths. Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions. An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants. Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed.

An Internationally Consented Standard for Nursing Process-Clinical Decision Support Systems in Electronic Health Records.

PubMed

Müller-Staub, Maria; de Graaf-Waar, Helen; Paans, Wolter

2016-11-01

Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.

An HL7-CDA wrapper for facilitating semantic interoperability to rule-based Clinical Decision Support Systems.

PubMed

Sáez, Carlos; Bresó, Adrián; Vicente, Javier; Robles, Montserrat; García-Gómez, Juan Miguel

2013-03-01

The success of Clinical Decision Support Systems (CDSS) greatly depends on its capability of being integrated in Health Information Systems (HIS). Several proposals have been published up to date to permit CDSS gathering patient data from HIS. Some base the CDSS data input on the HL7 reference model, however, they are tailored to specific CDSS or clinical guidelines technologies, or do not focus on standardizing the CDSS resultant knowledge. We propose a solution for facilitating semantic interoperability to rule-based CDSS focusing on standardized input and output documents conforming an HL7-CDA wrapper. We define the HL7-CDA restrictions in a HL7-CDA implementation guide. Patient data and rule inference results are mapped respectively to and from the CDSS by means of a binding method based on an XML binding file. As an independent clinical document, the results of a CDSS can present clinical and legal validity. The proposed solution is being applied in a CDSS for providing patient-specific recommendations for the care management of outpatients with diabetes mellitus. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Large resource development projects as markets for passive solar technologies. Final report

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

Roze-Benson, R V

1980-12-01

A basic premise of this study is that large resource development projects provide a major market opportunity for passive solar manufactured buildings. The primary objectives of the work are to document selected resource development projects and identify their potential housing needs and development schedules, to contact resource industry representatives and assess some of the processes and motivations behind their involvement in housing decisions, and to provide passive solar manufactured buildings producers with results of these steps as early initial market intelligence. The intent is to identify not only the industries, location of their planned projects, and their likely worker housingmore » needs, but also the individuals involved in making housing-related decisions. The 56 identified projects are located within 18 states and cover 11 types of resources. The report documents individual projects, provides protections of total worker-related housing needs, and presents overviews of resource development company involvement in the new construction market. In addition, the report profiles three organizations that expressed a strong interest in implementing the use of low-cost passive solar manufactured buildings in resource-development-related activities.« less

Assessing Contractor Capabilities for Streamlined Site Investigations

EPA Pesticide Factsheets

The purpose of this document is to familiarize and encourage brownfields decision makers to investigate and employ innovative methods for characterizing their sites, to assist brownfields decision makers in assessing contractors' capabilities.

IHE cross-enterprise document sharing for imaging: design challenges

NASA Astrophysics Data System (ADS)

Noumeir, Rita

2006-03-01

Integrating the Healthcare Enterprise (IHE) has recently published a new integration profile for sharing documents between multiple enterprises. The Cross-Enterprise Document Sharing Integration Profile (XDS) lays the basic framework for deploying regional and national Electronic Health Record (EHR). This profile proposes an architecture based on a central Registry that holds metadata information describing published Documents residing in one or multiple Documents Repositories. As medical images constitute important information of the patient health record, it is logical to extend the XDS Integration Profile to include images. However, including images in the EHR presents many challenges. The complete image set is very large; it is useful for radiologists and other specialists such as surgeons and orthopedists. The imaging report, on the other hand, is widely needed and its broad accessibility is vital for achieving optimal patient care. Moreover, a subset of relevant images may also be of wide interest along with the report. Therefore, IHE recently published a new integration profile for sharing images and imaging reports between multiple enterprises. This new profile, the Cross-Enterprise Document Sharing for Imaging (XDS-I), is based on the XDS architecture. The XDS-I integration solution that is published as part of the IHE Technical Framework is the result of an extensive investigation effort of several design solutions. This paper presents and discusses the design challenges and the rationales behind the design decisions of the IHE XDS-I Integration Profile, for a better understanding and appreciation of the final published solution.

Responding to nonwords in the lexical decision task: Insights from the English Lexicon Project.

PubMed

Yap, Melvin J; Sibley, Daragh E; Balota, David A; Ratcliff, Roger; Rueckl, Jay

2015-05-01

Researchers have extensively documented how various statistical properties of words (e.g., word frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, because a better specification of the mechanisms driving nonword responses may provide valuable insights into early lexical processes. In the present study, item-level and participant-level analyses were conducted on the trial-level lexical decision data for almost 37,000 nonwords in the English Lexicon Project in order to identify the influence of different psycholinguistic variables on nonword lexical decision performance and to explore individual differences in how participants respond to nonwords. Item-level regression analyses reveal that nonword response time was positively correlated with number of letters, number of orthographic neighbors, number of affixes, and base-word number of syllables, and negatively correlated with Levenshtein orthographic distance and base-word frequency. Participant-level analyses also point to within- and between-session stability in nonword responses across distinct sets of items, and intriguingly reveal that higher vocabulary knowledge is associated with less sensitivity to some dimensions (e.g., number of letters) but more sensitivity to others (e.g., base-word frequency). The present findings provide well-specified and interesting new constraints for informing models of word recognition and lexical decision. (c) 2015 APA, all rights reserved).

Addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 529: Area 25 Contaminated Materials, Nevada Test Site, Nevada, Revision 1

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

Krauss, Mark J

This document constitutes an addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 529: Area 25 Contaminated Materials, Nevada Test Site, Nevada as described in the document Recommendations and Justifications To Remove Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office Federal Facility Agreement and Consent Order dated September 2013. The Use Restriction (UR) Removal document was approved by the Nevada Division of Environmental Protection on October 16, 2013. The approval of the UR Removal document constituted approval of each of the recommended UR removals. In conformance with the URmore » Removal document, this addendum consists of: This page that refers the reader to the UR Removal document for additional information The cover, title, and signature pages of the UR Removal document The NDEP approval letter The corresponding section of the UR Removal document This addendum provides the documentation justifying the cancellation of the UR for CAS 25-23-17, Contaminated Wash (Parcel H). This UR was established as part of FFACO corrective actions and was based on the presence of total petroleum hydrocarbon diesel-range organics contamination at concentrations greater than the NDEP action level at the time of the initial investigation.« less

Public health privatization: proponents, registers, and decision-makers.

PubMed

Keane, Christopher; Marx, John; Ricci, Edmund

2002-01-01

We previously documented the extent and consequences of the privatization of public health, using a nationally representative sample of 347 Local Health Department (LHD) directors. Here we present the directors' descriptions of the actors involved in the privatization of services. LHD top administrators are the most influential privatization decision-makers in about half of LHDs. But other groups significantly influence privatization decisions, particularly state governments, state health departments, and local officials. Nearly two thirds of LHDs experienced pressures to privatize, either from state legislatures, state health departments, funding organizations, or other source of political pressure. Almost half of LHD directors reported resistance to privatization, often from employees. The majority of directors did not believe it was desirable to put employees on a temporary, contractual basis. Many directors believed that retaining permanent, full-time employees was fairer as well as necessary to maintain a cadre of experienced public health professionals.

An Overview of NASA's Program of Future M&S VV&A Outreach and Training Activities

NASA Technical Reports Server (NTRS)

Caine, Lisa; Hale, Joseph P.

2006-01-01

NASA's Exploration Systems Mission Directorate (ESMD) is implementing a management approach for modeling and simulation (M&S) that will provide decision-makers information on the model s fidelity, credibility, and quality. The Integrated Modeling & Simulation Verification, Validation and Accreditation (IM&S W&A) process will allow the decision-maker to understand the risks involved in using a model s results for mission-critical decisions. The W&A Technical Working Group (W&A TWG) has been identified to communicate this process throughout the agency. As the W&A experts, the W&A NVG will be the central resource for support of W&A policy, procedures, training and templates for documentation. This presentation will discuss the W&A Technical Working Group s outreach approach aimed at educating M&S program managers, developers, users and proponents on the W&A process, beginning at MSFC with the CLV program.

Detecting and reacting to change: the effect of exposure to narrow categorizations.

PubMed

Chakravarti, Amitav; Fang, Christina; Shapira, Zur

2011-11-01

The ability to detect a change, to accurately assess the magnitude of the change, and to react to that change in a commensurate fashion are of critical importance in many decision domains. Thus, it is important to understand the factors that systematically affect people's reactions to change. In this article we document a novel effect: decision makers' reactions to a change (e.g., a visual change, a technology change) were systematically affected by the type of categorizations they encountered in an unrelated prior task (e.g., the response categories associated with a survey question). We found that prior exposure to narrow, as opposed to broad, categorizations improved decision makers' ability to detect change and led to stronger reactions to a given change. These differential reactions occurred because the prior categorizations, even though unrelated, altered the extent to which the subsequently presented change was perceived as either a relatively large change or a relatively small one.

Superfund Record of Decision (EPA Region 3): Buckingham County Landfill Superfund Site, VA, September 1994

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

Not Available

1994-10-01

The Record of Decision (ROD) presents the final remedial action selected for the Buckingham County Landfill Superfund Site (Site), located near the town of Sprouse's Corner in Buckingham County, Virginia. The remedial action was chosen in accordance with the requirements of the Comprehensive Environmental Response Compensation and Liability Act of 1980 (CERCLA), 42 U.S.C. Section 9601 et. seg., as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), and the National Oil and Hazardous Substances Pollution Contingency Plan (NCP), 40 C.F.R. Part 300. The decision document explains the factual and legal basis for selecting the remedial action. Themore » selected remedy includes the two following options, both of which are fully protective of human health and the environment: Monitor the ground water and cap the hazardous waste disposal area; and Implement the source control measures.« less

Superfund record of decision (EPA Region 9): Aircraft Control and Warning Site, Mather Air Force Base, CA, December 1993

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

Not Available

This decision document, a Record of Decision (ROD), presents the selected remedial action for the AC W Site, Installation Restoration Program (IRP) Site 12, at Mather Air Force Base (AFB), Sacramento County, California. Reports indicate that from 1958 to 1966 waste solvents and transformer oils were disposed in a waste disposal pipe in the AC W area. Investigations conducted as part of the Air Force Installation Restoration Program (IRP) failed to locate the waste disposal pipe but did find trichloroethylene (TCE) contamination in the shallow water bearing zone (SWBZ) in the AC W area. The SWBZ is classified as amore » potential source of drinking water by the State of California, although it is not currently used in the AC W area. The selected remedy will address the potential threat to human health posed by TCE contamination in groundwater (primarily in the SWBZ).« less

Sequential Probability Ratio Test for Spacecraft Collision Avoidance Maneuver Decisions

NASA Technical Reports Server (NTRS)

Carpenter, J. Russell; Markley, F. Landis

2013-01-01

A document discusses sequential probability ratio tests that explicitly allow decision-makers to incorporate false alarm and missed detection risks, and are potentially less sensitive to modeling errors than a procedure that relies solely on a probability of collision threshold. Recent work on constrained Kalman filtering has suggested an approach to formulating such a test for collision avoidance maneuver decisions: a filter bank with two norm-inequality-constrained epoch-state extended Kalman filters. One filter models the null hypotheses that the miss distance is inside the combined hard body radius at the predicted time of closest approach, and one filter models the alternative hypothesis. The epoch-state filter developed for this method explicitly accounts for any process noise present in the system. The method appears to work well using a realistic example based on an upcoming, highly elliptical orbit formation flying mission.

Addendum to the Corrective Action Decision Document/Closure Report for Corrective Action Unit 406: Area 3 Building 03-74 & Building 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 & Area 9 Building 09-52 Underground Discharge Points, Tonopah Test Range, Nevada, Revision 0

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

Lynn Kidman

This document constitutes an addendum to the March 2000, Corrective Action Decision Document / Closure Report for Corrective Action Unit 406: Area 3 Building 03-74 & 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 & Area 9 Building 09-52 Underground Discharge Points (TTR) as described in the document Recommendations and Justifications for Modifications for Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office Federal Facility Agreement and Consent Order (UR Modification document) dated February 2008. The UR Modification document was approved by NDEP on February 26, 2008. Themore » approval of the UR Modification document constituted approval of each of the recommended UR modifications. In conformance with the UR Modification document, this addendum consists of: • This cover page that refers the reader to the UR Modification document for additional information • The cover and signature pages of the UR Modification document • The NDEP approval letter • The corresponding section of the UR Modification document This addendum provides the documentation justifying the cancellation of the UR for CAS 03-51-001-0355 – Photo Shop UDP, Drains in CAU 429. It should be noted that there are no changes to CAU 406. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996; as amended August 2006). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006c). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004f). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Multispectral Photogrammetric Data Acquisition and Processing Forwall Paintings Studies

NASA Astrophysics Data System (ADS)

Pamart, A.; Guillon, O.; Faraci, S.; Gattet, E.; Genevois, M.; Vallet, J. M.; De Luca, L.

2017-02-01

In the field of wall paintings studies different imaging techniques are commonly used for the documentation and the decision making in term of conservation and restoration. There is nowadays some challenging issues to merge scientific imaging techniques in a multimodal context (i.e. multi-sensors, multi-dimensions, multi-spectral and multi-temporal approaches). For decades those CH objects has been widely documented with Technical Photography (TP) which gives precious information to understand or retrieve the painting layouts and history. More recently there is an increasing demand of the use of digital photogrammetry in order to provide, as one of the possible output, an orthophotomosaic which brings a possibility for metrical quantification of conservators/restorators observations and actions planning. This paper presents some ongoing experimentations of the LabCom MAP-CICRP relying on the assumption that those techniques can be merged through a common pipeline to share their own benefits and create a more complete documentation.

Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

PubMed

Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-04-09

For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95% CI -0.5, -0.15, p < 0.001, very low-quality evidence). Structured communication tools may improve documentation of EOL decision making and may result in lower resource use. The supporting evidence is low to very low in quality. Further high-quality randomized studies of simple communication interventions are needed to determine whether structured, rather than ad hoc, approaches to end-of-life decision-making improve patient-level, family-level, and system-level outcomes. PROSPERO CRD42014012913.

Automatic extraction of numeric strings in unconstrained handwritten document images

NASA Astrophysics Data System (ADS)

Haji, M. Mehdi; Bui, Tien D.; Suen, Ching Y.

2011-01-01

Numeric strings such as identification numbers carry vital pieces of information in documents. In this paper, we present a novel algorithm for automatic extraction of numeric strings in unconstrained handwritten document images. The algorithm has two main phases: pruning and verification. In the pruning phase, the algorithm first performs a new segment-merge procedure on each text line, and then using a new regularity measure, it prunes all sequences of characters that are unlikely to be numeric strings. The segment-merge procedure is composed of two modules: a new explicit character segmentation algorithm which is based on analysis of skeletal graphs and a merging algorithm which is based on graph partitioning. All the candidate sequences that pass the pruning phase are sent to a recognition-based verification phase for the final decision. The recognition is based on a coarse-to-fine approach using probabilistic RBF networks. We developed our algorithm for the processing of real-world documents where letters and digits may be connected or broken in a document. The effectiveness of the proposed approach is shown by extensive experiments done on a real-world database of 607 documents which contains handwritten, machine-printed and mixed documents with different types of layouts and levels of noise.

Inert Reassessment Document for PEG Fatty Acid Esters

EPA Pesticide Factsheets

The tolerance reassessment decision document and action memorandum for the PEG fatty acid ester date September 28, 2005, included two tolerance exemptions (under 40 CFR 180.910 and $) CFR 180.930, respectively)

TransGuide : model deployment initiative design report

DOT National Transportation Integrated Search

1998-09-01

This report documents the high-level design of the TransGuide MDI project and discusses the design trade-off decisions. A detailed, specific project level design is provided in each projects System Design document.

Thoracic multidisciplinary tumor board routinely impacts therapeutic plans in patients with lung and esophageal cancer: a prospective cohort study.

PubMed

Schmidt, Henner M; Roberts, John M; Bodnar, Artur M; Kunz, Sonia; Kirtland, Steven H; Koehler, Richard P; Hubka, Michal; Low, Donald E

2015-05-01

National and subspecialty guidelines for lung and esophageal cancers recommend treatment decisions to be made in a multidisciplinary tumor board (MTB). This study prospectively analyzes the actual impact of presentation at the thoracic tumor board on decision making in thoracic cancer cases. During the electronic submission process for presentation at MTB managing physicians documented their current treatment plan. The initial treatment plan was compared with the MTB final recommendation. Patient demographics, physician's proposed treatment plan, MTB recommendation, and documentation of application of MTB recommendations were prospectively recorded in an Institutional Review Board approved database. Between June 2010 and December 2012, 185 patients with esophageal and 294 patients with lung cancer were presented at the MTB. One hundred sixty-six patients were presented on more than 1 occasion, resulting in 724 assessments of 479 patients. In 48 esophageal cancer patients (26%) and 118 lung cancer patients (40%) MTB recommendations differed from the initial treatment plan. Overall, a differing MTB recommendation from the primary treatment plan occurred in 330 of 724 case presentations (46%). The MTB recommendations changed treatment plans in 40% and staging and assessment plans in 60% of patients. Follow-up in a cohort of 249 patients confirmed that MTB recommendations were followed in 97% of cases. This study validates the impact of the thoracic MTB. Recommendations will differ from the managing providers' initial plan in 26% to 40% of cases. However, MTB recommendations can be successfully initiated in the majority of patients. Complex thoracic cancer patients will benefit from multidisciplinary review and should ideally be presented at tumor board. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A written consent form dating back to 1524 in Bursa Ser'iye (Sharia Court) records and a proposal of a new start date for consent forms.

PubMed

Sayligil, Omur; Ozden, Hilmi

2014-01-01

Qadi registers are important documents for Ottoman medical history re.search. "Sharia Court Records (Ser'iyye Sicilleri)" are notebooks that include the records that qadis kept with regard to their decisions and deeds. These registers are the only authentic sources from which to acquire information on rural life, away from the center of the town, and to understand the daily practices of the Ottoman society. The objective of this study is to provide evidence for the fact that the concept of informed consent on medical interventions, and hence the written consent documents arranged between patients and physicians, dates back to older times in our history when compared to the Western world. A large number of Ser'iyye (Sharia Court) record originals have been surveyed. The consent form registered as A-40. 221a in Ser'iyye (Sharia Court) Records found in Bursa has been presented here as the earliest consent document found by the authors. Transcription of the original document has been performed and analyzed. The aforementioned consent form dates back to 26/Dhu al-Qi'dah/933 (August 24, 1524). The original version of the referenced consent document is the earliest consent document presented so far to the best of the authors' knowledge; it was found in Bursa Ser'iyye Records and evaluated accordingly. Based on the document, it is argued that the history of consent forms dates back about 500 years. Obtaining consent in scientific research from human beings was considered to have originated from the Nuremberg Code (1949). However, with this study, it has been shown that the concept of informed consent was already present in the Ottoman Period, during the 16th century, and that the original consent document dates back to 1524, pertaining to a surgical intervention.

Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

PubMed

Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

2017-11-17

The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints were found to play an important role. Some of those aspects seem modifiable, which offers possibilities for the reorganization of MDTMs.

CORRRECTIVE ACTION DECISION DOCUMENT FOR CORRECTIVE ACTION UNIT 427: AREA 3 SEPTIC WASTE SYSTEMS 2 AND 6, TONOPAH TEST RANGE, NEVADA, REVISION 0, JUNE 1998

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

ITLV.

1998-06-01

This Corrective Action Decision Document has been prepared for the Area 3 Septic Waste Systems 2 and 6 (Corrective Action Unit 427) in accordance with the Federal Facility Agreement and Consent Order of 1996 (FFACO, 1996). Corrective Action Unit 427 is located at the Tonopah Test Range, Nevada, and is comprised of the following Corrective Action Sites, each an individual septic waste system (DOE/NV, 1996a): Septic Waste System 2 is Corrective Action Site Number 03-05-002-SW02. Septic Waste System 6 is Corrective Action Site Number 03-05-002-SW06. The purpose of this Corrective Action Decision Document is to identify and provide a rationalemore » for the selection of a recommended corrective action alternative for each Corrective Action Site. The scope of this Correction Action Decision Document consists of the following tasks: Develop corrective action objectives. Identify corrective action alternative screening criteria. Develop corrective action alternatives. Perform detailed and comparative evaluations of the corrective action alternatives in relation to the corrective action objectives and screening criteria. Recommend and justify a preferred corrective action alternative for each CAS. From November 1997 through January 1998, a corrective action investigation was performed as set forth in the Corrective Action Investigation Plan for Corrective Action Unit No. 427: Area 3 Septic Waste System Numbers 2 and 6, Tonopah Test Range, Nevada (DOE/NV, 1997b). Details can be found in Appendix A of this document. The results indicated that contamination is present in some portions of the CAU and not in others as described in Table ES-1 and shown in Figure A.2-2 of Appendix A. Based on the potential exposure pathways, the following corrective action objectives have been identified for Corrective Action Unit 427: Prevent or mitigate human exposure to subsurface soils containing TPH at concentrations greater than 100 milligrams per kilogram (NAC, 1996b). Close Septic Tank 33-5 in accordance with Nevada Administrative Code 459 (NAC, 1996c). Prevent adverse impacts to groundwater quality. Based on the review of existing data, future land use, and current operations at the Tonopah Test Range, the following alternatives were developed for consideration at the Area 3 Septic Waste Systems 2 and 6: Alternative 1 - No Further Action Alternative 2 - Closure of Septic Tank 33-5 and Administrative Controls Alternative 3 - Closure of Septic Tank 33-5, Excavation, and Disposal The corrective action alternatives were evaluated based on four general corrective action standards and five remedy selection decision factors. Based on the results of this evaluation, the preferred alternative for Corrective Action Unit 427 is Alternative 2, Closure of Septic Tank 33-5 and Administrative Controls. The preferred corrective action alternative was evaluated on technical merit, focusing on performance, reliability, feasibility, and safety. The alternative was judged to meet all requirements for the technical components evaluated. The alternative meets all applicable state and federal regulations for closure of the site and will reduce potential future exposure pathways to the contaminated soils. During corrective action implementation, this alternative will present minimal potential threat to site workers who come in contact with the waste. However, procedures will be developed and implemented to ensure worker health and safety.« less

Statement of Mark R. Disler, Deputy Assistant Attorney General, Civil Rights Division, before the Committee on Labor and Human Resources, United States Senate, Concerning Grove City Legislation.

ERIC Educational Resources Information Center

Disler, Mark R.

Testimony concerning the Supreme Court decisions in the case of Grove City College v. Bell (1984) is presented in this document. The Courts ruling that Federal aid to a student constitutes funding only of the college's student air program, nor the entire institution, reflected the more persuasive reading of the Title IX Education Amendments,…

[The Glivec® case: the first example of a global debate on the drug patent system].

PubMed

Moital, Inês; Bosch, Fèlix; Farré, Magí; Maddaleno, Mariano; Baños, Josep-E

2014-01-01

To describe the sequence of events involving the Glivec® case in India and to analyze the opinions generated in distinct settings. We performed a systematic search for articles concerning the imatinib (Glivec®) patent in India. We selected those sources that described the events, decisions of the authorities involved, and press and scientific opinions. Dates and arguments presented by the involved parties were clearly identified. Of 886 documents initially obtained, we selected 40 documents published between 2003 and 2013. Most of them were press news and commentaries. The process lasted 7 years, starting in 2006 when the Indian Patent Office rejected the patent application filed by Novartis. It ended in 2013 when the Indian Supreme Court upheld this decision. It was argued that the Indian Patent Law would facilitate access to medicines in the Third World and the final decision has received support by the general population. Although the court's final decision has been supported by several institutions, an objective analysis should also take into account the arguments of the pharmaceutical companies and other entities. The Glivec® case gave rise to an intense debate on the appropriateness of international standards on patents, their applicability and how they should be adopted in each country. This case, as well as other cases, should serve to stimulate reflection on the international patent system and to achieve scenarios in which the health of the poorest populations is protected but also balanced against intellectual property protection and innovation. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

PubMed

Leong, James; Walker, Stuart; Salek, Sam

2015-01-01

The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards. A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR) Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA). The BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders. The use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

Scientific literacy for democratic decision-making

NASA Astrophysics Data System (ADS)

Yacoubian, Hagop A.

2018-02-01

Scientifically literate citizens must be able to engage in making decisions on science-based social issues. In this paper, I start by showing examples of science curricula and policy documents that capitalise the importance of engaging future citizens in decision-making processes whether at the personal or at the societal levels. I elucidate the ideological underpinnings behind a number of the statements within those documents that have defined the trajectory of scientific literacy and have shaped what ought to be considered as personal and societal benefits. I argue that science curricula and policy documents can truly endorse scientific literacy when they embed principles of democratic education at their core. The latter entails fostering learning experiences where some of the underlying assumptions and political ideologies are brought to the conscious level and future citizens encouraged to reflect upon them critically and explicitly. Such a proposal empowers the future citizens to engage in critical deliberation on science-based social issues without taking the underlying status quo for granted. I end up the paper by situating the preparation of scientifically literate citizens within a framework of democratic education, discuss conditions through which a curriculum for scientific literacy can serve democratic decision-making processes, and provide modest recommendations.

75 FR 53298 - A Method to Assess Climate-Relevant Decisions: Application in the Chesapeake Bay

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9195-4; Docket ID No. EPA-HQ-ORD-2010-0709] A Method to... comment period for the draft document titled, ``A Method to Assess Climate-Relevant Decision: Application... draft ``A Method To Assess Climate-Relevant Decisions: Application in the Chesapeake Bay'' is available...

36 CFR 215.7 - Legal notice of decision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Legal notice of decision. 215..., COMMENT, AND APPEAL PROCEDURES FOR NATIONAL FOREST SYSTEM PROJECTS AND ACTIVITIES § 215.7 Legal notice of... Official shall publish a legal notice of any decision documented in a ROD or DN in the applicable newspaper...

36 CFR 215.7 - Legal notice of decision.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Legal notice of decision. 215..., COMMENT, AND APPEAL PROCEDURES FOR NATIONAL FOREST SYSTEM PROJECTS AND ACTIVITIES § 215.7 Legal notice of... Official shall publish a legal notice of any decision documented in a ROD or DN in the applicable newspaper...

Protest Motherhood: Pregnancy Decision-Making Behavior and Attitudes Towards Abortion.

ERIC Educational Resources Information Center

Chesney-Lind, Meda

The document describes research on womens' attitudes toward abortion and their decision-making when pregnant leading to either birth or abortion. The objective was "to explore how womens' perceptions of the option of legal abortion have affected their pregnancy decision-making behavior" and to note the impact of their particular choices on their…

Professional Development to Improve Accommodations Decisions--A Review of the Literature. Synthesis Report 84

ERIC Educational Resources Information Center

Hodgson, Jennifer R.; Lazarus, Sheryl S.; Thurlow, Martha L.

2011-01-01

Teachers play an important role in making decisions about students' accommodations for instruction and assessment. Although teachers are a significant part of the decision-making process, "gaps" in teachers' accommodations knowledge are well documented. Some of these gaps may be due to challenges in providing teacher professional…

Scientific Literacy for Democratic Decision-Making

ERIC Educational Resources Information Center

Yacoubian, Hagop A.

2018-01-01

Scientifically literate citizens must be able to engage in making decisions on science-based social issues. In this paper, I start by showing examples of science curricula and policy documents that capitalise the importance of engaging future citizens in decision-making processes whether at the personal or at the societal levels. I elucidate the…

78 FR 76829 - Approval of Application Submitted by Eastern Shoshone Tribe and Northern Arapaho Tribe for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-19

... regulatory authority under the Clean Air Act. DATES: EPA's decision approving the Tribes' TAS application was... Decision Document, Attachment 1 (Legal Analysis of the Wind River Indian Reservation Boundary), Attachment... decision to approve the application does not approve, Tribal authority to implement any Clean Air Act...

Semantic-Web Architecture for Electronic Discharge Summary Based on OWL 2.0 Standard.

PubMed

Tahmasebian, Shahram; Langarizadeh, Mostafa; Ghazisaeidi, Marjan; Safdari, Reza

2016-06-01

Patients' electronic medical record contains all information related to treatment processes during hospitalization. One of the most important documents in this record is the record summary. In this document, summary of the whole treatment process is presented which is used for subsequent treatments and other issues pertaining to the treatment. Using suitable architecture for this document, apart from the aforementioned points we can use it in other fields such as data mining or decision making based on the cases. In this study, at first, a model for patient's medical record summary has been suggested using semantic web-based architecture. Then, based on service-oriented architecture and using Java programming language, a software solution was designed and run in a way to generate medical record summary with this structure and at the end, new uses of this structure was explained. in this study a structure for medical record summaries along with corrective points within semantic web has been offered and a software running within Java along with special ontologies are provided. After discussing the project with the experts of medical/health data management and medical informatics as well as clinical experts, it became clear that suggested design for medical record summary apart from covering many issues currently faced in the medical records has also many advantages including its uses in research projects, decision making based on the cases etc.

Maintenance program decision-making utilizing crash data.

DOT National Transportation Integrated Search

2013-07-01

This document describes methods that may be used by UDOT Maintenance personnel to improve highway safety. Four programs have been recommended using crash data to make more informed decisions concerning maintenance programs as follows: : Snow & Ic...

Briefing Number 3 to Space Station Operations Task Force Oversight Committee

NASA Technical Reports Server (NTRS)

Lyman, Peter; Shelley, Carl

1987-01-01

This document reviews certain issues in relationship to the operation of the Space Station Freedom. The document is in outline format and includes some organizational hierarchy charts, pert charts and decision charts.

Tallgrass Prairie National Preserve Vehicle Decision Document.

DOT National Transportation Integrated Search

2004-07-31

This document serves as technical substantiation in support of a procurement for a vehicle to : be used to operate an interpretive bus tour at Tallgrass Prairie National Preserve (TAPR), : located just north of Strong City, Kansas.

EPA Guidance for Geospatially Related Quality Assurance Project Plans

EPA Pesticide Factsheets

This March 2003 document discusses EPA's Quality Assurance (QA) Project Plan as a tool for project managers and planners to document the type and quality of data and information needed for making environmental decisions

Document Management in Local Government.

ERIC Educational Resources Information Center

Williams, Bernard J. S.

1998-01-01

The latest in electronic document management in British local government is discussed. Finance, revenues, and benefits systems of leading vendors to local authorities are highlighted. A planning decisions archive management system and other information services are discussed. (AEF)

49 CFR 106.120 - Appeal deadline.

Code of Federal Regulations, 2010 CFR

2010-10-01

... withdrawal of a proposed rulemaking, your appeal document must reach us no later than 30 days after the date... you appeal PHMSA's decision on a petition for rulemaking, your appeal document must reach us no later...

49 CFR 106.120 - Appeal deadline.

Code of Federal Regulations, 2011 CFR

2011-10-01

... withdrawal of a proposed rulemaking, your appeal document must reach us no later than 30 days after the date... you appeal PHMSA's decision on a petition for rulemaking, your appeal document must reach us no later...

50 CFR 23.19 - What CITES documents are required to export Appendix-I plants?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION, TRANSPORTATION, SALE, PURCHASE, BARTER... CITES documents are required to export Appendix-I plants? Answer the questions in the following decision...

TRIAD VIII: Nationwide Multicenter Evaluation to Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care.

PubMed

Mirarchi, Ferdinando L; Cooney, Timothy E; Venkat, Arvind; Wang, David; Pope, Thaddeus M; Fant, Abra L; Terman, Stanley A; Klauer, Kevin M; Williams-Murphy, Monica; Gisondi, Michael A; Clemency, Brian; Doshi, Ankur A; Siegel, Mari; Kraemer, Mary S; Aberger, Kate; Harman, Stephanie; Ahuja, Neera; Carlson, Jestin N; Milliron, Melody L; Hart, Kristopher K; Gilbertson, Chelsey D; Wilson, Jason W; Mueller, Larissa; Brown, Lori; Gordon, Bradley D

2017-06-01

End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine. Each survey asked for code status interpretation of stand-alone Physician Orders for Life-Sustaining Treatment (POLST) and living will (LW) documents in 9 scenarios. Respondents assigned code status and resuscitation decisions to each scenario. For 1 of 2 surveys, a VM was included to help clarify patient wishes. Response rate was 54%, and most were male emergency physicians who lacked formal advanced planning document interpretation training. Consensus was not achievable for stand-alone POLST or LW documents (68%-78% noted "DNR"). Two of 9 scenarios attained consensus for code status (97%-98% responses) and treatment decisions (96%-99%). Adding a VM significantly changed code status responses by 9% to 62% (P ≤ 0.026) in 7 of 9 scenarios with 4 achieving consensus. Resuscitation responses changed by 7% to 57% (P ≤ 0.005) with 4 of 9 achieving consensus with VMs. For most scenarios, consensus was not attained for code status and resuscitation decisions with stand-alone LW and POLST documents. Adding VMs produced significant impacts toward achieving interpretive consensus.

The Antibiotic Prescribing Pathway for Presumed Urinary Tract Infections in Nursing Home Residents.

PubMed

Kistler, Christine E; Zimmerman, Sheryl; Scales, Kezia; Ward, Kimberly; Weber, David; Reed, David; McClester, Mallory; Sloane, Philip D

2017-08-01

Due to the high rates of inappropriate antibiotic prescribing for presumed urinary tract infections (UTIs) in nursing home (NH) residents, we sought to examine the antibiotic prescribing pathway and the extent to which it agrees with the Loeb criteria; findings can suggest strategies for antibiotic stewardship. Chart review of 260 randomly-selected cases from 247 NH residents treated with an antibiotic for a presumed UTI in 31 NHs in North Carolina. We examined the prescribing pathway from presenting illness, to the prescribing event, illness work-up and subsequent clinical events including emergency department use, hospitalization, and death. Analyses described the decision-making processes and outcomes and compared decisions made with Loeb criteria for initiation of antibiotics. Of 260 cases, 60% had documented signs/symptoms of the presenting illness and 15% met the Loeb criteria. Acute mental status change was the most commonly documented sign/symptom (24%). NH providers (81%) were the most common prescribers and ciprofloxacin (32%) was the most commonly prescribed antibiotic. Fourteen percent of presumed UTI cases included a white blood cell count, 71% included a urinalysis, and 72% had a urine culture. Seventy-five percent of cultures grew at least one organism with ≥100,000 colony-forming units/milliliter and 12% grew multi-drug resistant organisms; 28% of antibiotics were prescribed for more than 7 days, and 7% of cases had a subsequent death, emergency department visit, or hospitalization within 7 days. Non-specific signs/symptoms appeared to influence prescribing more often than urinary tract-specific signs/symptoms. Prescribers rarely stopped antibiotics, and a minority prescribed for overly long periods. Providers may need additional support to guide the decision-making process to reduce antibiotic overuse and antibiotic resistance. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

PVEX: An expert system for producibility/value engineering

NASA Technical Reports Server (NTRS)

Lam, Chun S.; Moseley, Warren

1991-01-01

PVEX is described as an expert system that solves the problem of selection of the material and process in missile manufacturing. The producibility and the value problem has been deeply studied in the past years, and was written in dBase III and PROLOG before. A new approach is presented in that the solution is achieved by introducing hypothetical reasoning, heuristic criteria integrated with a simple hypertext system and shell programming. PVEX combines KMS with Unix scripts which graphically depicts decision trees. The decision trees convey high level qualitative problem solving knowledge to users, and a stand-alone help facility and technical documentation is available through KMS. The system developed is considerably less development costly than any other comparable expert system.

Superfund record of decision (EPA Region 1): Peterson/Puritan Site, Operable Unit 1, Cumberland/Lincoln, RI, September 1993

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

Not Available

1993-09-01

This Decision Document presents the selected remedial action for the Peterson/Puritan, Inc. Superfund Site, Operable Unit 1, in Cumberland and Lincoln, Rhode Island. Operable Unit 1 contains two remediation areas. The CCL remediation area, a source of volatile organic contamination, includes the former Peterson/Puritan, Inc. facility, which is the Site's namesake (currently the CCL Custom Manufacturing facility, and referred to as CCL). The PAC remediation area includes the Pacific Anchor Chemical Corporation (PAC ) facility (formerly the Lonza and Universal Chemical Company facility), which is a source of arsenic and volatile organic contamination. Each remediation area is further split intomore » source and downgradient area components, respectively.« less

EPA Region 9 Guidance for Quality Assurance Program Plans - R9qa/03.2

EPA Pesticide Factsheets

In order for decision makers to have confidence in the quality of environmental data used to support their decisions, the organization must have structured and documented process for quality in place.

Towards Rational Decision-Making in Secondary Education.

ERIC Educational Resources Information Center

Cohn, Elchanan

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

Ecological models supporting environmental decision making: a strategy for the future

USGS Publications Warehouse

Schmolke, Amelie; Thorbek, Pernille; DeAngelis, Donald L.; Grimm, Volker

2010-01-01

Ecological models are important for environmental decision support because they allow the consequences of alternative policies and management scenarios to be explored. However, current modeling practice is unsatisfactory. A literature review shows that the elements of good modeling practice have long been identified but are widely ignored. The reasons for this might include lack of involvement of decision makers, lack of incentives for modelers to follow good practice, and the use of inconsistent terminologies. As a strategy for the future, we propose a standard format for documenting models and their analyses: transparent and comprehensive ecological modeling (TRACE) documentation. This standard format will disclose all parts of the modeling process to scrutiny and make modeling itself more efficient and coherent.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-06-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-02-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-12-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-04-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

General Motors, Inc. PSD Appeal No. 01-30 EAB Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Entergy - Monroe Electric Generating Plant Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Exxon - Baton Rouge Polyolefins Plant Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

BACT/LEAR Cutoff Date Policy and Recent PSD Appeal Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Indeck-Niles, LLC PSD Appeal No. 02-03 EAB Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Roosevelt Regional Landfill Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Shintech Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Pacificorp's Bridger and Naughton Decision

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 477: Area 12 N-Tunnel Muckpile, Nevada Test Site

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

NSTec Environmental Restoration

This Corrective Action Decision Document (CADD)/Closure Report (CR) was prepared by the Defense Threat Reduction Agency (DTRA) for Corrective Action Unit (CAU) 477, N-Tunnel Muckpile. This CADD/CR is consistent with the requirements of the Federal Facility Agreement and Consent Order (FFACO) agreed to by the State of Nevada, the U.S. Department of Energy, and the U.S. Department of Defense. Corrective Action Unit 477 is comprised of one Corrective Action Site (CAS): • 12-06-03, Muckpile The purpose of this CADD/CR is to provide justification and documentation supporting the recommendation for closure with no further action, by placing use restrictions on CAUmore » 477.« less

Education Leaders' Decision-Making Processes about Educational Facilities in a University Multiple Stakeholder Environment

ERIC Educational Resources Information Center

Kelting, Scott

2011-01-01

This research is a retrospective case study designed to document and analyze the process of decision-making by educational leaders and stakeholders at a four-year university. For this study, educational leaders and key stakeholders agreed to extensive interviews about the decisions made during the design, construction, and post-occupancy phases of…

Trouble in Paradise: Teacher Conflicts in Shared Decision Making. NCEL Occasional Paper No. 8.

ERIC Educational Resources Information Center

Weiss, Carol H.; And Others

Drawing on interviews with 180 staff members from 45 public high schools in 15 states, this document examines the advantages and disadvantages of teacher participation in shared decision making. The settings of six high schools that had structured mechanisms for teacher participation in school decisions are described, and problems that emerged…

20 CFR 416.1453 - The decision of an administrative law judge.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the findings of fact and the reasons for the decision. The administrative law judge must base the... document that sets forth the key data, findings of fact, and narrative rationale for the decision. If the... instance may be extended by the total number of days of the delays. The delays include delays in submitting...

75 FR 27996 - Record of Decision (ROD) for the Training Land Acquisition (Including Purchase and Lease) at Fort...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... DEPARTMENT OF DEFENSE Department of the Army Record of Decision (ROD) for the Training Land Acquisition (Including Purchase and Lease) at Fort Polk, LA AGENCY: Department of the Army, DoD. ACTION... which summarizes and documents its decision to proceed with Alternative 3, the acquisition of up to 100...

Establishing Trustworthiness When Students Read Multiple Documents Containing Conflicting Scientific Evidence

ERIC Educational Resources Information Center

Bråten, Ivar; Braasch, Jason L. G.; Strømsø, Helge I.; Ferguson, Leila E.

2015-01-01

Students read six documents that varied in terms of their perspectives on a scientific issue and the trustworthiness of the source features. After reading, students wrote essays, rank-ordered the documents according to perceived trustworthiness, and provided reasons for their rank-order decisions. Students put the most trust in a textbook and a…

The values underlying team decision-making in work rehabilitation for musculoskeletal disorders.

PubMed

Loisel, Patrick; Falardeau, Marlène; Baril, Raymond; José-Durand, Marie; Langley, Ann; Sauvé, Sandrine; Gervais, Julie

2005-05-20

This paper presents the results of a qualitative study on the values underlying the decision-making process of an interdisciplinary team working in a work rehabilitation facility of a Québec teaching hospital. In order to document the values underlying the decision-making process, a single case observational study was conducted. Interdisciplinary team weekly discussions on ongoing cases of 22 workers absent from work due to musculoskeletal disorders were videotaped. All discourses were transcribed and analyzed following an inductive and iterative approach. The values identified were validated by feedback from team members. Ten common decision values emerged from the data: (1) team unity and credibility, (2) collaboration with stakeholders, (3) worker's internal motivation, (4) worker's adherence to the program, (5) worker's reactivation, (6) single message, (7) reassurance, (8) graded intervention, (9) pain management and (10) return to work as a therapy. The analysis of these values led to the design of a model describing interrelations between them. This study throws light on some mechanisms underlying the decisions made by the team and determining its action. This improves understanding of the actions taken by an interdisciplinary team in work rehabilitation and may facilitate knowledge transfer in the training of other teams.

Foundations of Broadband Multifunctional Metamaterials Inspired by the Analogy of Formation

DTIC Science & Technology

2013-01-30

25] S. Lim and M.F. Iskander, “ Design of a Dual-Band, Compact Yagi Antenna Over an EBG Ground Plane,’’ IEEE Antennas Wireless Propagat. Lett., vol. 8...For VHF and UHF frequency bands total EBG plus antenna thickness could be prohibitively large. This report presents a unique concept to design and...official Department of the Army position, policy or decision, unless so designated by other documentation. 12. DISTRIBUTION AVAILIBILITY STATEMENT

Healthy eating decisions require efficient dietary self-control in children: A mouse-tracking food decision study.

PubMed

Ha, Oh-Ryeong; Bruce, Amanda S; Pruitt, Stephen W; Cherry, J Bradley C; Smith, T Ryan; Burkart, Dominic; Bruce, Jared M; Lim, Seung-Lark

2016-10-01

Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions. Published by Elsevier Ltd.

Data Quality Objectives for Tank Farms Waste Compatibility Program

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

BANNING, D.L.

1999-07-02

There are 177 waste storage tanks containing over 210,000 m{sup 3} (55 million gal) of mixed waste at the Hanford Site. The River Protection Project (RPP) has adopted the data quality objective (DQO) process used by the U.S. Environmental Protection Agency (EPA) (EPA 1994a) and implemented by RPP internal procedure (Banning 1999a) to identify the information and data needed to address safety issues. This DQO document is based on several documents that provide the technical basis for inputs and decision/action levels used to develop the decision rules that evaluate the transfer of wastes. A number of these documents are presentlymore » in the process of being revised. This document will need to be revised if there are changes to the technical criteria in these supporting documents. This DQO process supports various documents, such as sampling and analysis plans and double-shell tank (DST) waste analysis plans. This document identifies the type, quality, and quantity of data needed to determine whether transfer of supernatant can be performed safely. The requirements in this document are designed to prevent the mixing of incompatible waste as defined in Washington Administrative Code (WAC) 173-303-040. Waste transfers which meet the requirements contained in this document and the Double-Shell Tank Waste Analysis Plan (Mulkey 1998) are considered to be compatible, and prevent the mixing of incompatible waste.« less

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

PubMed

Trevena, Lyndal J; Zikmund-Fisher, Brian J; Edwards, Adrian; Gaissmaier, Wolfgang; Galesic, Mirta; Han, Paul K J; King, John; Lawson, Margaret L; Linder, Suzanne K; Lipkus, Isaac; Ozanne, Elissa; Peters, Ellen; Timmermans, Danielle; Woloshin, Steven

2013-01-01

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

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

PubMed Central

2013-01-01

Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice. PMID:24625237

Toward the Computational Representation of Individual Cultural, Cognitive, and Physiological State: The Sensor Shooter Simulation

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

RAYBOURN,ELAINE M.; FORSYTHE,JAMES C.

2001-08-01

This report documents an exploratory FY 00 LDRD project that sought to demonstrate the first steps toward a realistic computational representation of the variability encountered in individual human behavior. Realism, as conceptualized in this project, required that the human representation address the underlying psychological, cultural, physiological, and environmental stressors. The present report outlines the researchers' approach to representing cognitive, cultural, and physiological variability of an individual in an ambiguous situation while faced with a high-consequence decision that would greatly impact subsequent events. The present project was framed around a sensor-shooter scenario as a soldier interacts with an unexpected target (twomore » young Iraqi girls). A software model of the ''Sensor Shooter'' scenario from Desert Storm was developed in which the framework consisted of a computational instantiation of Recognition Primed Decision Making in the context of a Naturalistic Decision Making model [1]. Recognition Primed Decision Making was augmented with an underlying foundation based on our current understanding of human neurophysiology and its relationship to human cognitive processes. While the Gulf War scenario that constitutes the framework for the Sensor Shooter prototype is highly specific, the human decision architecture and the subsequent simulation are applicable to other problems similar in concept, intensity, and degree of uncertainty. The goal was to provide initial steps toward a computational representation of human variability in cultural, cognitive, and physiological state in order to attain a better understanding of the full depth of human decision-making processes in the context of ambiguity, novelty, and heightened arousal.« less

Decision-making competence and attempted suicide

PubMed Central

Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y

2015-01-01

Objective The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases, which may ultimately obscure alternative solutions and deterrents to suicide in a crisis. Method We assessed older and middle-aged individuals who made high-lethality (medically serious; N=31) and low-lethality suicide attempts (N=29). Comparison groups included suicide ideators (N=30), non-suicidal depressed (N=53), and psychiatrically healthy participants (N=28). Attempters, ideators, and non-suicidal depressed participants had unipolar non-psychotic major depression. Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), under/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June of 2010 and February of 2014. Results Both high- and low-lethality attempters were more susceptible to framing effects, as compared to the other groups included in this study (p≤ 0.05, ηp2 =.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (p≤ 0.01, ηp2 =.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Conclusion Suicide attempters’ failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Low-lethality attempters’ failure to resist sunk-cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal thoughts. PMID:26717535

Decision-making competence and attempted suicide.

PubMed

Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y

2015-12-01

The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral-decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases that may ultimately obscure alternative solutions and deterrents to suicide in a crisis. We assessed older and middle-aged (42-97 years) individuals who made high-lethality (medically serious) (n = 31) and low-lethality suicide attempts (n = 29). Comparison groups included suicide ideators (n = 30), nonsuicidal depressed participants (n = 53), and psychiatrically healthy participants (n = 28). Attempters, ideators, and nonsuicidal depressed participants had nonpsychotic major depression (DSM-IV criteria). Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), underconfidence/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June 2010 and February 2014. Both high- and low-lethality attempters were more susceptible to framing effects as compared to the other groups included in this study (P ≤ .05, ηp2 = 0.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (P ≤ .01, ηp2 = 0.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Suicide attempters' failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Failure of low-lethality attempters to resist sunk cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal thoughts. © Copyright 2015 Physicians Postgraduate Press, Inc.

Documents Related to the Decision Not to List Fourteen Solvents as Hazardous Waste

EPA Pesticide Factsheets

Links to federal register notices and fact sheets about the decision to not list wastes generated from the use of 14 solvents as hazardous wastes under the Resource Conservation and Recovery Act (RCRA).

First Reconsideration Decision and Rationale: Nutrient and Sediment TMDLs for the Indian Creek Watershed, Pennsylvania

EPA Pesticide Factsheets

Reconsideration Decision and Rationale: Nutrient and Sediment TMDLs for the Indian Creek Watershed, Pennsylvania: Established by the U.S. Environmental Protection Agency, Region 3, Philadelphia, PA. March 21, 2014. 6 Documents, below

The Mayak Worker Dosimetry System (Mwds-2013): An Introduction to The Documentation

DOE PAGES

Napier, B. A.

2017-03-17

The reconstruction of radiation doses to Mayak Production Association workers in central Russia supports radiation epidemiological studies for the U.S.-Russian Joint Coordinating Committee on Radiation Effects Research. The most recent version of the dosimetry was performed with the Mayak Worker Dosimetry System-2013. Here, this introduction outlines the logic and general content of the series of articles presented in this issue of Radiation Protection Dosimetry. The articles summarize the models, describe the basis for most of the key decisions made in developing the models and present an overview of the results.

Configuration Management (CM) Support for KM Processes at NASA/Johnson Space Center (JSC)

NASA Technical Reports Server (NTRS)

Cioletti, Louis

2010-01-01

Collection and processing of information are critical aspects of every business activity from raw data to information to an executable decision. Configuration Management (CM) supports KM practices through its automated business practices and its integrated operations within the organization. This presentation delivers an overview of JSC/Space Life Sciences Directorate (SLSD) and its methods to encourage innovation through collaboration and participation. Specifically, this presentation will illustrate how SLSD CM creates an embedded KM activity with an established IT platform to control and update baselines, requirements, documents, schedules, budgets, while tracking changes essentially managing critical knowledge elements.

The Mayak Worker Dosimetry System (Mwds-2013): An Introduction to The Documentation

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

Napier, B. A.

The reconstruction of radiation doses to Mayak Production Association workers in central Russia supports radiation epidemiological studies for the U.S.-Russian Joint Coordinating Committee on Radiation Effects Research. The most recent version of the dosimetry was performed with the Mayak Worker Dosimetry System-2013. Here, this introduction outlines the logic and general content of the series of articles presented in this issue of Radiation Protection Dosimetry. The articles summarize the models, describe the basis for most of the key decisions made in developing the models and present an overview of the results.

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANUP OF AUTOMOTIVE RECYCLING BROWNFIELDS

EPA Science Inventory

The guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically automotive recycling sites. The document helps users to understand...

North Cascades Stehekin Valley Vehicle Decision Document.

DOT National Transportation Integrated Search

2007-08-31

This document serves as technical substantiation in support of a procurement for a fleet of vehicles to be used to operate a scheduled shuttle operation with multiple stops at North Cascades National Park Service Complex (NOCA), in the Stehekin Valle...

18 CFR 388.101 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... governing public notice of proceedings, publication of decisions, requests for informal advice from... responding to subpoenas seeking documents or testimony from Commission employees or former employees, fees for various requests for documents, and requests for reduction or waiver of these fees. ...

United States Air Force 611th Air Support Group/Civil Engineering Squadron, Elmendorf AFB, Alaska. Decision document for no further response action planned Oliktok Point Radar Installation, Alaska. Final report

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

Karmi, S.

1996-06-03

This Decision Document discusses the selection of no further action as the recommended action for four sites located at the Oliktok Point radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the eight sites located at the Oliktok Point installation (U.S. Air Force 1996a,b). Based on the findings of these activities, four sites are recommended for no further action.

Qualitative analysis of national documents on health care services and pharmaceuticals` purchasing challenges: evidence from Iran.

PubMed

Bastani, Peivand; Samadbeik, Mahnaz; Dinarvand, Rassoul; Kashefian-Naeeini, Sara; Vatankhah, Soudabeh

2018-06-05

Iranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting. It was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president's site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10. Findings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes. It seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

A heuristic framework for understanding the role of participatory decision making in community-based non-profits.

PubMed

Bess, Kimberly D; Perkins, Douglas D; Cooper, Daniel G; Jones, Diana L

2011-06-01

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members' input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs' capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.

Executive summary of the GeSIDA/National AIDS Plan consensus document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2018).

PubMed

2018-05-11

This update to the document on antiretroviral therapy (ART) in adults, which has been prepared jointly by GeSIDA and the Spanish National AIDS Plan for the last two decades, supersedes the document published in 2017. 1 The update provides physicians treating HIV-1-infected adults with evidence-based recommendations to guide their therapeutic decisions. The main difference with respect to the previous document concerns recommended initial ART regimens, only three of which are maintained as preferential. All three include dolutegravir or raltegravir, together with emtricitabine/tenofovir alafenamide or abacavir/lamivudine. Other differences concern the section on switching ART in patients with suppressed viral replication, which now includes new two- and three-drug regimens, and the antiretroviral drugs recommended for pregnant women and patients with tuberculosis. A recommendation has also been added for patients who present with acute HIV infection after pre-exposure prophylaxis. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 371: Johnnie Boy Crater and Pin Stripe Nevada Test Site, Nevada, Revision 0

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

Patrick Matthews

This Corrective Action Decision Document/Closure Report has been prepared for Corrective Action Unit 371, Johnnie Boy Crater and Pin Stripe, located within Areas 11 and 18 at the Nevada Test Site, Nevada, in accordance with the Federal Facility Agreement and Consent Order (FFACO). Corrective Action Unit (CAU) 371 comprises two corrective action sites (CASs): • 11-23-05, Pin Stripe Contamination Area • 18-45-01, U-18j-2 Crater (Johnnie Boy) The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that no further corrective action is needed for CAU 371 based on the implementation of correctivemore » actions. The corrective action of closure in place with administrative controls was implemented at both CASs. Corrective action investigation (CAI) activities were performed from January 8, 2009, through February 16, 2010, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 371: Johnnie Boy Crater and Pin Stripe. The approach for the CAI was divided into two facets: investigation of the primary release of radionuclides and investigation of other releases (migration in washes and chemical releases). The purpose of the CAI was to fulfill data needs as defined during the data quality objective (DQO) process. The CAU 371 dataset of investigation results was evaluated based on the data quality indicator parameters. This evaluation demonstrated the dataset is acceptable for use in fulfilling the DQO data needs. Analytes detected during the CAI were evaluated against final action levels (FALs) established in this document. Radiological doses exceeding the FAL of 25 millirem per year were not found to be present in the surface soil. However, it was assumed that radionuclides are present in subsurface media within the Johnnie Boy crater and the fissure at Pin Stripe. Due to the assumption of radiological dose exceeding the FAL, corrective actions were undertaken that consist of implementing a use restriction and posting warning signs at each site. These use restrictions were recorded in the FFACO database; the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Facility Information Management System; and the NNSA/NSO CAU/CAS files. Therefore, NNSA/NSO provides the following recommendations: • No further corrective actions are necessary for CAU 371. • A Notice of Completion to NNSA/NSO is requested from the Nevada Division of Environmental Protection for closure of CAU 371. • Corrective Action Unit 371 should be moved from Appendix III to Appendix IV of the FFACO.« less

Exploring work-related issues on corporate sustainability.

PubMed

Brunoro, C M; Bolis, I; Sznelwar, L I

2015-01-01

In a research project about work-related issues and corporate sustainability conducted in Brazil, the goal was to better understand how work-related issues were addressed in the corporate context. Particularly, there are some specific initiatives that serve as guides to organizational decisions, which make their performance indicators for the context of corporate sustainability. 1) To explore the presence of work-related issues and their origins in corporate sustainability approach, analyzing a) corporate disclosures; b) sustainability guidelines that are identified as relevant in corporate disclosures; c) documents that are related to sustainable development and also identified as key-documents for these guidelines and initiatives. 2) To present the activity-centered ergonomics and psychodynamics of work contributions to work-related issues in a corporate sustainability approach. An exploratory study based on multiple sources of evidence that were performed from 2012 to 2013, including interviews with companies that engaged in corporate sustainability and document analysis using the content analysis approach. Work-related issues have been presented since the earliest sustainable development documents. It is feasible to construct an empirical framework for work-related issues and corporate sustainability approaches. 1) Although some authors argue that corporate sustainability has its roots based only on the environmental dimension, there is strong empirical evidence showing that social dimension aspects such as work-related issues have been present since the beginning. 2) Some indicators should be redesigned to more precisely translate the reality of some workplaces, particularly those indicators related to organizational design and mental health.

Executive overview and introduction to the SMAP information system life-cycle and documentation standards

NASA Technical Reports Server (NTRS)

1989-01-01

An overview of the five volume set of Information System Life-Cycle and Documentation Standards is provided with information on its use. The overview covers description, objectives, key definitions, structure and application of the standards, and document structure decisions. These standards were created to provide consistent NASA-wide structures for coordinating, controlling, and documenting the engineering of an information system (hardware, software, and operational procedures components) phase by phase.

STS-114: Engine Cut-Off Sensors Are a No-Go: Teaching Notes for NASA Case Study

NASA Technical Reports Server (NTRS)

Ransom, Khadijah S.; Johnson, Grace K.

2013-01-01

This case study format is intended to simulate the experience of facing the same difficult challenges and making the same critical decisions as managers, engineers, and scientists in the Space Shuttle Program. It has been designed for use in the classroom setting to help students develop skills related to decision-making. Students will read about the engine cut-off sensor anomaly which created challenges during the STS-114 mission and have the opportunity to make decisions as lead NASA engineers and Mission Management Team members. Included within this document are three case study presentation options - class discussion, group activity, and open-ended research. Please read the full case prior to in-class presentation to allow ample time for students' analysis and reflection, as well as to prepare additional questions. activities or exercises, material selection, etc. Depending upon the setting of your presentation and the number of participants, please choose at least one presentation format beforehand and plan accordingly. You may expect the following learning objectives by using the proposed formats. Learning Objectives: To enable students to experience the responsibilities of NASA management, engineers, and analysis; to discover possible procedures for investigating system anomalies; to become familiar with the liquid hydrogen low level engine cut-off sensor, including its function, connecting components, and location within the Space Shuttle; and to encourage critical analysis and stimulating discussion of Space Shuttle mission challenges.

7 CFR 652.35 - State Conservationist decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... technical service provider, the technical service provider will be given written notice of that... technical service provider's written response and supporting documentation. Both a copy of the decision and..., DEPARTMENT OF AGRICULTURE SUPPORT ACTIVITIES TECHNICAL SERVICE PROVIDER ASSISTANCE Decertification § 652.35...

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANING UP BROWNFIELDS SITES: RAILROAD YARDS

EPA Science Inventory

This guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically railroad yards. The document helps users to understand the proble...

Basis and Purpose Document for the proposed NESHAP for Pharmaceuticals Production

EPA Pesticide Factsheets

The Basis and Purpose Document provides background information on, and the rationale for, decisions made by EPA related to the proposed standards for the reduction of hazardous air pollutants (HAP) emitted through the manufacture of pharmaceutical products

Final Documentation: Incident Management And Probabilities Courses of action Tool (IMPACT).

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

Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.

This report pulls together the documentation produced for the IMPACT tool, a software-based decision support tool that provides situational awareness, incident characterization, and guidance on public health and environmental response strategies for an unfolding bio-terrorism incident.

5 CFR 1201.4 - General definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... documents associated with electronic filings under paragraph (h) of § 1201.14, on the MSPB. (l) Date of... date of electronic submission. (m) Electronic filing (e-filing). Filing and receiving documents in... of Personnel Management reconsideration decisions concerning retirement benefits, and appeals of...

5 CFR 1201.4 - General definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... documents associated with electronic filings under paragraph (h) of § 1201.14, on the MSPB. (l) Date of... date of electronic submission. (m) Electronic filing (e-filing). Filing and receiving documents in... of Personnel Management reconsideration decisions concerning retirement benefits, and appeals of...

30 CFR 761.16 - Submission and processing of requests for valid existing rights determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... rights. The decision document must explain how you have or have not satisfied all applicable elements of... appropriate. The agency must then proceed with the decision process under paragraph (e)(2) of this section. (4... statement that the agency will not make a decision on the merits of your request if, by the close of the...

77 FR 35080 - Entergy Nuclear Operations, Inc., Pilgrim Nuclear Power Station; Record of Decision and Issuance...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

...., Pilgrim Nuclear Power Station; Record of Decision and Issuance of Renewed Facility Operating License No... as the record of decision for the renewal of facility operating license No. DPR-35, consistent with... referenced. NRC's PDR: You may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21...

13 CFR 124.205 - Can an applicant ask SBA to reconsider SBA's initial decision to decline its application?

Code of Federal Regulations, 2014 CFR

2014-01-01

... reconsider SBA's initial decision to decline its application? (a) An applicant may request the AA/BD to..., including information and documentation regarding changed circumstances. (b) The AA/BD will issue a written decision within 45 days of SBA's receipt of the applicant's request. The AA/BD may either approve the...

13 CFR 124.205 - Can an applicant ask SBA to reconsider SBA's initial decision to decline its application?

Code of Federal Regulations, 2013 CFR

2013-01-01

... reconsider SBA's initial decision to decline its application? (a) An applicant may request the AA/BD to..., including information and documentation regarding changed circumstances. (b) The AA/BD will issue a written decision within 45 days of SBA's receipt of the applicant's request. The AA/BD may either approve the...

13 CFR 124.205 - Can an applicant ask SBA to reconsider SBA's initial decision to decline its application?

Code of Federal Regulations, 2012 CFR

2012-01-01

... reconsider SBA's initial decision to decline its application? (a) An applicant may request the AA/BD to..., including information and documentation regarding changed circumstances. (b) The AA/BD will issue a written decision within 45 days of SBA's receipt of the applicant's request. The AA/BD may either approve the...

Decision support for the integrated restoration and protection strategy of the Forest Service, Northern Region

Treesearch

Keith Reynolds; Barry Bollenbacher; Chip Fisher; Melissa Hart; Mary Manning; Eric Henderson; Bruce Sims

2016-01-01

This report documents a decision-support process developed in the U.S. Department of Agriculture, Forest Service, Northern Region to assess management opportunities as part of an ecosystem-based approach to management that emphasizes ecological resilience. The decision-support system described in this work implements what is known as the Integrated Restoration and...

EPA Concurrence/Approval of Federal Facility Proposed Plans and Records of Decision and other Documents

EPA Pesticide Factsheets

The purpose of this memorandum is to ensure that EPA Regions scrutinize all proposed plans, draft and final RODs, and post-ROD documents that address institutional controls (ICs) in order to verify that they adequately document the objectives of the ICs and clearly identify who has responsibility for implementation, monitoring, reporting, and enforcement of the IC.

Shemya Air Force Base, Alaska No Further Action Decision document for Hg-1. Final report

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

Not Available

1993-03-05

This document is being prepared to document that a No Further Action Decision (NFAD) document is appropriate for the Hg-1 site at Shemya Air Force Base (AFB), Alaska, under the Air Force Installation Restoration Program (IRP). The IRP is a Department of Defense (DOD) program established to identify and remediate hazardous waste problems on DOD property that result from past practices. The Alaska Department of Environmental Conservation (ADEC) draft document {open_quotes}No Further Action Criteria for DOD Military/FUD Sites{close_quotes} has been used as a guide in preparing this document. Air Force personnel have stated that the Hg-1 site may have beenmore » used to store mercury and PCB-contaminated material. The site was added to the IRP in 1987, and later that year a field investigation was conducted at the site. Soil samples were collected and analyzed for mercury, EP toxicity, polychlorinated biphenyls (PCBs), and dioxin. All concentrations of contaminants found in Area Hg-1 are below regulatory action levels for PCBs (40 CFR 761) and mercury (55 FR 30798) or below detection levels for dioxin/furans. Therefore, leaving these soils in place is acceptable.« less

Shemya Air Force Base, Alaska No Further Action Decision document for Hg-1

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

Not Available

1993-03-05

This document is being prepared to document that a No Further Action Decision (NFAD) document is appropriate for the Hg-1 site at Shemya Air Force Base (AFB), Alaska, under the Air Force Installation Restoration Program (IRP). The IRP is a Department of Defense (DOD) program established to identify and remediate hazardous waste problems on DOD property that result from past practices. The Alaska Department of Environmental Conservation (ADEC) draft document [open quotes]No Further Action Criteria for DOD Military/FUD Sites[close quotes] has been used as a guide in preparing this document. Air Force personnel have stated that the Hg-1 site maymore » have been used to store mercury and PCB-contaminated material. The site was added to the IRP in 1987, and later that year a field investigation was conducted at the site. Soil samples were collected and analyzed for mercury, EP toxicity, polychlorinated biphenyls (PCBs), and dioxin. All concentrations of contaminants found in Area Hg-1 are below regulatory action levels for PCBs (40 CFR 761) and mercury (55 FR 30798) or below detection levels for dioxin/furans. Therefore, leaving these soils in place is acceptable.« less

Implementation of a publication strategy in the context of reporting biases. A case study based on new documents from Neurontin litigation.

PubMed

Vedula, S Swaroop; Goldman, Palko S; Rona, Ilyas J; Greene, Thomas M; Dickersin, Kay

2012-08-13

Previous studies have documented strategies to promote off-label use of drugs using journal publications and other means. Few studies have presented internal company communications that discussed financial reasons for manipulating the scholarly record related to off-label indications. The objective of this study was to build on previous studies to illustrate implementation of a publication strategy by the drug manufacturer for four off-label uses of gabapentin (Neurontin, Pfizer, Inc.): migraine prophylaxis, treatment of bipolar disorders, neuropathic pain, and nociceptive pain. We included in this study internal company documents, email correspondence, memoranda, study protocols and reports that were made publicly available in 2008 as part of litigation brought by consumers and health insurers against Pfizer for fraudulent sales practices in its marketing of gabapentin (see http://pacer.mad.uscourts.gov/dc/cgi-bin/recentops.pl?filename=saris/pdf/ucl%20opinion.pdf for the Court's findings).We reviewed documents pertaining to 20 clinical trials, 12 of which were published. We categorized our observations related to reporting biases and linked them with topics covered in internal documents, that is, deciding what should and should not be published and how to spin the study findings (re-framing study results to explain away unfavorable findings or to emphasize favorable findings); and where and when findings should be published and by whom. We present extracts from internal company marketing assessments recommending that Pfizer and Parke-Davis (Pfizer acquired Parke-Davis in 2000) adopt a publication strategy to conduct trials and disseminate trial findings for unapproved uses rather than an indication strategy to obtain regulatory approval. We show internal company email correspondence and documents revealing how publication content was influenced and spin was applied; how the company selected where trial findings would be presented or published; how publication of study results was delayed; and the role of ghost authorship. Taken together, the extracts we present from internal company documents illustrate implementation of a strategy at odds with unbiased study conduct and dissemination. Our findings suggest that Pfizer and Parke-Davis's publication strategy had the potential to distort the scientific literature, and thus misinform healthcare decision-makers.

Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

NASA Astrophysics Data System (ADS)

Leguizamon, J. H.; Braidot, A.; Catalfamo Formento, P.

2011-12-01

There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

t4 report*: Toward Good Read-Across Practice (GRAP) Guidance

PubMed Central

Ball, Nicholas; Cronin, Mark T. D.; Shen, Jie; Blackburn, Karen; Booth, Ewan D.; Bouhifd, Mounir; Donley, Elizabeth; Egnash, Laura; Hastings, Charles; Juberg, Daland R.; Kleensang, Andre; Kleinstreuer, Nicole; Kroese, E. Dinant; Lee, Adam C.; Luechtefeld, Thomas; Maertens, Alexandra; Marty, Sue; Naciff, Jorge M.; Palmer, Jessica; Pamies, David; Penman, Mike; Richarz, Andrea-Nicole; Russo, Daniel P.; Stuard, Sharon B.; Patlewicz, Grace; van Ravenzwaay, Bennard; Wu, Shengde; Zhu, Hao; Hartung, Thomas

2017-01-01

Summary Grouping of substances and utilizing read-across of data within those groups represents an important data gap filling technique for chemical safety assessments. Categories/analogue groups are typically developed based on structural similarity and, increasingly often, also on mechanistic (biological) similarity. While read-across can play a key role in complying with legislation such as the European REACH regulation, the lack of consensus regarding the extent and type of evidence necessary to support it often hampers its successful application and acceptance by regulatory authorities. Despite a potentially broad user community, expertise is still concentrated across a handful of organizations and individuals. In order to facilitate the effective use of read-across, this document presents the state of the art, summarizes insights learned from reviewing ECHA published decisions regarding the relative successes/pitfalls surrounding read-across under REACH, and compiles the relevant activities and guidance documents. Special emphasis is given to the available existing tools and approaches, an analysis of ECHA's published final decisions associated with all levels of compliance checks and testing proposals, the consideration and expression of uncertainty, the use of biological support data, and the impact of the ECHA Read-Across Assessment Framework (RAAF) published in 2015. PMID:26863606

Informing Environmental Water Management Decisions: Using Conditional Probability Networks to Address the Information Needs of Planning and Implementation Cycles.

PubMed

Horne, Avril C; Szemis, Joanna M; Webb, J Angus; Kaur, Simranjit; Stewardson, Michael J; Bond, Nick; Nathan, Rory

2018-03-01

One important aspect of adaptive management is the clear and transparent documentation of hypotheses, together with the use of predictive models (complete with any assumptions) to test those hypotheses. Documentation of such models can improve the ability to learn from management decisions and supports dialog between stakeholders. A key challenge is how best to represent the existing scientific knowledge to support decision-making. Such challenges are currently emerging in the field of environmental water management in Australia, where managers are required to prioritize the delivery of environmental water on an annual basis, using a transparent and evidence-based decision framework. We argue that the development of models of ecological responses to environmental water use needs to support both the planning and implementation cycles of adaptive management. Here we demonstrate an approach based on the use of Conditional Probability Networks to translate existing ecological knowledge into quantitative models that include temporal dynamics to support adaptive environmental flow management. It equally extends to other applications where knowledge is incomplete, but decisions must still be made.

Informing Environmental Water Management Decisions: Using Conditional Probability Networks to Address the Information Needs of Planning and Implementation Cycles

NASA Astrophysics Data System (ADS)

Horne, Avril C.; Szemis, Joanna M.; Webb, J. Angus; Kaur, Simranjit; Stewardson, Michael J.; Bond, Nick; Nathan, Rory

2018-03-01

One important aspect of adaptive management is the clear and transparent documentation of hypotheses, together with the use of predictive models (complete with any assumptions) to test those hypotheses. Documentation of such models can improve the ability to learn from management decisions and supports dialog between stakeholders. A key challenge is how best to represent the existing scientific knowledge to support decision-making. Such challenges are currently emerging in the field of environmental water management in Australia, where managers are required to prioritize the delivery of environmental water on an annual basis, using a transparent and evidence-based decision framework. We argue that the development of models of ecological responses to environmental water use needs to support both the planning and implementation cycles of adaptive management. Here we demonstrate an approach based on the use of Conditional Probability Networks to translate existing ecological knowledge into quantitative models that include temporal dynamics to support adaptive environmental flow management. It equally extends to other applications where knowledge is incomplete, but decisions must still be made.

Multi-Sector Sustainability Browser (MSSB) User Manual: A ...

EPA Pesticide Factsheets

EPA’s Sustainable and Healthy Communities (SHC) Research Program is developing methodologies, resources, and tools to assist community members and local decision makers in implementing policy choices that facilitate sustainable approaches in managing their resources affecting the built environment, natural environment, and human health. In order to assist communities and decision makers in implementing sustainable practices, EPA is developing computer-based systems including models, databases, web tools, and web browsers to help communities decide upon approaches that support their desired outcomes. Communities need access to resources that will allow them to achieve their sustainability objectives through intelligent decisions in four key sustainability areas: • Land Use • Buildings and Infrastructure • Transportation • Materials Management (i.e., Municipal Solid Waste [MSW] processing and disposal) The Multi-Sector Sustainability Browser (MSSB) is designed to support sustainable decision-making for communities, local and regional planners, and policy and decision makers. Document is an EPA Technical Report, which is the user manual for the Multi-Sector Sustainability Browser (MSSB) tool. The purpose of the document is to provide basic guidance on use of the tool for users

Final safety analysis report for the Galileo Mission: Volume 1, Reference design document

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

Not Available

The Galileo mission uses nuclear power sources called Radioisotope Thermoelectric Generators (RTGs) to provide the spacecraft's primary electrical power. Because these generators contain nuclear material, a Safety Analysis Report (SAR) is required. A preliminary SAR and an updated SAR were previously issued that provided an evolving status report on the safety analysis. As a result of the Challenger accident, the launch dates for both Galileo and Ulysses missions were later rescheduled for November 1989 and October 1990, respectively. The decision was made by agreement between the DOE and the NASA to have a revised safety evaluation and report (FSAR) preparedmore » on the basis of these revised vehicle accidents and environments. The results of this latest revised safety evaluation are presented in this document (Galileo FSAR). Volume I, this document, provides the background design information required to understand the analyses presented in Volumes II and III. It contains descriptions of the RTGs, the Galileo spacecraft, the Space Shuttle, the Inertial Upper Stage (IUS), the trajectory and flight characteristics including flight contingency modes, and the launch site. There are two appendices in Volume I which provide detailed material properties for the RTG.« less

Automatic system for computer program documentation

NASA Technical Reports Server (NTRS)

Simmons, D. B.; Elliott, R. W.; Arseven, S.; Colunga, D.

1972-01-01

Work done on a project to design an automatic system for computer program documentation aids was made to determine what existing programs could be used effectively to document computer programs. Results of the study are included in the form of an extensive bibliography and working papers on appropriate operating systems, text editors, program editors, data structures, standards, decision tables, flowchart systems, and proprietary documentation aids. The preliminary design for an automated documentation system is also included. An actual program has been documented in detail to demonstrate the types of output that can be produced by the proposed system.

Earth Observations and the Role of UAVs: A Capabilities Assessment

NASA Technical Reports Server (NTRS)

Cox, Timothy H.

2006-01-01

This three-volume document, based on the draft document located on the website given on page 6, presents the findings of a NASA-led capabilities assessment of Uninhabited Aerial Vehicles (UAVs) for civil (defined as non-DoD) use in Earth observations. Volume 1 is the report that presents the overall assessment and summarizes the data. The second volume contains the appendices and references to address the technologies and capabilities required for viable UAV missions. The third volume is the living portion of this effort and contains the outputs from each of the Technology Working Groups (TWGs) along with the reviews conducted by the Universities Space Research Association (USRA). The focus of this report, intended to complement the Office of the Secretary of Defense UAV Roadmap, is four-fold: 1) To determine and document desired future Earth observation missions for all UAVs based on user-defined needs; 2) To determine and document the technologies necessary to support those missions; 3) To discuss the present state of the art platform capabilities and required technologies, including identifying those in progress, those planned, and those for which no current plans exist; 4) Provide the foundations for development of a comprehensive civil UAV roadmap. It is expected that the content of this report will be updated periodically and used to assess the feasibility of future missions. In addition, this report will provide the foundation to help influence funding decisions to develop those technologies that are considered enabling or necessary but are not contained within approved funding plans. This document is written such that each section will be supported by an Appendix that will give the reader a more detailed discussion of that section's topical materials.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 478: Area 12 T-Tunnel Ponds, Nevada Test Site

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

NSTec Environmental Restoration

This Corrective Action Decision Document (CADD)/Closure Report (CR) was prepared by the Defense Threat Reduction Agency (DTRA) for Corrective Action Unit (CAU) 478, Area 12 T-Tunnel Ponds. This CADD/CR is consistent with the requirements of the Federal Facility Agreement and Consent Order (FFACO) agreed to by the State of Nevada, the U.S. Department of Energy (DOE), and the U.S. Department of Defense. Corrective Action Unit 478 is comprised of one corrective action site (CAS): • 12-23-01, Ponds (5) RAD Area The purpose of this CADD/CR is to provide justification and documentation supporting the recommendation for closure in place with usemore » restrictions for CAU 478.« less

Corrective Action Decision Document/Closure Report for Corrective Action Unit 559: T Tunnel Compressor/Blower Pad, Nevada Test Site

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

NSTec Environmental Restoration

This Corrective Action Decision Document (CADD)/Closure Report (CR) was prepared by the Defense Threat Reduction Agency (DTRA) for Corrective Action Unit (CAU) 559, T-Tunnel Compressor/Blower Pad. This CADD/CR is consistent with the requirements of the Federal Facility Agreement and Consent Order (FFACO) agreed to by the State of Nevada, the U.S. Department of Energy, and the U.S. Department of Defense. Corrective Action Unit 559 is comprised of one Corrective Action Site (CAS): • 12-25-13, Oil Stained Soil and Concrete The purpose of this CADD/CR is to provide justification and documentation supporting the recommendation for closure in place with use restrictionsmore » for CAU 559.« less

Performance assurance of the re-applying project documentation

NASA Astrophysics Data System (ADS)

Kozlova, Olga

2017-10-01

Usage of the re-applying project documentation is cost effective measure. Saving of budgetary funds for purchases for development of new project documentation occurs by means of it. It also becomes possible to consider better decisions and prevent the repetition of mistakes. Nowadays, state authorities in construction management are forming separate institute for re-applying project documentation. The article shows the main tasks of such events and the issues to be solved for achievement of a high positive result.

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

Proceedings of the Second Joint Technology Workshop on Neural Networks and Fuzzy Logic, volume 1

NASA Technical Reports Server (NTRS)

Lea, Robert N. (Editor); Villarreal, James (Editor)

1991-01-01

Documented here are papers presented at the Neural Networks and Fuzzy Logic Workshop sponsored by NASA and the University of Houston, Clear Lake. The workshop was held April 11 to 13 at the Johnson Space Flight Center. Technical topics addressed included adaptive systems, learning algorithms, network architectures, vision, robotics, neurobiological connections, speech recognition and synthesis, fuzzy set theory and application, control and dynamics processing, space applications, fuzzy logic and neural network computers, approximate reasoning, and multiobject decision making.

Identification of Novel Drug Targets and Lead Compounds for Advanced Prostate Cancer through Genomic and Cheminformatic Analyses

DTIC Science & Technology

2016-10-01

regular group meetings and attended bi- weekly journal clubs at VPC. During the course of the two year period, I have presented the research project...DATE: October 2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012...author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation

The California Central Coast Research Partnership: Building Relationships, Partnerships and Paradigms for University-Industry Research Collaboration

DTIC Science & Technology

2005-10-14

of the decision-support systems that underlie and are key to these strategies. Cal Poly’s Collaborative Agent Design (CAD) Research Center is the...architect and lead developer of one of the first such systems: IMMACCS (Integrated Marine Multi- Agent Command and Control System), with JPL, SPAWAR...presented later in this document. An overview of accomplishments to date on the project follows: " Research carried out by the CADRC (Cooperative Agent

Ordered Rate Constitutive Theories: Development of Rate Constitutive Equations for Solids, Liquids, and Gases

DTIC Science & Technology

2010-08-18

the author(s) and should not contrued as an official Department of the Army position, policy or decision, unless so designated by other documentation...Daniel S. Nunez 0.50 Yong-Ting Ma 0.50 Tristan Moody 0.50 1.50FTE Equivalent: 3Total Number: Names of Post Doctorates PERCENT_SUPPORTEDNAME FTE...demonstrated that the constitutive theory for ordered thermofluids of all orders is indeed rate constitutive theory. The reseach work presented in this chapter

United States Air Force 611th Civil Engineer Squadron, Elmendorf AFB, Alaska. Final engineering evaluation/cost analysis potential tce impact to the drinking water supply, Galena Airport, Alaska

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

NONE

1996-02-05

This decision document presents the selected removal action to address potential trichloroethene (TCE) impact to drinking water supply wells, located in the Installation Restoration Program (IRP) site ST009, otherwise known as the West Unit, at Galena Airport, Alaska. The information fron the RI Report is summarized, along with an analysis of potential removal action alternatives, in the Engineering Evaluation/Cost Analysis (EE/CA).

United States Air Force 611th Civil Engineer Squadron, Elmendorf, AFB, Alaska. Final engineering evaluation/cost analysis, million gallon hill source area of the West Unit, Galena Airport, Alaska

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

NONE

1996-02-05

This decision document presents the selected removal action for the Million Gallon Hill source area of the Installation Restoration Program (IRP) site ST009, otherwise known as the West Unit at Galena Airport, Alaska. The information from the RI Report is summarized, along with an analysis of potential removal action alternatives in the Engineering Evaluation/Cost Analysis (EE/CA).

Watershed Management Optimization Support Tool (WMOST) v3: Theoretical Documentation

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context, accounting fo...

Change Processes in Organization.

ERIC Educational Resources Information Center

1998

This document contains four papers from a symposium on change processes in organizations. "Mid-stream Corrections: Decisions Leaders Make during Organizational Change Processes" (David W. Frantz) analyzes three organizational leaders to determine whether and how they take corrective actions or adapt their decision-making processes when…

Watershed Management Optimization Support Tool (WMOST) v2: Theoretical Documentation

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that evaluates the relative cost-effectiveness of management practices at the local or watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed c...

12 CFR 19.100 - Filing documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... motions; briefs; the record filed by the administrative law judge after the issuance of a recommended decision; the recommended decision filed by the administrative law judge following a motion for summary disposition; referrals by the administrative law judge of motions for interlocutory review; exceptions and...

(Docket A-93-02) Category V-B: Final Support Documents

EPA Pesticide Factsheets

This Index lists supporting documents related to the decision to certify that the Department of Energy had met the compliance criteria established by EPA in 40 CFR Part 194 and the disposal regulations set by EPA in 40 CFR Part 191.

TECHNICAL APPROACHES TO CHARACTERIZING AND REDEVELOPING BROWNFIELDS SITES: MUNICIPAL LANDFILLS AND ILLEGAL DUMPS

EPA Science Inventory

The guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically, municipal landfill and illegal dump sites. The document helps use...

INCORPORATING BATS IN AGROECOSYSTEM MANAGEMENT AND CROP PROTECTION DECISIONS

EPA Science Inventory

By characterizing the diet of bats in agroecosystems, this research likely will document that bats are important consumers of pest species. Additionally, this investigation will document which pest species are consumed and the relative contribution of these species to bat d...

Court of Appeals Decision Upholding PSD Actual to Potential Applicability Rules Puerto Rican Cement Co., Inc. v. EPA

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Administrator's Decision on PSD Issue -- Review of New Source's Ability to Meet BACT

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Recent Administrative and Judicial Decisions Regarding Consideration of Source Separation in Determining BACT Under PSD

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Policy Decisions With Regard To The Applicability Of The Clean Air Act Requirements To The Strategic Petroleum Reserve

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Agency and the construction of social preference: between inequality aversion and prosocial behavior.

PubMed

Choshen-Hillel, Shoham; Yaniv, Ilan

2011-12-01

The term social preference refers to decision makers' satisfaction with their own outcomes and those attained by comparable others. The present research was inspired by what appears to be a discrepancy in the literature on social preferences--specifically, between a class of studies demonstrating people's concern with inequality and others documenting their motivation to increase social welfare. The authors propose a theoretical framework to account for this puzzling difference. In particular, they argue that a characteristic of the decision setting--an individual's role in creating the outcomes, referred to as agency--critically affects decision makers' weighting of opposing social motives. Namely, in settings in which people can merely judge the outcomes, but cannot affect them ("low agency"), their concern with inequality figures prominently. In contrast, in settings in which people determine the outcomes for themselves and others ("high agency"), their concern with the welfare of others is prominent. Three studies using a new salary-allocation paradigm document a robust effect of agency. In the high-agency condition, participants had to assign salaries, whereas in the low-agency condition, they indicated their satisfaction with equivalent predetermined salaries. It was found that, compared with low-agency participants, high-agency participants were less concerned with disadvantageous salary allocations and were even willing to sacrifice a portion of their pay to better others' outcomes. The effects of agency are discussed in connection to inequality aversion, social comparison, prosocial behavior, and preference construction.

Superfund record of decision (EPA Region 7): Cornhusker Army Ammunition Plant, Operable Unit 1, Hall County, Grand Island, NE, September 29, 1994

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

NONE

1995-04-01

The decision document presents the selected interim remedial action for the groundwater operable unit at the Cornhusker Army Ammunition Plant (CAAP). Operable Unit One encompasses the explosives groundwater plume(s), both on-post and off-post. Explosives of concern in the contaminant plume include RDX, TNT, HMX, and their decomposition products. The objective of the interim action is to contain the plume and prevent further migration of contaminants, and does not encompass full restoration of the plume of contaminated groundwater. The recommended alternatives provide an approach to containing and removing contaminant mass from the groundwater plume. This approach will control further migration ofmore » the plume and reduce the levels of the contamination in groundwater.« less

Superfund Record of Decision (EPA Region 4): Milan Army Ammunition Plant, O-Line Ponds Area, Milan, TN, September 1993

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

Not Available

1993-09-01

The decision document presents the selected remedial action for Operable Unit Two (OU2) at the O-Line Ponds Area, Milan Army Ammunition Plant, Milan, Tennessee. The goal of the overall cleanup activities at the site is to prevent migration of contaminants from soil at the site and to prevent exposures to these contaminants, so that no adverse health effects will result from current or future off-post or on-post use. Soil contaminated with explosives compounds is known to exist in the O-Line Ponds area, and under current conditions, this contamination poses a potential threat to groundwater at the site. Currently contaminated groundwatermore » is being addressed by separate remedial actions under different Operable Units (OUs).« less

Superfund record of decision (EPA Region 1): Loring Air Force Base, operable unit 3 (Debris Disposal Unit), Limestone, ME, September 27, 1996

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

NONE

1997-04-01

This decision document presents the final remedies for OU3, which consists of 17 sites: No further action for the following 14 NFA (no further action) sites - Ohio Road Debris Area, Oklahoma Road Debris Area, KC-135 Crash Area, Dumpster Cleaning Area Site/Building 7841, Explosive Ordnance Disposal (EOD) Area-Cylinders, Golf Course Maintenance Shed Area, Chapman Pit Debris Area, 9000 Debris Area, Solvent/Paint Dock Area, Prima Beef Debris Area, Buildings 8951 and 8960 (DRMO), Old PX Gas Station UST, F-106A Crash Area, and Demineralization Plant; Further investigation for the Outdoor Firing Range and EOD Range; and Remedial action for the Contract Storagemore » Shed Area site to address the contaminated soils/sediments.« less

Superfund record of decision (EPA Region 3): Allegany Ballistics Laboratory (USNavy) Site 10, Mineral, WV, June 30, 1998

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

NONE

1998-12-01

This decision document presents the selected remedial action for Site 10 (the Site) Groundwater at the Allegany Ballistics Laboratory (ABL), Rocket Center, West Virginia. The major components of the selected remedy are: Institutional controls, including land use restrictions imposed through appropriate administrative mechanisms to prevent groundwater use; Groundwater pumping from a minimum of three extraction wells to capture the hot spot of the VOC contaminant plume; Installation of a pipeline to transport groundwater from Site 10 to the Site 1 treatment plant; Discharge to the North Branch Potomac River; and Groundwater monitoring on a timely basis, quarterly to semi-annually, willmore » evaluate groundwater quality, contaminant migration, and degradation for inclusion in the 5-year site reviews.« less

Superfund record of decision (EPA Region 4): Marine Corps Base (site 35), operable unit 10, Camp Lejeune, NC, September 22, 1995

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

NONE

1996-01-01

This decision document presents the selected remedy for surficial groundwater for a portion of Operable Unit (OU) No. 10 (Site 35), Marine Corps Base (MCB), Camp Lejeune, North Carolina. Five Remedial Action Alternatives (RAAs) were evaluated as part of an interim remedial investigation/feasibility study for surficial groundwater at OU No. 10 (Site 35). These RAAs included RAA 1 (No Action), RAA 2 (No Action With Institutional Controls), RAA 3 (Groundwater Collection and On-site Treatment), RAA 4 (In Situ Air Sparging and Off-Gas Carbon Adsorption) and RAA 5 (In Well Aeration and Off-Gas Adsorption). After all five RAAs were compared tomore » established criteria, RAA 5 was selected as the preferred alternative.« less

External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

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

Shakespeare, Thomas P.; Back, Michael F.; Lu, Jiade J.

2006-03-01

Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/qualitymore » assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs.« less

Screening-Level Ecological Risk Assessment Methods, Revision 3

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

Mirenda, Richard J.

2012-08-16

This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessmentmore » is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.« less

Implementation of Improvements in an Electronic Documentation Nursing Process System Structured on NANDA-I, NOC and NIC (NNN) Classification.

PubMed

Peres, Heloísa; Cruz, Diná; Tellez, Michelle; de Cássia Gengo E Silva, Rita; Ortiz, Diley; Diogo, Regina; Ortiz, Dóris R

2016-01-01

The aim of this study was to present the experience of a teaching hospital with the implementation of improvements to an electronic documentation system of the nursing process (PROCEnf-USP®). The improvements were based on functional performance and technical quality of the system. It was adopted Scrum^™ method for version control PROCEnf-USP® by enabling agility, flexibility and possibility of integration between development and users. The PROCEnf-USP® has been used since 2009 and has professional and academic environments. The current version lets you generate reports and supports decisions about diagnoses, outcomes and interventions. It is provided the use of indicators to monitor results and registration at the point of care. The establishment of important.

Superfund record of decision amendment (EPA Region 5): Ott/Story/Cordova Chemical Co., Dalton Township, MI, February 26, 1998

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

NONE

This decision document presents the amendment to the Record of Decision (ROD) for Operable Unit (O.U.) No. 3 at the Ott/Story/Cordova Site (the Site) in Muskegon, MI. On September 27, 1993 a ROD was signed for the O.U. No. 3 Remedial Action choosing Low Temperature Thermal Desorption (LTTD) to treat contaminated plant area soils and sediments in Little Bear Creek and its unnamed tributary. This amendment to the ROD: eliminates LTTD from the remedy; revises the volume of soils to be remediated by excavation and off-site disposal as a result of an understanding that the land use for the sitemore » will remain industrial instead of residential as provided for in the 1993 ROD; requires regular sampling of surface water and sediments to determine the need for remedial action in the Little Bear Creek; and requires deed restrictions to insure that use of the site remains industrial.« less

Documentation of Decision-Aiding Software: Introductory Guide

DTIC Science & Technology

1980-02-01

for the Manager ( New York: Holt, ’ 6 ( Simply put, the discipline assists planners and deci- sion makers in choosing between alternative courses of...con- ducting international negotiations on tanker safety; g. use by Headquarters, U.S. Marine Corps as an orga- nizing vehicle for the preparation of...literature on decision analysis. For an introductory treatment the reader should refer to Howard Raiffa, Decision Analysis (Reading, Massachusetts

Corporate Information Management: A Case Study

DTIC Science & Technology

1991-03-01

SUBJECT TERMS ( FIELD GROUP SUB-GROUP ICorporate Information Management (CIM), Case study, Strategic level decision making, Department Of Defense. 19...ABSTRACT ( This thesis documents in a case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s...case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s Corporate Information Management

Supporting Students with Disabilities Entering the Science, Technology, Engineering, and Mathematics Field Disciplines

NASA Astrophysics Data System (ADS)

Dishauzi, Karen M.

Extensive research exists on female, African American, and Hispanic students pursuing Science, Technology, Engineering and Mathematics (STEM) field disciplines. However, little research evaluates students with disabilities and career decision-making relating to STEM field disciplines. This study explored the career decision-making experiences and self-efficacy for students with disabilities. The purpose of this research study was to document experiences and perceptions of students with disabilities who pursue, and may consider pursuing, careers in the STEM field disciplines by exploring the career decision-making self-efficacy of students with disabilities. This study documented the level of influence that the students with disabilities had or may not have had encountered from parents, friends, advisors, counselors, and instructors as they managed their decision-making choice relating to their academic major/career in the STEM or non-STEM field disciplines. A total of 85 respondents of approximately 340 students with disabilities at one Midwestern public university completed a quantitatively designed survey instrument. The Career Decision-Making Self-Efficacy Scale-Short Form by Betz and Hackett was the instrument used, and additional questions were included in the survey. Data analysis included descriptive statistics and analysis of variance. Based upon the results, college students with disabilities are not currently being influenced by individuals and groups of individuals to pursue the STEM field disciplines. This is a cohort of individuals who can be marketed to increase enrollment in STEM programs at academic institutions. This research further found that gender differences at the institution under study did not affect the career decision-making self-efficacy scores. The men did not score any higher in confidence in career decision-making than the women. Disability type did not significantly affect the relationship between the Career Decision-Making Self-Efficacy Total Scores or college major choice. Of the three disability types represented more frequently, the Mental Health disability was found to be a growing disability at the institution under study. This research was found to be beneficial in the documentation of specific levels of influence perceived by students with disabilities from parents, friends, advisors, counselors, and instructors that related to their career decision-making and academic major choices.

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

United States Air Force 611th Air Support Group/Civil Engineering Squadron Elmendorf AFB, Alaska. Decision document for no further response action planned: Barter Island Radar Installation, Alaska. Final report, December 1995-May 1996

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

Karmi, S.; Madden, J.; Borsetti, R.

1996-05-03

This Decision Document discusses the selection of no further action as the recommended action for nine sites located at the Barter Island radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the 14 sites located at the Barter Island installation (U.S. Air Force 1996a,b). Based on the findings of these activities, nine sites are recommended for no further action.

25 CFR 1000.230 - How is a waiver approval documented for the record?

Code of Federal Regulations, 2010 CFR

2010-04-01

... record? The waiver decision is made part of the AFA by attaching a copy of it to the AFA and by mutually... posted on the Office of Self-Governance web site and all such decisions shall be made available on...

48 CFR 2415.308 - Source selection decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Source selection decision. 2415.308 Section 2415.308 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN... document its selection recommendation(s) in a final written report. The final report shall include...

50 CFR 13.28 - Permit revocation.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., POSSESSION, TRANSPORTATION, SALE, PURCHASE, BARTER, EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS... documentation. (3) A decision on the revocation shall be made within 45 days after the end of the objection period. The issuing officer shall notify the permittee in writing of the Service's decision and the...

“Smart Forms” in an Electronic Medical Record: Documentation-based Clinical Decision Support to Improve Disease Management

PubMed Central

Schnipper, Jeffrey L.; Linder, Jeffrey A.; Palchuk, Matvey B.; Einbinder, Jonathan S.; Li, Qi; Postilnik, Anatoly; Middleton, Blackford

2008-01-01

Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due, in part, to the fact that clinicians do not use CDSS fully. Barriers to clinicians' use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing “Smart Forms” to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions. PMID:18436911

"Smart Forms" in an Electronic Medical Record: documentation-based clinical decision support to improve disease management.

PubMed

Schnipper, Jeffrey L; Linder, Jeffrey A; Palchuk, Matvey B; Einbinder, Jonathan S; Li, Qi; Postilnik, Anatoly; Middleton, Blackford

2008-01-01

Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due, in part, to the fact that clinicians do not use CDSS fully. Barriers to clinicians' use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing "Smart Forms" to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions.

Increasing Sales by Developing Production Consortiums.

ERIC Educational Resources Information Center

Smith, Christopher A.; Russo, Robert

Intended to help rehabilitation facility administrators increase organizational income from manufacturing and/or contracted service sources, this document provides a decision-making model for the development of a production consortium. The document consists of five chapters and two appendices. Chapter 1 defines the consortium concept, explains…

TECHNICAL APPROACHES TO CHARACTERIZING AND CLEANING UP BROWNFIELDS SITES: PULP AND PAPER MILLS

EPA Science Inventory

This guidance document gives assistance to communities, decision-makers, states and municipalities, academia, and the private sector to address issues related to the redevelopment of Brownfields sites, specifically pulp and paper mills sites. The document helps users to understan...

The Need for Systematic Identification of Stakeholders for Public Engagement with Environmental Research

EPA Science Inventory

Despite the increasing promotion of stakeholder engagement in science contributing to environmental decision making, the mechanisms for identifying which stakeholders should be included are rarely strategic or documented. When documented, many of these efforts use ad hoc and/or ...

The Vendors' Corner--The Request for Proposal.

ERIC Educational Resources Information Center

Sugnet, Chris; And Others

1987-01-01

Several online vendors address the issue of RFPs (requests for proposals) for library systems, discussing the documents' style, technical standards, library expectations, liabilities associated with using this procedure, factors in the decision to bid, and the need for a standardized document and national clearinghouse. (CLB)

32 CFR 317.4 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...'s written Privacy Act request for access to or amendment of documents filed in Privacy Act systems... Privacy Act request for access to or amendment of documents filed in Privacy Act systems of records. This... decisions of respective initial denial authorities. (b) The Chief, Administrative Management Division under...

Consensus of recommendations guiding comparative effectiveness research methods.

PubMed

Morton, Jacob B; McConeghy, Robert; Heinrich, Kirstin; Gatto, Nicolle M; Caffrey, Aisling R

2016-12-01

Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations. We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap. We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents. We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Use of Video Decision Aids to Promote Advance Care Planning in Hilo, Hawai'i.

PubMed

Volandes, Angelo E; Paasche-Orlow, Michael K; Davis, Aretha Delight; Eubanks, Robert; El-Jawahri, Areej; Seitz, Rae

2016-09-01

Advance care planning (ACP) seeks to promote care delivery that is concordant with patients' informed wishes. Scalability and cost may be barriers to widespread ACP, and video decision aids may help address such barriers. Our primary hypothesis was that ACP documentation would increase in Hilo after ACP video implementation. Secondary hypotheses included increased use of hospice, fewer deaths in the hospital, and decreased costs in the last month of life. The city of Hilo in Hawai'i (population 43,263), which is served by one 276-bed hospital (Hilo Medical Center), one hospice (the Hospice of Hilo), and 30 primary care physicians. The intervention consisted of a single, 1- to 4-h training and access to a suite of ACP video decision aids. Prior to implementation, the rate of ACP documentation for hospitalized patients with late-stage disease was 3.2 % (11/346). After the intervention, ACP documentation was 39.9 % (1,107/2,773) (P < 0.001). Primary care providers in the intervention had an ACP completion rate for patients over 75 years of 37.0 % (1,437/3,888) compared to control providers, who had an average of 25.6 % (10,760/42,099) (P < 0.001). The rate of discharge from hospital to hospice for patients with late-stage disease was 5.7 % prior to the intervention and 13.8 % after the intervention (P < 0.001). The average total insurance cost for the last month of life among Hilo patients was $3,458 (95 % CI $3,051 to 3,865) lower per patient after the intervention when compared to the control region. Implementing ACP video decision aids was associated with improved ACP documentation, greater use of hospice, and decreased costs. Decision aids that promote ACP offer a scalable and cost-efficient medium to place patients at the center of their care.

How to improve vital sign data quality for use in clinical decision support systems? A qualitative study in nine Swedish emergency departments.

PubMed

Skyttberg, Niclas; Vicente, Joana; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2016-06-04

Vital sign data are important for clinical decision making in emergency care. Clinical Decision Support Systems (CDSS) have been advocated to increase patient safety and quality of care. However, the efficiency of CDSS depends on the quality of the underlying vital sign data. Therefore, possible factors affecting vital sign data quality need to be understood. This study aims to explore the factors affecting vital sign data quality in Swedish emergency departments and to determine in how far clinicians perceive vital sign data to be fit for use in clinical decision support systems. A further aim of the study is to provide recommendations on how to improve vital sign data quality in emergency departments. Semi-structured interviews were conducted with sixteen physicians and nurses from nine hospitals and vital sign documentation templates were collected and analysed. Follow-up interviews and process observations were done at three of the hospitals to verify the results. Content analysis with constant comparison of the data was used to analyse and categorize the collected data. Factors related to care process and information technology were perceived to affect vital sign data quality. Despite electronic health records (EHRs) being available in all hospitals, these were not always used for vital sign documentation. Only four out of nine sites had a completely digitalized vital sign documentation flow and paper-based triage records were perceived to provide a better mobile workflow support than EHRs. Observed documentation practices resulted in low currency, completeness, and interoperability of the vital signs. To improve vital sign data quality, we propose to standardize the care process, improve the digital documentation support, provide workflow support, ensure interoperability and perform quality control. Vital sign data quality in Swedish emergency departments is currently not fit for use by CDSS. To address both technical and organisational challenges, we propose five steps for vital sign data quality improvement to be implemented in emergency care settings.