Decision-making in diabetes mellitus type 1.

PubMed

Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

2013-01-01

Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.

Diffusion of responsibility attenuates altruistic punishment: A functional magnetic resonance imaging effective connectivity study.

PubMed

Feng, Chunliang; Deshpande, Gopikrishna; Liu, Chao; Gu, Ruolei; Luo, Yue-Jia; Krueger, Frank

2016-02-01

Humans altruistically punish violators of social norms to enforce cooperation and pro-social behaviors. However, such altruistic behaviors diminish when others are present, due to a diffusion of responsibility. We investigated the neural signatures underlying the modulations of diffusion of responsibility on altruistic punishment, conjoining a third-party punishment task with event-related functional magnetic resonance imaging and multivariate Granger causality mapping. In our study, participants acted as impartial third-party decision-makers and decided how to punish norm violations under two different social contexts: alone (i.e., full responsibility) or in the presence of putative other third-party decision makers (i.e., diffused responsibility). Our behavioral results demonstrated that the diffusion of responsibility served as a mediator of context-dependent punishment. In the presence of putative others, participants who felt less responsible also punished less severely in response to norm violations. Our neural results revealed that underlying this behavioral effect was a network of interconnected brain regions. For unfair relative to fair splits, the presence of others led to attenuated responses in brain regions implicated in signaling norm violations (e.g., AI) and to increased responses in brain regions implicated in calculating values of norm violations (e.g., vmPFC, precuneus) and mentalizing about others (dmPFC). The dmPFC acted as the driver of the punishment network, modulating target regions, such as AI, vmPFC, and precuneus, to adjust altruistic punishment behavior. Our results uncovered the neural basis of the influence of diffusion of responsibility on altruistic punishment and highlighted the role of the mentalizing network in this important phenomenon. Hum Brain Mapp 37:663-677, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Warfighter decision making performance analysis as an investment priority driver

NASA Astrophysics Data System (ADS)

Thornley, David J.; Dean, David F.; Kirk, James C.

2010-04-01

Estimating the relative value of alternative tactics, techniques and procedures (TTP) and information systems requires measures of the costs and benefits of each, and methods for combining and comparing those measures. The NATO Code of Best Practice for Command and Control Assessment explains that decision making quality would ideally be best assessed on outcomes. Lessons learned in practice can be assessed statistically to support this, but experimentation with alternate measures in live conflict is undesirable. To this end, the development of practical experimentation to parameterize effective constructive simulation and analytic modelling for system utility prediction is desirable. The Land Battlespace Systems Department of Dstl has modeled human development of situational awareness to support constructive simulation by empirically discovering how evidence is weighed according to circumstance, personality, training and briefing. The human decision maker (DM) provides the backbone of the information processing activity associated with military engagements because of inherent uncertainty associated with combat operations. To develop methods for representing the process in order to assess equipment and non-technological interventions such as training and TTPs we are developing componentized or modularized timed analytic stochastic model components and instruments as part of a framework to support quantitative assessment of intelligence production and consumption methods in a human decision maker-centric mission space. In this paper, we formulate an abstraction of the human intelligence fusion process from the Defence Science and Technology Laboratory's (Dstl's) INCIDER model to include in our framework, and synthesize relevant cost and benefit characteristics.

Multi-criteria decision aid approach for the selection of the best compromise management scheme for ELVs: the case of Cyprus.

PubMed

Mergias, I; Moustakas, K; Papadopoulos, A; Loizidou, M

2007-08-25

Each alternative scheme for treating a vehicle at its end of life has its own consequences from a social, environmental, economic and technical point of view. Furthermore, the criteria used to determine these consequences are often contradictory and not equally important. In the presence of multiple conflicting criteria, an optimal alternative scheme never exists. A multiple-criteria decision aid (MCDA) method to aid the Decision Maker (DM) in selecting the best compromise scheme for the management of End-of-Life Vehicles (ELVs) is presented in this paper. The constitution of a set of alternatives schemes, the selection of a list of relevant criteria to evaluate these alternative schemes and the choice of an appropriate management system are also analyzed in this framework. The proposed procedure relies on the PROMETHEE method which belongs to the well-known family of multiple criteria outranking methods. For this purpose, level, linear and Gaussian functions are used as preference functions.

Environmental Systems Conflict Resolution

NASA Astrophysics Data System (ADS)

Hipel, K. W.

2017-12-01

The Graph Model for Conflict Resolution (GMCR) is applied to a real-life groundwater contamination dispute to demonstrate how one can realistically model and analyze the controversy in order to obtain an enhanced understanding and strategic insights for permitting one to make informed decisions. This highly divisive conflict is utilized to explain a rich range of inherent capabilities of GMCR, as well as worthwhile avenues for extensions, which make GMCR a truly powerful decision technology for addressing challenging conflict situations. For instance, a flexible preference elicitation method called option prioritization can be employed to obtain the relative preferences of each decision maker (DM) in the dispute over the states or scenarios which can occur, based upon preference statements regarding the options or courses of actions available to the DMs. Solution concepts, reflecting the way a chess player thinks in terms of moves and counter-moves, are defined to mirror the ways humans may behave under conflict, varying from short to long term thinking. After ascertaining the best outcome that a DM can achieve on his or her own in a conflict, coalition analysis algorithms are available to check if a DM can fare even better via cooperating with others. The ability of GMCR to take into account emotions, strength of preference, attitudes, misunderstandings (referred to as hypergames), and uncertain preferences (unknown, fuzzy, grey and probabilistic) greatly broadens its scope of applicability. Techniques for tracing how a conflict can evolve over time from a status quo state to a final specified outcome, as well as how to handle hierarchical structures, such as when a central government interacts with its provinces or states, further enforces the comprehensive nature of GMCR. Within ongoing conflict research mimicking how physical systems are analyzed, methods for inverse engineering of preferences are explained for determining the preferences required by one or more DMs in order for a desirable resolution to be reached. In the behavioral engine problem, the manner in which a DM may be thinking strategically under conflict can be calculated given the input preferences and a selected equilibrium.

Factors influencing decision regret regarding placement of a PEG among substitute decision-makers of older persons in Japan: a prospective study.

PubMed

Kuraoka, Yumiko; Nakayama, Kazuhiro

2017-06-28

A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made. The objective of this study was to explore the factors that influence decision regret among substitute decision-makers 6 months after using a decision aid for PEG placement. In this prospective study, participants comprised substitute decision-makers for 45 inpatients aged 65 years and older who were being considered for placement of a PEG tube in hospitals, nursing homes and patients' homes in Japan. The Decisional Conflict Scale (DCS) was used to evaluate decisional conflict among substitute decision-makers immediately after deciding whether to introduce tube feeding and the Decision Regret Scale (DRS) was used to evaluate decisional regret among substitute decision-makers 6 months after they made their decision. Normalized scores were evaluated and analysis of variance was used to compare groups. The results of the multiple regression analysis suggest that PEG placement (P < .01) and decision conflict (P < .001) are explanatory factors of decision regret regarding placement of a PEG among substitute decision-makers. PEG placement and decision conflict immediately after deciding whether to allow PEG placement have an influence on decision regret among substitute decision-makers after 6 months.

What do decision makers learn from public forums on climate-related hazards and resilience?

NASA Astrophysics Data System (ADS)

Weller, N.; Farooque, M.; Sittenfeld, D.

2017-12-01

Public engagement around climate resilience efforts can foster learning for both public audiences and decision makers. On the one hand, public audiences learn about environmental hazards and strategies to increase community resilience through effective public engagement. On the other, decision makers and scientists learn about community members' values and priorities and their relation to environmental hazards and resilience strategies. Evidence from other public engagement efforts involving decision makers suggests that decision maker involvement results in reflection by officials on their own values, capacities, and roles. However, few public engagement exercises evaluate impacts on decision makers. As part of the Science Center Public Forums project, which aims to conduct public forums in eight cities across the country on resiliency to drought, heat, extreme precipitation, and sea level rise, we sought to 1) build partnerships with local decision makers and scientists around public forums and 2) explore how decision makers and scientists interacted with the planning and undertaking of those public forums. We held workshops with decision makers and scientists to inform forum content and identify local resilience issues. We will conduct interviews with local decision makers regarding their involvement in forum planning, their reflections and takeaways from the forum itself, and their perspectives on the value of public engagement for policy making. We will present our model of engagement with decision makers, initial findings from interviews, and lessons learned from connecting decision makers and scientists to public engagement efforts.

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

PubMed

Trees, April R; Ohs, Jennifer E; Murray, Meghan C

2017-06-07

End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Cost-utility analysis of intravenous immunoglobulin for the treatment of steroid-refractory dermatomyositis in Thailand.

PubMed

Bamrungsawad, Naruemon; Chaiyakunapruk, Nathorn; Upakdee, Nilawan; Pratoomsoot, Chayanin; Sruamsiri, Rosarin; Dilokthornsakul, Piyameth

2015-05-01

Intravenous immunoglobulin (IVIG) has been shown to be effective in treating steroid-refractory dermatomyositis (DM). There remains no evidence of its cost-effectiveness in Thailand. Our objective was to estimate the cost utility of IVIG as a second-line therapy in steroid-refractory DM in Thailand. A Markov model was developed to estimate the relevant costs and health benefits for IVIG plus corticosteroids in comparison with immunosuppressant plus corticosteroids in steroid-refractory DM from a societal perspective over a patient's lifetime. The effectiveness and utility parameters were obtained from clinical literature, meta-analyses, medical record reviews, and patient interviews, whereas cost data were obtained from an electronic hospital database and patient interviews. Costs are presented in $US, year 2012 values. All future costs and outcomes were discounted at a rate of 3% per annum. One-way and probabilistic sensitivity analyses were also performed. Over a lifetime horizon, the model estimated treatment under IVIG plus corticosteroids to be cost saving compared with immunosuppressant plus corticosteroids, where the saving of costs and incremental quality-adjusted life-years (QALYs) were $US4738.92 and 1.96 QALYs, respectively. Sensitivity analyses revealed that probability of response of immunosuppressant plus corticosteroids was the most influential parameter on incremental QALYs and costs. At a societal willingness-to-pay threshold in Thailand of $US5148 per QALY gained, the probability of IVIG being cost effective was 97.6%. The use of IVIG plus corticosteroids is cost saving compared with treatment with immunosuppressant plus corticosteroids in Thai patients with steroid-refractory DM. Policy makers should consider using our findings in their decision-making process for adding IVIG to corticosteroids as the second-line therapy for steroid-refractory DM patients.

Appropriateness for Total Joint Replacement: Perspectives of Decision-Makers

PubMed Central

Clavel, Nathalie; De coster, Carolyn; Pomey, Marie-Pascale; Sanmartin, Claudia; Bohm, Éric; Dunbar, Michael J.; Frank, CY; Hawker, Gillian; Noseworthy, Tom

2016-01-01

Background: Improving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incurring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR. Objective: While our previous research focused on the appropriateness of TJR from clinical and patient perspectives, this study is aimed at understanding decision-makers' perspectives. Methods: Using a semi-structured guide, we interviewed a convenience sample of decision-makers in four Canadian provinces (Alberta, Manitoba, Nova Scotia and Quebec) between February and March 2013. For the purposes of this study, a decision-maker was defined as a manager, institutional leader or policy maker. Results: Fifteen interviews were conducted with decision-makers at ministry (n = 3), regional (n = 6) and institutional levels (n = 8). Decision-makers see themselves as having a key role in the appropriateness discourse, that of optimizing resource allocation and efficient delivery of services for TJR, to improve population outcomes. Conclusion: The decision-makers' view of appropriateness recognizes the importance of the clinical view, but it offers a very different input into the appropriateness discourse, more closely aligned with appropriateness of setting, which refers to cost-effectiveness considerations. PMID:27027795

Strategic control in decision-making under uncertainty.

PubMed

Venkatraman, Vinod; Huettel, Scott A

2012-04-01

Complex economic decisions - whether investing money for retirement or purchasing some new electronic gadget - often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, evaluate outcomes against a variety of contexts, and flexibly match behavior to changes in the environment. In recent years, substantial research has implicated the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision-making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision-making. This region contains a functional topography such that the posterior dmPFC supports response-related control, whereas the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue for both generalized contributions of the dmPFC to cognitive control, and specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are likely to be critical for decision-making in other domains, including interpersonal interactions in social settings. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Strategic Control in Decision Making under Uncertainty

PubMed Central

Venkatraman, Vinod; Huettel, Scott

2012-01-01

Complex economic decisions – whether investing money for retirement or purchasing some new electronic gadget – often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, to evaluate outcomes against a variety of contexts, and to flexibly match behavior to changes in the environment. In recent years, substantial research implicates the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision making. This region contains a functional topography such that the posterior dmPFC supports response-related control while the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue both for generalized contributions of the dmPFC to cognitive control, and for specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are also likely to be critical for decision making in other domains, including interpersonal interactions in social settings. PMID:22487037

Is It Social Problem Solving or Decision Making? Implications for Health Education

ERIC Educational Resources Information Center

Frauenknecht, Marianne; Black, David R.

2010-01-01

This paper makes a case that decision making (DM) is not social problem solving (SPS) and DM is subordinate and subsumed within SPS. Both terms are defined and distinguished. Confusion between SPS and DM is widespread and has occurred for at least four decades. DM, not SPS, has been established as one of the seven National Health Education…

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

PubMed

Reddy, K Srikanth; Sahay, Seema

2016-01-01

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

Deriving preference order of post-mining land-uses through MLSA framework: application of an outranking technique

NASA Astrophysics Data System (ADS)

Soltanmohammadi, Hossein; Osanloo, Morteza; Aghajani Bazzazi, Abbas

2009-08-01

This study intends to take advantage of a previously developed framework for mined land suitability analysis (MLSA) consisted of economical, social, technical and mine site factors to achieve a partial and also a complete pre-order of feasible post-mining land-uses. Analysis by an outranking multi-attribute decision-making (MADM) technique, called PROMETHEE (preference ranking organization method for enrichment evaluation), was taken into consideration because of its clear advantages on the field of MLSA as compared with MADM ranking techniques. Application of the proposed approach on a mined land can be completed through some successive steps. First, performance of the MLSA attributes is scored locally by each individual decision maker (DM). Then the assigned performance scores are normalized and the deviation amplitudes of non-dominated alternatives are calculated. Weights of the attributes are calculated by another MADM technique namely, analytical hierarchy process (AHP) in a separate procedure. Using the Gaussian preference function beside the weights, the preference indexes of the land-use alternatives are obtained. Calculation of the outgoing and entering flows of the alternatives and one by one comparison of these values will lead to partial pre-order of them and calculation of the net flows, will lead to a ranked preference for each land-use. At the final step, utilizing the PROMETHEE group decision support system which incorporates judgments of all the DMs, a consensual ranking can be derived. In this paper, preference order of post-mining land-uses for a hypothetical mined land has been derived according to judgments of one DM to reveal applicability of the proposed approach.

Attunement and alignment of people with schizophrenia and their preferred alternative decision-makers: An exploratory pilot study comparing treatment and research decisions.

PubMed

Roberts, Laura Weiss; Kim, Jane Paik

2015-12-01

Schizophrenia is a serious mental disorder that may affect the decisional capacity, and as a consequence, preferred alternative decision-makers may be engaged to help with clinical care and research-related choices. Ideally, alternative decision-makers will seek to make decisions that fit with the views and preferences of the ill individual. Few data exist, however, comparing the views of alternative decision-makers to those of individuals with schizophrenia. We conducted a written survey with individuals with schizophrenia living in a community setting, and a parallel survey with the person whom the ill individual identified as being a preferred alternative decision-maker. Complete data were obtained on 20 pairs (n = 40, total). Domains queried included (a) burden, happiness, and safety of the ill individual and of his or her family in treatment and research decisions and (b) importance of ethical principles in every day life. Two-sided paired t-tests and graphical summaries were used to compare responses. Individuals with schizophrenia and their linked preferred alternative decision-makers were attuned on four of six aspects of treatment decision-making and on all six aspects of research decision-making that we queried. The preferred alternative decision-makers overall demonstrated attunement to the views of the ill individuals in this small study. Ill individuals and their preferred alternative decision-makers were aligned in their views of ethically-salient aspects of every day life. These novel findings suggest that alternative decision-makers identified by ill individuals may be able to guide choices based on an accurate understanding of the ill individuals' views and values. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dissociation between decision-making under risk and decision-making under ambiguity in premanifest and manifest Huntington's disease.

PubMed

Adjeroud, Najia; Besnard, Jeremy; Verny, Christophe; Prundean, Adriana; Scherer, Clarisse; Gohier, Bénédicte; Bonneau, Dominique; Massioui, Nicole El; Allain, Philippe

2017-08-01

We investigated decision-making under ambiguity (DM-UA) and decision making under risk (DM-UR) in individuals with premanifest and manifest Huntington's disease (HD). Twenty individuals with premanifest HD and 23 individuals with manifest HD, on one hand, and 39 healthy individuals divided into two control groups, on the other, undertook a modified version of the Iowa Gambling Task (IGT), an adaptation of a DM-UA task, and a modified version of the Game of Dice Task (GDT), an adaptation of a DM-UR task. Participants also filled in a questionnaire of impulsivity and responded to cognitive tests specifically designed to assess executive functions. Compared to controls, individuals with premanifest HD were unimpaired in performing executive tests as well as in decision-making tasks, except for the Stroop task. In contrast, individuals with manifest HD were impaired in both the IGT and executive tasks, but not in the GDT. No sign of impulsivity was observed in individuals with premanifest or manifest HD. Our results suggest that the progression of HD impairs DM-UA without affecting DM-UR, and indicate that decision-making abilities are preserved during the premanifest stage of HD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bridging the gap between science and decision making.

PubMed

von Winterfeldt, Detlof

2013-08-20

All decisions, whether they are personal, public, or business-related, are based on the decision maker's beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers' information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making.

Trusted Advisors, Decision Models and Other Keys to Communicating Science to Decision Makers

NASA Astrophysics Data System (ADS)

Webb, E.

2006-12-01

Water resource management decisions often involve multiple parties engaged in contentious negotiations that try to navigate through complex combinations of legal, social, hydrologic, financial, and engineering considerations. The standard approach for resolving these issues is some form of multi-party negotiation, a formal court decision, or a combination of the two. In all these cases, the role of the decision maker(s) is to choose and implement the best option that fits the needs and wants of the community. However, each path to a decision carries the risk of technical and/or financial infeasibility as well as the possibility of unintended consequences. To help reduce this risk, decision makers often rely on some type of predictive analysis from which they can evaluate the projected consequences of their decisions. Typically, decision makers are supported in the analysis process by trusted advisors who engage in the analysis as well as the day to day tasks associated with multi-party negotiations. In the case of water resource management, the analysis is frequently a numerical model or set of models that can simulate various management decisions across multiple systems and output results that illustrate the impact on areas of concern. Thus, in order to communicate scientific knowledge to the decision makers, the quality of the communication between the analysts, the trusted advisor, and the decision maker must be clear and direct. To illustrate this concept, a multi-attribute decision analysis matrix will be used to outline the value of computer model-based collaborative negotiation approaches to guide water resources decision making and communication with decision makers. In addition, the critical role of the trusted advisor and other secondary participants in the decision process will be discussed using examples from recent water negotiations.

Good decision-making is associated with an adaptive cardiovascular response to social competitive stress.

PubMed

Alacreu-Crespo, Adrián; Costa, Raquel; Abad-Tortosa, Diana; Salvador, Alicia; Serrano, Miguel Ángel

2018-06-22

Competition elicits different psychological and cardiovascular responses depending on a person's skills. Decision-making has been considered a distal factor that influences competition, but there are no studies analyzing this relationship. Our objective was to analyze whether decision-making affects the response to competition. Specifically, we aimed to test whether good performers on a decision-making test, the Iowa Gambling Task (IGT), showed an adaptive cardiovascular response to competition. In all, 116 participants (44 women) performed the IGT and were classified into Good or Poor decision-makers. Subsequently, they were exposed to a stress task in two different conditions: a face-to-face competition (winners/losers) or a control condition, while an electrocardiogram was recorded. In the competition group, good decision-makers increased their high-frequency respect to the total heart rate variability (HF/HRV) levels during the task, compared to Poor decision-makers. Again, competition group good decision-makers, showed lower LF and higher HF/HRV reactivity than the control group, which represents lower HRV stress pattern. Moreover, in the group of losers, good decision-makers had a decline in low frequency (LF) during the task and faster recovery than poor decision-makers. In conclusion, good decision-makers have a more adaptive stress response and higher levels of mental effort, based on total HRV interpretation. Decision-making skills could be a factor in a more adaptive cardiovascular response to competition.

Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study

PubMed Central

2014-01-01

Background Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon. Objective To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM. Results A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time. PMID:24906634

Use of economic evaluation in decision making: evidence and recommendations for improvement.

PubMed

Simoens, Steven

2010-10-22

Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

SCIENCE, SCIENTISTS, AND POLICY ADVOCACY

EPA Science Inventory

To effectively resolve many current ecological policy issues, decision-makers require an array of scientific information. Sometimes scientific information is summarized for decision-makers by policy analysts or others, but often it comes directly from scientists to decision-maker...

Helping decision makers frame, analyze, and implement decisions

USGS Publications Warehouse

Runge, Michael C.; McDonald-Madden, Eve

2018-01-01

All decisions have the same recognizable elements. Context, objectives, alternatives, consequences, and deliberation. Decision makers and analysts familiar with these elements can quickly see the underlying structure of a decision.There are only a small number of classes of decisions. These classes differ in the cognitive and scientific challenge they present to the decision maker; the ability to recognize the class of decision leads a decision maker to tools to aid in the analysis.Sometimes we need more information, sometimes we don’t. The role of science in a decision-making process is to provide the predictions that link the alternative actions to the desired outcomes. Investing in more science is only valuable if it helps to choose a better action.Implementation. The successful integration of decision analysis into environmental decisions requires careful attention to the decision, the people, and the institutions involved.

Method of predicting a change in an economy

DOEpatents

Pryor, Richard J [Albuquerque, NM; Basu, Nipa [Albany, NY

2006-01-10

An economy whose activity is to be predicted comprises a plurality of decision makers. Decision makers include, for example, households, government, industry, and banks. The decision makers are represented by agents, where an agent can represent one or more decision makers. Each agent has decision rules that determine the agent's actions. Each agent can affect the economy by affecting variable conditions characteristic of the economy or the internal state of other agents. Agents can communicate actions through messages. On a multiprocessor computer, the agents can be assigned to processing elements.

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

ERIC Educational Resources Information Center

Woods, Jeffrey G.

2012-01-01

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

49 CFR 1503.657 - Appeal from initial decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND ENFORCEMENT PROCEDURES Rules of Practice in TSA Civil Penalty Actions § 1503.657 Appeal from... order of the TSA decision maker have been entered on the record. (b) Issues on appeal. A party may... appeal with the consent of the TSA decision maker. If the TSA decision maker grants an extension of time...

Bridging the Gap: Tailor-made Information Products for Decision Makers

NASA Astrophysics Data System (ADS)

Mandler, B. E.; Rose, C. A.; Gonzales, L. M.; Boland, M. A.

2016-12-01

The American Geosciences Institute (AGI) is launching a new information platform designed to link decision makers with information generated by geoscientific research. Decision makers, especially those at the state and local level, frequently need scientific information but do not always have easy access to it, while scientists create new knowledge but often lack opportunities to communicate this knowledge more broadly to the people who need it the most. Major differences in communication styles and language can also hinder the use of scientific information by decision makers. AGI is building an online portfolio of case studies and fact sheets that are based on cutting-edge research presented in a format and style that meets the needs and expectations of decision makers. Based on discussions with state and local decision makers around the country, AGI has developed a template for these products. Scientists are invited to write short (500-700-word) summaries of their research and the ways in which it provides useful tools and information to decision makers. We are particularly interested in showcasing actionable information derived from basic or applied research. Researchers are encouraged to contact AGI to discuss topics that may be an appropriate basis for case studies or fact sheets, and AGI may also contact researchers based on scientific needs identified during our discussions with decision makers. All submissions will be edited and reviewed by AGI staff and an external peer review team before being published online and made available to decision makers through AGI's Critical Issues web platform and extensive professional networks. Publicizing the results of scientific research to key legislative, regulatory, advisory, and engaged citizen groups and individuals broadens the impact of scientists' research and highlights the value and importance of the geosciences to society. By presenting the information in a format that is designed with the end-user in mind, this initiative provides a much-needed service to decision makers at all levels and serves the geoscience community by increasing the distribution and dissemination of research findings. We will discuss early results and challenges from this program, and feedback from state and local decision makers.

Low Complexity Compression and Speed Enhancement for Optical Scanning Holography

PubMed Central

Tsang, P. W. M.; Poon, T.-C.; Liu, J.-P.; Kim, T.; Kim, Y. S.

2016-01-01

In this paper we report a low complexity compression method that is suitable for compact optical scanning holography (OSH) systems with different optical settings. Our proposed method can be divided into 2 major parts. First, an automatic decision maker is applied to select the rows of holographic pixels to be scanned. This process enhances the speed of acquiring a hologram, and also lowers the data rate. Second, each row of down-sampled pixels is converted into a one-bit representation with delta modulation (DM). Existing DM-based hologram compression techniques suffers from the disadvantage that a core parameter, commonly known as the step size, has to be determined in advance. However, the correct value of the step size for compressing each row of hologram is dependent on the dynamic range of the pixels, which could deviate significantly with the object scene, as well as OSH systems with different opical settings. We have overcome this problem by incorporating a dynamic step-size adjustment scheme. The proposed method is applied in the compression of holograms that are acquired with 2 different OSH systems, demonstrating a compression ratio of over two orders of magnitude, while preserving favorable fidelity on the reconstructed images. PMID:27708410

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

EPA Science Inventory

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

A meta-analysis of decision-making and attention in adults with ADHD.

PubMed

Mowinckel, Athanasia M; Pedersen, Mads Lund; Eilertsen, Espen; Biele, Guido

2015-05-01

Deficient reward processing has gained attention as an important aspect of ADHD, but little is known about reward-based decision-making (DM) in adults with ADHD. This article summarizes research on DM in adult ADHD and contextualizes DM deficits by comparing them to attention deficits. Meta-analytic methods were used to calculate average effect sizes for different DM domains and continuous performance task (CPT) measures. None of the 59 included studies (DM: 12 studies; CPT: 43; both: 4) had indications of publication bias. DM and CPT measures showed robust, small to medium effects. Large effect sizes were found for a drift diffusion model analysis of the CPT. The results support the existence of DM deficits in adults with ADHD, which are of similar magnitude as attention deficits. These findings warrant further examination of DM in adults with ADHD to improve the understanding of underlying neurocognitive mechanisms. © 2014 SAGE Publications.

[The Intentions Affecting the Medical Decision-Making Behavior of Surrogate Decision Makers of Critically Ill Patients and Related Factors].

PubMed

Su, Szu-Huei; Wu, Li-Min

2018-04-01

The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. A cross-sectional, correlation study design was used. A total of 193 surrogate decision makers from six ICUs in a medical center in southern Taiwan were enrolled as participants. Three structured questionnaires were used, including a demographic datasheet, the Family Relationship Scale, and the Behavioral Intention of Medical Decisions Scale. Significantly positive correlations were found between the behavioral intentions underlying medical decisions and the following variables: the relationship of the participant to the patient (Eta = .343, p = .020), the age of the patient (r = .295, p < .01), and whether the patient had signed a currently valid advance healthcare directive (Eta = .223, p = .002). Furthermore, a significantly negative correlation was found between these intentions and length of stay in the ICU (r = -.263, p < .01). Patient age, whether the patient had signed a currently valid advance healthcare directive, and length of stay in the ICU were all predictive factors for the behavioral intentions underlying the medical decisions of the surrogate decision makers, explaining 13.9% of the total variance. In assessing the behavioral intentions underlying the medical decisions of surrogate decision makers, health providers should consider the relationship between critical patients and their surrogate decision makers, patient age, the length of ICU stay, and whether the patient has a pre-signed advance healthcare directive in order to maximize the effectiveness of medical care provided to critically ill patients.

Discrepancies between cognition and decision making in older adults

PubMed Central

Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Barnes, Lisa L.; Bennett, David A.

2015-01-01

Background and aims There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project. Methods Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived. Results Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM < COG, while 11.0 % showed DM > COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM < COG group. Being male was associated with higher odds of being in the DM > COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors. Conclusion These results support the consideration of decision making and cognition as potentially separate constructs. PMID:25995167

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

ERIC Educational Resources Information Center

Goodnough, Lawrence T.; And Others

1992-01-01

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

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

DOE PAGES

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

2016-09-03

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

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

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Decision making in high-velocity environments: implications for healthcare.

PubMed

Stepanovich, P L; Uhrig, J D

1999-01-01

Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

Information processing by networks of quantum decision makers

NASA Astrophysics Data System (ADS)

Yukalov, V. I.; Yukalova, E. P.; Sornette, D.

2018-02-01

We suggest a model of a multi-agent society of decision makers taking decisions being based on two criteria, one is the utility of the prospects and the other is the attractiveness of the considered prospects. The model is the generalization of quantum decision theory, developed earlier for single decision makers realizing one-step decisions, in two principal aspects. First, several decision makers are considered simultaneously, who interact with each other through information exchange. Second, a multistep procedure is treated, when the agents exchange information many times. Several decision makers exchanging information and forming their judgment, using quantum rules, form a kind of a quantum information network, where collective decisions develop in time as a result of information exchange. In addition to characterizing collective decisions that arise in human societies, such networks can describe dynamical processes occurring in artificial quantum intelligence composed of several parts or in a cluster of quantum computers. The practical usage of the theory is illustrated on the dynamic disjunction effect for which three quantitative predictions are made: (i) the probabilistic behavior of decision makers at the initial stage of the process is described; (ii) the decrease of the difference between the initial prospect probabilities and the related utility factors is proved; (iii) the existence of a common consensus after multiple exchange of information is predicted. The predicted numerical values are in very good agreement with empirical data.

Quality of life in type 2 diabetes mellitus patients requiring insulin treatment in Buenos Aires, Argentina: a cross-sectional study

PubMed Central

Pichon-Riviere, Andres; Irazola, Vilma; Beratarrechea, Andrea; Alcaraz, Andrea; Carrara, Carolina

2015-01-01

Background: Decision-makers have begun to recognize Health-Related Quality of Life (HRQoL) as an important and measurable outcome of healthcare interventions; and HRQoL data is increasingly being used by policy-makers to prioritize health resources. Our objective was to measure HRQoL in a group of Type 2 Diabetes Mellitus (T2DM) patients receiving insulin treatment in Buenos Aires, Argentina. Methods: We conducted a cross-sectional study of patients with T2DM over 21 years of age, treated with either Neutral Protamine Hagedorn (NPH) insulin or Insulin Glargine (IG), who had not changed their baseline schedule in the last 6 months. The recruitment was during 2006–7 in nine private diabetes specialists’ offices in Buenos Aires, Argentina. A standardized diabetes-specific HRQoL questionnaire, the Audit of Diabetes Dependent Quality of Life (ADDQoL), was used. Results: A total of 183 patients were included (93 receiving NPH and 90 receiving IG). The mean QoL score was: 0.98 (SD: 0.89) and the diabetes specific QoL was: -1.49 (SD: 0.90). T2DM had a negative impact on HRQoL with a mean Average Weighted Impact (AWI) score on QoL of -1.77 (SD: 1.58). The greatest negative impact was observed for domains: ‘worries about the future’, ‘freedom to eat’, ‘living conditions’, ‘sex life’, and ‘family life’. The mean AWI score was -1.71 (SD: 1.48) in patients treated with IG and -1.85 (SD: 1.68) in patients receiving NPH, this difference was not statistically significant. Conclusion: The ADDQoL questionnaire is a tool that can be used in Argentina to measure the QoL of patients with diabetes when evaluating diabetes care programs. The scores of QoL in our selected population did not differ from those reported in high-income countries. We expect that the results of this study will increase healthcare providers’ awareness of patients’ perceived QoL and help to overcome the barriers that delay insulin treatment; mainly clinical inertia and patient resistance PMID:26188812

The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis.

PubMed

Varney, J E; Liew, D; Weiland, T J; Inder, W J; Jelinek, G A

2016-09-27

Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Telephone Coaching Study (DTCS) demonstrated that telephone coaching is an intervention that may improve the risk factor status and diabetes management practices of people with T2DM. Measuring the cost effectiveness of this intervention is important to inform funding decisions that may facilitate the translation of this research into clinical practice. The purpose of this study is to assess the cost-effectiveness of telephone coaching, compared to usual diabetes care, in participants with poorly controlled T2DM. A cost utility analysis was undertaken using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model to extrapolate outcomes collected at 6 months in the DTCS over a 10 year time horizon. The intervention's impact on life expectancy, quality-adjusted life expectancy (QALE) and costs was estimated. Costs were reported from a health system perspective. A 5 % discount rate was applied to all future costs and effects. One-way sensitivity analyses were conducted to reflect uncertainty surrounding key input parameters. The intervention dominated the control condition in the base-case analysis, contributing to cost savings of $3327 per participant, along with non-significant improvements in QALE (0.2 QALE) and life expectancy (0.3 years). The cost of delivering the telephone coaching intervention continuously, for 10 years, was fully recovered through cost savings and a trend towards net health benefits. Findings of cost savings and net health benefits are rare and should prove attractive to decision makers who will determine whether this intervention is implemented into clinical practice. ACTRN12609000075280.

The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making.

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Charles, Cathy; Gafni, Amiram; Entwistle, Vikki; Epstein, Ronald; Juraskova, Ilona

2017-11-01

Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM. Copyright © 2017 Elsevier B.V. All rights reserved.

Information Needs Assessment for Coastal and Marine Management and Policy: Ecosystem Services Under Changing Climatic, Land Use, and Demographic Conditions.

PubMed

Goldsmith, Kaitlin A; Granek, Elise F; Lubitow, Amy

2015-12-01

Changing climatic, demographic, and land use conditions are projected to alter the provisioning of ecosystem services in estuarine, coastal, and nearshore marine ecosystems, necessitating mitigation and adaptation policies and management. The current paradigm of research efforts occurring in parallel to, rather than in collaboration with, decision makers will be insufficient for the rapid responses required to adapt to and mitigate for projected changing conditions. Here, we suggest a different paradigm: one where research begins by engaging decision makers in the identification of priority data needs (biophysical, economic, and social). This paper uses synthesized interview data to provide insight into the varied demands for scientific research as described by decision makers working on coastal issues in Oregon, USA. The findings highlight the need to recognize (1) the differing framing of ecosystem services by decision makers versus scientists; and (2) the differing data priorities relevant to inland versus coastal decision makers. The findings further serve to highlight the need for decision makers, scientists, and funders to engage in increased communication. This research is an important first step in advancing efforts toward evidence-based decision making in Oregon and provides a template for further research across the US.

A randomized comparison between league tables and funnel plots to inform health care decision-making.

PubMed

Anell, Anders; Hagberg, Oskar; Liedberg, Fredrik; Ryden, Stefan

2016-12-01

Comparison of provider performance is commonly used to inform health care decision-making. Little attention has been paid to how data presentations influence decisions. This study analyzes differences in suggested actions by decision-makers informed by league tables or funnel plots. Decision-makers were invited to a survey and randomized to compare hospital performance using either league tables or funnel plots for four different measures within the area of cancer care. For each measure, decision-makers were asked to suggest actions towards 12-16 hospitals (no action, ask for more information, intervene) and provide feedback related to whether the information provided had been useful. Swedish health care. Two hundred and twenty-one decision-makers at administrative and clinical levels. Data presentations in the form of league tables or funnel plots. Number of actions suggested by participants. Proportion of appropriate actions. For all four measures, decision-makers tended to suggest more actions based on the information provided in league tables compared to funnel plots (44% vs. 21%, P < 0.001). Actions were on average more appropriate for funnel plots. However, when using funnel plots, decision-makers more often missed to react even when appropriate. The form of data presentation had an influence on decision-making. With league tables, decision-makers tended to suggest more actions compared to funnel plots. A difference in sensitivity and specificity conditioned by the form of presentation could also be identified, with different implications depending on the purpose of comparisons. Explanations and visualization aids are needed to support appropriate actions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Bridge over troubled waters: A Synthesis Session to connect ...

EPA Pesticide Factsheets

Lack of access to relevant scientific data has limited decision makers from incorporating scientific information into their management and policy schemes. Yet, there is increasing interest among decision makers and scientists to integrate coastal and marine science into the policy and management process. Strategies designed to build communication between decision makers and scientists can be an effective means to disseminate and/or generate policy relevant scientific information. Here researchers develop, test, and present a workshop model designed to bridge the gap between coastal and marine decision makers and scientists. Researchers identify successful components of such a workshop as well as areas for improvement and recommendations to design and conduct similar workshops in the future. This novel workshop format can be used in other fora to effectively connect decision makers and scientists, and to initiate an iterative process to generate and transfer policy relevant scientific information into evidence-based decisions, an important element in protecting coastal and marine resources. In this paper we develop and present a model for increasing collaboration between scientists and decision makers to promote evidence based decisions. Successes and areas for improvement in the tested model are discussed. This novel workshop model is intended to build and sustain connections, with the ultimate goal of creating better policy and management practices. In a recent

Prompting students to make socioscientific decisions: embedding metacognitive guidance in an e-learning environment

NASA Astrophysics Data System (ADS)

Hsu, Ying-Shao; Lin, Shu-Sheng

2017-05-01

This study aimed at improving the decision-making (DM) skills of 11th graders by incorporating a DM framework, visualisation tools, collaboration, and metacognitive guidance into a socioscientific issue context. Two classes, the experimental group (embedded metacognitive guidance, N = 42) and the comparison group (no metacognitive guidance, N = 32), were involved in the implementation of the experimental methodology. An open-ended test and worksheets were developed to assess the students' DM skills. The results indicated that the two versions of the DM learning modules had similar effects on the improvement in the students' DM skills, but there were significant differences in their overall skills in DM (Z = -6.410, p < .001), generating criteria (Z = -6.956, p < .001), and evaluating DM results (Z = -2.533, p < .011) based on the student responses on the worksheets. These findings indicate that further studies need to explore the mechanism of metacognitive guidance for students with different socioscientific issue DM skills in e-learning environments.

Taking off the white coat: can family members who are physicians be good surrogate decision-makers?

PubMed

Issa, Amalia M

2002-05-01

The challenges inherent in physicians treating members of their own families are well known. However, the issues related to physicians acting as surrogate decision-makers on behalf of relatives have not been addressed. The growing number of older persons will increase the need not only for healthcare resources, but also for physicians to act on behalf of incapacitated family members as surrogate decision-makers. In this paper, some of the clinical and ethical tensions evoked by physicians serving as surrogate decision-makers for family members are explored. Some recommendations for managing these tensions are suggested.

Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

PubMed

Convey, Helen; Holt, Janet; Summers, Barbara

2018-07-01

This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

Information needs and decision-making preferences of older women offered a choice between surgery and primary endocrine therapy for early breast cancer.

PubMed

Burton, Maria; Kilner, Karen; Wyld, Lynda; Lifford, Kate Joanna; Gordon, Frances; Allison, Annabel; Reed, Malcolm; Collins, Karen Anna

2017-12-01

To establish older women's (≥75 years) information preferences regarding 2 breast cancer treatment options: surgery plus adjuvant endocrine therapy versus primary endocrine therapy. To quantify women's preferences for the mode of information presentation and decision-making (DM) style. This was a UK multicentre survey of women, ≥75 years, who had been offered a choice between PET and surgery at diagnosis of breast cancer. A questionnaire was developed including 2 validated scales of decision regret and DM preferences. Questionnaires were sent to 247 women, and 101 were returned (response rate 41%). The median age of participants was 82 (range 75 to 99), with 58 having had surgery and 37 having PET. Practical details about the impact, safety, and efficacy of treatment were of most interest to participants. Of least interest were cosmetic outcomes after surgery. Information provided verbally by doctors and nurses, supported by booklets, was preferred. There was little interest in technology-based sources of information. There was equal preference for a patient- or doctor-centred DM style and lower preference for a shared DM style. The majority (74%) experienced their preferred DM style. Levels of decision regret were low (15.73, scale 0-100). Women strongly preferred face to face information. Written formats were also helpful but not computer-based resources. Information that was found helpful to women in the DM process was identified. The study demonstrates many women achieved their preferred DM style, with a preference for involvement, and expressed low levels of decision regret. Copyright © 2017 John Wiley & Sons, Ltd.

Multi-criteria decision analysis using hydrological indicators for decision support - a conceptual framework.

NASA Astrophysics Data System (ADS)

Butchart-Kuhlmann, Daniel; Kralisch, Sven; Meinhardt, Markus; Fleischer, Melanie

2017-04-01

Assessing the quantity and quality of water available in water stressed environments under various potential climate and land-use changes is necessary for good water and environmental resources management and governance. Within the region covered by the Southern African Science Service Centre for Climate Change and Adaptive Land Management (SASSCAL) project, such areas are common. One goal of the SASSCAL project is to develop and provide an integrated decision support system (DSS) with which decision makers (DMs) within a given catchment can obtain objective information regarding potential changes in water flow quantity and timing. The SASSCAL DSS builds upon existing data storage and distribution capability, through the SASSCAL Information System (IS), as well as the J2000 hydrological model. Using output from validated J2000 models, the SASSCAL DSS incorporates the calculation of a range of hydrological indicators based upon Indicators of Hydrological Alteration/Environmental Flow Components (IHA/EFC) calculated for a historic time series (pre-impact) and a set of model simulations based upon a selection of possible climate and land-use change scenarios (post-impact). These indicators, obtained using the IHA software package, are then used as input for a multi-criteria decision analysis (MCDA) undertaken using the open source diviz software package. The results of these analyses will provide DMs with an indication as to how various hydrological indicators within a catchment may be altered under different future scenarios, as well providing a ranking of how each scenario is preferred according to different DM preferences. Scenarios are represented through a combination of model input data and parameter settings in J2000, and preferences are represented through criteria weighting in the MCDA. Here, the methodology is presented and applied to the J2000 Luanginga model results using a set of hypothetical decision maker preference values as input for an MCDA based on the PROMETHEE II outranking method. Future work on the SASSCAL DSS will entail automation of this process, as well as its application to other hydrological models and land-use and/or climate change scenarios.

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

ERIC Educational Resources Information Center

LiaBraaten, James Clayton

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

NREL's Winning Hand of Clean Transportation Tools - Continuum Magazine |

Science.gov Websites

kinds of decision makers-supplying resources for fleets to reduce petroleum use or an individual warehouse that offers invaluable information to decision makers, such as city planners, to help them with ;The TSDC provided useful data for decision-makers. And the state passed what will be a $65 million

Forensic issues in medical evaluation: competency and end-of-life issues.

PubMed

Soliman, Sherif; Hall, Ryan C W

2015-01-01

Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments. © 2015 S. Karger AG, Basel.

Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

PubMed

Petrinec, Amy B; Mazanec, Polly M; Burant, Christopher J; Hoffer, Alan; Daly, Barbara J

2015-06-01

To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. A single-group descriptive longitudinal correlational study. Medical, surgical, and neurological ICUs in a large tertiary care university hospital. Consecutive family decision makers of adult critical care patients from August 2012 to November 2013. Study inclusion occurred after the patient's fifth day in the ICU. None. Family decision makers of incapacitated adult ICU patients completed the Brief COPE instrument assessing coping strategy use 5 days after ICU admission and 30 days after hospital discharge or death of the patient and completed the Impact of Event Scale-Revised assessing posttraumatic stress symptoms 60 days after hospital discharge. Seventy-seven family decision makers of the eligible 176 completed all data collection time points of this study. The use of problem-focused (p=0.01) and emotion-focused (p<0.01) coping decreased over time while avoidant coping (p=0.20) use remained stable. Coping strategies 30 days after hospitalization (R2=0.50, p<0.001) were better predictors of later posttraumatic stress symptoms than coping strategies 5 days after ICU admission (R2=0.30, p=0.001) controlling for patient and decision-maker characteristics. The role of decision maker for a parent and patient death were the only noncoping predictors of posttraumatic stress symptoms. Avoidant coping use 30 days after hospitalization mediated the relationship between patient death and later posttraumatic stress symptom severity. Coping strategy use is a significant predictor of posttraumatic stress symptom severity 60 days after hospitalization in family decision makers of ICU patients.

Linking decision-making research and cancer prevention and control: important themes.

PubMed

McCaul, Kevin D; Peters, Ellen; Nelson, Wendy; Stefanek, Michael

2005-07-01

This article describes 6 themes underlying the multiple presentations from the Basic and Applied Decision Making in Cancer Control meeting, held February 19-20, 2004. The following themes have important implications for research and practice linking basic decision-making research to cancer prevention and control: (a) Traditional decision-making theories fail to capture real-world decision making, (b) decision makers are often unable to predict future preferences, (c) preferences are often constructed on the spot and thus are influenced by situational cues, (d) decision makers often rely on feelings rather than beliefs when making a decision, (e) the perspective of the decision maker is critical in determining preferences, and (f) informed decision making may--or may not--yield the best decisions.

Defining decision making: a qualitative study of international experts' views on surgical trainee decision making.

PubMed

Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H

2011-06-01

Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

The current capacity and future development of economic evaluation for policy decision-making: a survey among researchers and decision-makers in Thailand.

PubMed

Chaikledkaew, Usa; Lertpitakpong, Chanida; Teerawattananon, Yot; Thavorncharoensap, Montarat; Tangcharoensathien, Viroj

2009-01-01

This study aims to explore the knowledge, experience, and attitudes toward economic evaluation (EE) among decision-makers and researchers in Thailand. Researchers were purposively selected from Thai academics and both public and private research organizations related to EE. Decision-makers at the provincial level were purposively selected from the members of the Management Committees of Provincial Health Offices, and those at hospital level were randomly selected from members of the public and private hospital formulary drug committees throughout Thailand. The self-administered postal questionnaires were distributed. Univariate and bivariate analyses were applied. Of the total 2575 questionnaires distributed, 758 (29.4% response rate) were completed and sent back. The majority of researchers and decision-makers were not familiar with technical terms commonly used in health EE, e.g., incremental cost-effectiveness ratio, discounting, and sensitivity analysis. More decision-makers (70.6%) had never had EE training compared to researchers (50.0%). Both roles indicated that value for money was one of the important issues to consider for health technology adoption. An extensive unmet demand for EE training among Thai researchers and decision-makers still exists. Findings from this study contribute to the short- and long-term plans for research capacity building.

Fuzzy bilevel programming with multiple non-cooperative followers: model, algorithm and application

NASA Astrophysics Data System (ADS)

Ke, Hua; Huang, Hu; Ralescu, Dan A.; Wang, Lei

2016-04-01

In centralized decision problems, it is not complicated for decision-makers to make modelling technique selections under uncertainty. When a decentralized decision problem is considered, however, choosing appropriate models is no longer easy due to the difficulty in estimating the other decision-makers' inconclusive decision criteria. These decision criteria may vary with different decision-makers because of their special risk tolerances and management requirements. Considering the general differences among the decision-makers in decentralized systems, we propose a general framework of fuzzy bilevel programming including hybrid models (integrated with different modelling methods in different levels). Specially, we discuss two of these models which may have wide applications in many fields. Furthermore, we apply the proposed two models to formulate a pricing decision problem in a decentralized supply chain with fuzzy coefficients. In order to solve these models, a hybrid intelligent algorithm integrating fuzzy simulation, neural network and particle swarm optimization based on penalty function approach is designed. Some suggestions on the applications of these models are also presented.

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

PubMed

Tsalatsanis, Athanasios; Hozo, Iztok; Vickers, Andrew; Djulbegovic, Benjamin

2010-09-16

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

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

PubMed Central

2010-01-01

Background Decision curve analysis (DCA) has been proposed as an alternative method for evaluation of diagnostic tests, prediction models, and molecular markers. However, DCA is based on expected utility theory, which has been routinely violated by decision makers. Decision-making is governed by intuition (system 1), and analytical, deliberative process (system 2), thus, rational decision-making should reflect both formal principles of rationality and intuition about good decisions. We use the cognitive emotion of regret to serve as a link between systems 1 and 2 and to reformulate DCA. Methods First, we analysed a classic decision tree describing three decision alternatives: treat, do not treat, and treat or no treat based on a predictive model. We then computed the expected regret for each of these alternatives as the difference between the utility of the action taken and the utility of the action that, in retrospect, should have been taken. For any pair of strategies, we measure the difference in net expected regret. Finally, we employ the concept of acceptable regret to identify the circumstances under which a potentially wrong strategy is tolerable to a decision-maker. Results We developed a novel dual visual analog scale to describe the relationship between regret associated with "omissions" (e.g. failure to treat) vs. "commissions" (e.g. treating unnecessary) and decision maker's preferences as expressed in terms of threshold probability. We then proved that the Net Expected Regret Difference, first presented in this paper, is equivalent to net benefits as described in the original DCA. Based on the concept of acceptable regret we identified the circumstances under which a decision maker tolerates a potentially wrong decision and expressed it in terms of probability of disease. Conclusions We present a novel method for eliciting decision maker's preferences and an alternative derivation of DCA based on regret theory. Our approach may be intuitively more appealing to a decision-maker, particularly in those clinical situations when the best management option is the one associated with the least amount of regret (e.g. diagnosis and treatment of advanced cancer, etc). PMID:20846413

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

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

Webb, Erik Karl; Tidwell, Vincent Carroll

2009-10-01

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

Health decision-making preferences among African American men recruited from urban barbershops.

PubMed

Hart, Alton; Smith, Wally R; Tademy, Raymond H; McClish, Donna K; McCreary, Micah

2009-07-01

To examine general health decision-making roles among African American men ages 40 to 70 recruited in barbershops in the Richmond, Virginia, metropolitan area. We adapted the 1-item Control Preference scale to study the associations between health decision-making role preferences and demographic variables. Forty African-American men were recruited from barbershops to complete a self-administered survey. After performing descriptive statistics, we dichotomized our outcome into active vs nonactive (collaborative or passive) decision makers. Data were then analyzed using chi2, Wilcoxon-Mann-Whitney rank sum, and multiple logistic regression. Fifteen subjects responded that they engaged in active decision making, 20 in collaborative, and 5 in passive decision making. Almost all (86.7%) active decision makers were home owners, vs 41.7% of nonactive decision makers. Among active decision makers, 46.7% had incomes of more than $70000, vs 12.5% of nonactive decision makers. The active group reported health status that was good to excellent, while 20.8% of those in the nonactive group reported poor/fair health. African American male barbershop clients preferred an active or collaborative health decision-making role with their physician, rather than a passive role. The relationship among home ownership, income, and decision style may best be understood by considering the historical and cultural influences on gender role socialization among African American males. More comprehensive assessment of decision styles is necessary to better understand health decision making among African American male patients.

QEEG-based neural correlates of decision making in a well-trained eight year-old chess player.

PubMed

Alipour, Abolfazl; Seifzadeh, Sahar; Aligholi, Hadi; Nami, Mohammad

2017-10-25

The neurocognitive substrates of decision making (DM) in the context of chess has appealed to researchers' interest for decades. Expert and beginner chess players are hypothesized to employ different brain functional networks when involved in episodes of critical DM upon chess. Cognitive capacities including, but not restricted to pattern recognition, visuospatial search, reasoning, planning and DM are perhaps the key determinants of rewarding and judgmental decisions in chess. Meanwhile, the precise neural correlates of DM in this context has largely remained elusive. The quantitative electroencephalography (QEEG) is an investigation tool possessing a proper temporal resolution in the study of neural correlates of cognitive tasks at cortical level. Here, we used a 22-channel EEG setup and digital polygraphy in a well-trained 8 year-old boy while engaged in playing chess against the computer. Quantitative analyses were done to map and source-localize the EEG signals. Our analyses indicated a lower power spectral density (PSD) for higher frequency bands in the right hemisphere upon DM-related epochs. Moreover, the information flow upon DM blocks in this particular case was more of posterior towards anterior brain regions.

Effect of a patient decision aid (PDA) for type 2 diabetes on knowledge, decisional self-efficacy, and decisional conflict.

PubMed

Bailey, Robert A; Pfeifer, Michael; Shillington, Alicia C; Harshaw, Qing; Funnell, Martha M; VanWingen, Jeffrey; Col, Nanada

2016-01-14

Patients with type 2 diabetes (T2DM) often have poor glycemic control on first-line pharmacologic therapy and require treatment intensification. Intensification decisions can be difficult because of many available options and their many benefits and risks. The American Diabetes Association recommends patient-centered, evidence-based tools supporting shared decision-making between patients and clinicians. We developed a patient decision aid (PDA) targeting decisions about treatment intensification for T2DM. Our objective was to determine the effectiveness of this PDA for patients with T2DM on metformin who require treatment intensification. This study was a pragmatic randomized controlled trial conducted in 27 US primary care and endocrinology clinics. Subjects were English-speaking adults with T2DM receiving metformin with persistent hyperglycemia who were recommended to consider medication intensification. Subjects were randomized to receive either the PDA or usual care (UC). Main outcome measures were change in knowledge, decisional self-efficacy, and decisional conflict. Of 225 subjects enrolled, 114 were randomized to the PDA and 111 to UC. Mean [SD] age was 52 [1] years, time since T2DM diagnosis was 6 [+/-6] years, 45.3% were male, and most (55.5%) were non-Caucasian. Compared to UC, PDA users had significantly larger knowledge gains (35.0% [22.3] vs 9.9% [22.2]; P < 0.0001) and larger improvements in self-efficacy (3.7 [16.7] vs-3.9 [19.2]; P < 0.0001) and decisional conflict (-22.2 [20.6] vs-7.5 [16.6]; P < 0.0001). The PDA resulted in substantial and significant improvements in knowledge, decisional conflict and decisional self-efficacy. Decisional conflict scores after PDA use were within the range that correlates with effective decision-making. This PDA has the potential to facilitate shared-decision-making for patients with T2DM. NCT02110979.

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

PubMed

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

2014-06-01

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

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

PubMed Central

2011-01-01

Background In many countries occupational health care system is in change. Occupational health studies are mainly focused on occupational health substance and content. This study offers new perspectives on municipal OHS and its operations from management perspective. Aim The aim of this study is to analyse how New Public Management (NPM) doctrines are applied in the Finnish occupational health care system (OHS). The main focus is to describe and compare the views of decision-makers' and OH workers within the framework of NPM. Methods The data were collected by semi-structured interviews from 17 municipal decision-makers' and 26 municipal OH workers. Data was analyzed by examining coded data in a theory-driven way according to Hood's doctrine of NPM. Results The doctrines were not as compatible with the OH personnel view as with the decision-makers' view. Decision-makers and OH personnel highlighted the strict criteria required for operation evaluation. Moreover, decision-makers strongly accentuated professional management in the public sector and the reorganization of public sector units. These were not equally relevant in OH personnel views. In OH personnel views, other doctrines (more attention to performance and accomplishments, emphasizing and augmentation of the competition and better control of public expense and means test) were not similarly in evidence, only weak evidence was observed when their importance viewed as medium by decision-makers. Neither of the respondents group kept the doctrine of management models of the private sector relevant. Conclusions The NPM and Hoods doctrine fitted well with OH research. The doctrine brought out view differences and similarities between decision-makers and OH personnel. For example, policymakers highlighted more strongly the structural change by emphasizing professional management compared to OH personnel. The need for reorganization of municipal OH, regardless of different operational preconditions, was obvious for both decision-makers and OH personnel. The adaptation of more clarify management to a municipal context is not trouble-free. The municipality systemic structure, complex operational environment, and reconciliation of political and officer authority set challenges to management of municipalities. PMID:21880141

Decision Theory and the Governance of Technology.

ERIC Educational Resources Information Center

Woodhouse, Edward J.

1987-01-01

Provides an overview of the decision making process for science and technology. Finds that government agencies and officials are not the major decision makers. Examines obstacles to achieving intelligent decisions when policy makers are scientists, business executives, and consumers. Concludes with five strategies for improving technological…

Decision-Making Skills and Vocational Maturity Among Adolescents.

ERIC Educational Resources Information Center

Lokan, Janice J.; Trebilco, Geoffrey R.

The learning of decision-making (DM) skills and appropriate attitudes is an important objective of career education. This study provides an empirical test of theoretical links between aspects of DM styles and vocational maturity (VM) in adolescence. Approximately 260 Australian students in grades ten and twelve answered questionnaires measuring…

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

NASA Astrophysics Data System (ADS)

Bray, D.

2012-12-01

This case study of climate change communications assesses the salient means of communication and the message adopted by regional political decision makers on the German Baltic coast. Realizing that cultural factors and local values (and not simply knowledge) are significant influences in explaining attitudes towards climate change, this analysis draws from the records of regional weather, from scientists with a specific focus on the region, from the political decision makers for that region, and the media message reaching the decision makers, ensuring all elements of the analysis are drawn from the same socioeconomic, geophysical, political and cultural context. This is important as the social dynamics surrounding the trust in science is of critical importance and, as such, all elements of the case study are specifically contained within a common context. If the utility of climate change knowledge is to prompt well conceived adaptation/mitigation strategies then the political decision process, or at least the perceptions shaping it, can best be understood by locating it within the world view of the decision makers involved in the production process. Using the results of two survey questionnaires, one of regional climate scientists and one of regional political decision makers, ten years of local weather records, and a summary of the message from mass media circulation, the discord in perceptions of regional climate change are quantitatively explored. The conclusions drawn from the analysis include, compared to the scientific assessment: The decision makers' perceptions of recent past differ from actual observations. The decision makers' perceptions of the future differ from scientific assessments. The decision makers tend to over estimate the magnitude of regional climate change and its impacts. The decision makers tend to over estimate the sense of immediacy for adaptation measures. The conclusions drawn suggest that in the regional political realm, it is often a social construction of climate change, not scientific claims, that are shaping decisions. While certainty is the common demand of those charged with making decisions concerning climate change, certainty is the quality that seems to be given least value in taking action. Weather records are all but ignored. The direct voice of scientists was heeded but not fully accepted. In the transition, the truth-to-power model appears to be somewhat modified, whereby power states that the future will be different, but the difference is determined by other sources; shaping images of risk and danger. One could not deny that climate and sea level have always been forces shaping patterns of human settlement. And one could not deny that perhaps the time is nigh to reassess the human relationship with nature. However, any measure considered should be done so with a rational sense of objectivity. To do otherwise, there is the risk of misallocating scare resources.

Consulting as a Strategy for Knowledge Transfer

PubMed Central

Jacobson, Nora; Butterill, Dale; Goering, Paula

2005-01-01

Academic researchers who work on health policy and health services are expected to transfer knowledge to decision makers. Decision makers often do not, however, regard academics’ traditional ways of doing research and disseminating their findings as relevant or useful. This article argues that consulting can be a strategy for transferring knowledge between researchers and decision makers and is effective at promoting the “enlightenment” and “interactive” models of knowledge use. Based on three case studies, it develops a model of knowledge transfer–focused consulting that consists of six stages and four types of work. Finally, the article explores how knowledge is generated in consulting and identifies several classes of factors facilitating its use by decision makers. PMID:15960773

Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

PubMed

Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

2017-01-26

The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of economic evaluations include, amongst others, educating decision-makers and the general population about economic evaluations and presenting economic evaluation results in a clearer and more understandable way. This study demonstrated that the current use and impact of economic evaluations in Dutch healthcare decision-making is limited at best. Therefore, strategies are needed to overcome the barriers that currently prevent economic evaluations from being used extensively.

Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing.

PubMed

Carter, Nancy; Lavis, John N; MacDonald-Rencz, Sandra

2014-01-01

Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

A Model for Oil-Gas Pipelines Cost Prediction Based on a Data Mining Process

NASA Astrophysics Data System (ADS)

Batzias, Fragiskos A.; Spanidis, Phillip-Mark P.

2009-08-01

This paper addresses the problems associated with the cost estimation of oil/gas pipelines during the elaboration of feasibility assessments. Techno-economic parameters, i.e., cost, length and diameter, are critical for such studies at the preliminary design stage. A methodology for the development of a cost prediction model based on Data Mining (DM) process is proposed. The design and implementation of a Knowledge Base (KB), maintaining data collected from various disciplines of the pipeline industry, are presented. The formulation of a cost prediction equation is demonstrated by applying multiple regression analysis using data sets extracted from the KB. Following the methodology proposed, a learning context is inductively developed as background pipeline data are acquired, grouped and stored in the KB, and through a linear regression model provide statistically substantial results, useful for project managers or decision makers.

Identifying Decision-Makers’ Science Needs for Adaptation to Climate-Related Impacts on Forest Ecosystem Services

NASA Astrophysics Data System (ADS)

Gordon, E.; Lukas, J.

2009-12-01

Through the Western Water Assessment RISA program, we are conducting a research project that will produce science synthesis information to help local, state, and federal decision-makers in Colorado and Wyoming develop adaptation strategies to deal with climate-related threats to forest ecosystem services, in particular bark beetle infestations and stand-replacing wildfires. We begin by using the problem orientation framework, a policy sciences methodology, to understand how decision-makers can most effectively address policy problems that threaten the attainment of socially accepted goals. By applying this framework to the challenges facing decision-makers, we more accurately identify specific areas where scientific research can improve decision-making. WWA researchers will next begin to connect decision-makers with relevant scientific literature and identify specific areas of future scientific research that will be most effective at addressing their needs.

Intelligence Failure: How a Commander Can Prevent It

DTIC Science & Technology

2009-10-23

Failure: How a Commander Can Prevent It The job of intelligence is to provide the decision maker with sufficient understanding of the enemy to make...Failure: How a Commander Can Prevent It The job of intelligence is to provide the decision maker with sufficient understanding of the enemy to make...reinforce these lessons. 1 Introduction The job of intelligence is to provide the decision maker with sufficient understanding of

A Case History of the Science and Management Collaboration in Understanding Hypoxia Events in Long Bay, South Carolina, USA

NASA Astrophysics Data System (ADS)

Sanger, Denise; Hernandez, Debra; Libes, Susan; Voulgaris, George; Davis, Braxton; Smith, Erik; Shuford, Rebecca; Porter, Dwayne; Koepfler, Eric; Bennett, Joseph

2010-09-01

Communication of knowledge between the scientific and management communities is a difficult process complicated by the distinctive nature of professional career goals of scientists and decision-makers. This article provides a case history highlighting a collaboration between the science and management communities that resulted from a response to a 2004 hypoxia, or low dissolved oxygen, event in Long Bay, off Myrtle Beach, South Carolina. A working group of scientists and decision-makers was established at the time of the event and has continued to interact to develop a firm understanding of the drivers responsible for hypoxia formation in Long Bay. Several factors were found to be important to ensure that these collaborative efforts were productive: (1) genuine interest in collaboratively working across disciplines to examine a problem; (2) commitment by agency leadership, decision-makers, and researchers to create successful communication mechanisms; (3) respect for each others’ perspectives and an understanding how science and management are performed and that they are not mutually exclusive; (4) networking among researchers and decision-makers to ensure appropriate team members are involved in the process; (5) use of decision-maker input in the formulation of research and monitoring projects; and (6) commitment of resources for facilitation to ensure that researchers and decision-makers are communicating effectively.

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

PubMed

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

2009-08-01

Information and Communication Technology (ICT) and Organizational Innovation (OI) are seen as the miracle of post-modernity in organizations. In this way, they are supposed to resolve most organizational problems, efficiently and rapidly. OI is highly dependent on the capacity and the investment in knowledge management (internal and external) to support decision making process and to implement significant changes. We know what explains ICT utilization (ICTU) and what determines OI development (OID) in healthcare services. Moreover, the literature tends to link ICTU to OID and vice versa. However, this dependency has never been explored empirically through the lens of roles combination. To identify the existing combined roles profiles of ICTU and OID among healthcare decision makers and determine factors of the shift from a profile to another. We did the following: (1) a structured review of the literature on healthcare management by focusing on ICTU and OID which allowed us to build two indexes and a comprehensive framework; (2) a copula methodology to identify with high precision the thresholds for ICTU and OID; and (3) a cross-sectional study based on a survey done with a sample of 942 decision makers from Canadian healthcare organizations through a multinomial logit model to identify determinants of the shift. ICTU and OID are correlated at 22% (Kendal's Tau). The joint distribution (combination) of ICTU and OID shows that four major profiles exist among decision makers in Canadian healthcare organizations: the traditional decision maker, the innovative decision maker, the technologic decision maker and the contemporary decision maker. We found out that classic factors act as barriers to the shift from one profile to the desired profile (from 1 to 4, from 2 to 4 and from 3 to 4). We have identified that the attitude toward research and relational capital are transversal barriers of shift. We have also found that some factors have a specific impact such as engaging in activities of research acquisition, the administrative position (being a manager), the preference for applied research results as source of information, the degree of novelty of research results, and the gender. Modern Canadian healthcare organizations need contemporary decision makers who use ICT and develop OI, if performance is the target. Our results let us suggest that the isolated administrative agents profile is no more effective in a dynamic and changing world. Contemporary decision makers need to be more active intellectually and to take risks in their decisions. Relying exclusively on research results and on their social network is no more helpful for a real shift. Moreover, the traditional factors, i.e. organization size, time, experience ... are no more effective, especially when we consider combined roles. We propose some practical and theoretical recommendations to support these changes.

Parents and end-of-life decision-making for their child: roles and responsibilities.

PubMed

Sullivan, Jane; Gillam, Lynn; Monagle, Paul

2015-09-01

Whether parents want to be and should be the decision-maker for their child in end-of-life matters are contested clinical and ethical questions. Previous research outcomes are equivocal. A qualitative interview method was used to examine the views and experiences of 25 bereaved parents in end-of-life decision-making for their child. Data were analysed thematically. Three types of decision-making roles were identified: self-determined, guided (both involving active decision-making) and acquiescent (passive).The majority of parents had been active in the decision-making process for their child. They perceived themselves as the ultimate end-of-life decision-maker. This was perceived as part of their parental responsibility. A minority of parents did not consider that they had been an active, ultimate decision-maker. Generally, parents in the self-determined and guided groups reported no negative consequences from their decision-making involvement. Importantly, parents in the acquiescent group described their experience as difficult at the time and subsequently, although not all difficulties related directly to decision-making. Parents considered that in principle parents should be the end-of-life decision-maker for their child, but understood personal characteristics and preference could prevent some parents from taking this role. This study unequivocally supports parents' desire to fulfil the end-of-life decision-making role. It provides a nuanced understanding of parents' roles and contributes evidence for the ethical position that parents should be the end-of-life decision-makers for their child, unless not in the child's best interests. On the whole, parents want this role and can manage its consequences. Indeed, not being the end-of-life decision-maker could be detrimental to parents' well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

URBAN DECISION-MAKING, THE UNIVERSITY'S ROLE.

ERIC Educational Resources Information Center

BAILEY, STEPHEN K.

THE AUTHOR EXAMINES THE VARIOUS WAYS IN WHICH THE UNIVERSITY CAN AND SHOULD INFLUENCE URBAN DECISION MAKING. THE CENTRAL UNIVERSITY ROLE IS SENSITIZING THE DECISION MAKERS AND THE CITIZENS TO HUMAN MISERY, SUCH AS BIGOTRY, SQUALOR, DISEASE, UGLINESS, POVERTY, AND IGNORANCE. LONG-RANGE ROLES ARE PINPOINTING THE PROBLEMS URBAN DECISION MAKERS SHOULD…

Quality of life in active surveillance and the associations with decision-making-a literature review.

PubMed

Menichetti, Julia; Valdagni, Riccardo; Bellardita, Lara

2018-02-01

Several studies have been conducted on the quality of life (QoL) in men with low risk prostate cancer (PCa) who choose active surveillance (AS). While recent reviews have shown a lack of consistency among the available QoL-studies, a few key points have been identified, including decision-making (DM)-related issues and their potential effect on QoL. The importance of this theme has also been recently highlighted by the international task force of the European School of Oncology. However, to our knowledge, there are no studies that have specifically marshalled scientific knowledge on the association between DM and QoL among men with low-risk PCa undergoing AS. We performed a literature review to fill this gap, taking a systematic approach to retrieving and selecting articles that included both DM and QoL measures. Among the 272 articles retrieved, we selected nine observational, quantitative articles with both DM and QoL measures. The most considered DM aspects within these studies were decisional conflict and preference for the patient's role in the DM process, as well as health-related QoL aspects. The studies included 42 assessments of the relationship between an empirical measure of DM and an empirical measure of QoL. Among these assessments, 23 (55%) were both positive and significant. They mostly concerned the relationship between patient-related (decisional self-efficacy, decisional control and knowledge) and external (presence of social support, collaborative role within the DM process, and influence of different physicians) DM aspects, as well as the QoL after choice. The findings of these studies revealed key challenges to research and clinical practice related to DM and QoL in AS. These include adopting a person-centred perspective where clinicians, caregivers and their interactions are also included in evaluations and where the psychosocial existential experience of individuals within the DM and AS journey is considered. Much more attention needs to be paid to the DM process after diagnosis, as well as to all the other moments where patients may have to or want to review their decision. Healthcare professionals play a key role in enabling men to make informed decisions and to take care of their health and well-being during AS. There is still work that needs to be done in training healthcare professionals from different disciplines to work together in a model of shared DM and AS tailored to the needs of low-risk PCa patients and their family members.

Solutions Network Formulation Report. Visible/Infrared Imager/Radiometer Suite and Advanced Microwave Scanning Radiometer Data Products for National Drought Monitor Decision Support

NASA Technical Reports Server (NTRS)

Estep, Leland

2007-01-01

Drought effects are either direct or indirect depending on location, population, and regional economic vitality. Common direct effects of drought are reduced crop, rangeland, and forest productivity; increased fire hazard; reduced water levels; increased livestock and wildlife mortality rates; and damage to wildlife and fish habitat. Indirect impacts follow on the heels of direct impacts. For example, a reduction in crop, rangeland, and forest productivity may result in reduced income for farmers and agribusiness, increased prices for food and timber, unemployment, reduced tax revenues, increased crime, foreclosures on bank loans to farmers and businesses, migration, and disaster relief programs. In the United States alone, drought is estimated to result in annual losses of between $6 - 8 billion. Recent sustained drought in the United States has made decision-makers aware of the impacts of climate change on society and environment. The eight major droughts that occurred in the United States between 1980 and 1999 accounted for the largest percentage of weather-related monetary losses. Monitoring drought and its impact that occurs at a variety of scales is an important government activity -- not only nationally but internationally as well. The NDMC (National Drought Mitigation Center) and the USDA (U.S. Department of Agriculture) RMA (Risk Management Agency) have partnered together to develop a DM-DSS (Drought Monitoring Decision Support System). This monitoring system will be an interactive portal that will provide users the ability to visualize and assess drought at all levels. This candidate solution incorporates atmospherically corrected VIIRS data products, such as NDVI (Normalized Difference Vegetation Index) and Ocean SST (sea surface temperature), and AMSR-E soil moisture data products into two NDMC vegetation indices -- VegDRI (Vegetation Drought Response Index) and VegOUT (Vegetation Outlook) -- which are then input into the DM-DSS.

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

PubMed

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

2016-08-01

Economic valuation of ecosystem services is widely advocated as being useful to support ecosystem management decision-making. However, the extent to which it is actually used or considered useful in decision-making is poorly documented. This literature blindspot is explored with an application to coastal and marine ecosystems management in Australia. Based on a nation-wide survey of eighty-eight decision-makers representing a diversity of management organizations, the perceived usefulness and level of use of economic valuation of ecosystem services, in support of coastal and marine management, are examined. A large majority of decision-makers are found to be familiar with economic valuation and consider it useful - even necessary - in decision-making, although this varies across groups of decision-makers. However, most decision-makers never or rarely use economic valuation. The perceived level of importance and trust in estimated dollar values differ across ecosystem services, and are especially high for values that relate to commercial activities. A number of factors are also found to influence respondent's use of economic valuation. Such findings concur with conclusions from other studies on the usefulness and use of ESV in environmental management decision-making. They also demonstrate the strength of the survey-based approach developed in this application to examine this issue in a variety of contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Attitudes and opinions of Palestinian decision-makers about premarital examination law].

PubMed

El Sharif, Nuha; Rifai, Ayshea; Assi, Sana'a; Al Hmidat, Amjad

2006-11-01

We explored the attitudes and opinions of 90 Palestinian decision-makers about the draft law on premarital examination. The findings revealed that decision-makers were aware of the spread of genetic diseases but not infectious diseases. The majority agreed on the draft law; however, they differed on the mode of its application. Half believed that the law is not ready yet for application due to insufficient financial support to establish the needed infrastructure. The most significant recommendations made by the decision-makers were to: enhance community awareness of the law, ensure proper coordination among the concerned ministries and institutions, and establish a national organization to work on endorsement of the tests and issuance of the appropriate application strategies and regulations.

The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review

PubMed Central

Orton, Lois; Lloyd-Williams, Ffion; Taylor-Robinson, David; O'Flaherty, Martin; Capewell, Simon

2011-01-01

Background The use of research evidence to underpin public health policy is strongly promoted. However, its implementation has not been straightforward. The objectives of this systematic review were to synthesise empirical evidence on the use of research evidence by public health decision makers in settings with universal health care systems. Methods To locate eligible studies, 13 bibliographic databases were screened, organisational websites were scanned, key informants were contacted and bibliographies of included studies were scrutinised. Two reviewers independently assessed studies for inclusion, extracted data and assessed methodological quality. Data were synthesised as a narrative review. Findings 18 studies were included: 15 qualitative studies, and three surveys. Their methodological quality was mixed. They were set in a range of country and decision making settings. Study participants included 1063 public health decision makers, 72 researchers, and 174 with overlapping roles. Decision making processes varied widely between settings, and were viewed differently by key players. A range of research evidence was accessed. However, there was no reliable evidence on the extent of its use. Its impact was often indirect, competing with other influences. Barriers to the use of research evidence included: decision makers' perceptions of research evidence; the gulf between researchers and decision makers; the culture of decision making; competing influences on decision making; and practical constraints. Suggested (but largely untested) ways of overcoming these barriers included: research targeted at the needs of decision makers; research clearly highlighting key messages; and capacity building. There was little evidence on the role of research evidence in decision making to reduce inequalities. Conclusions To more effectively implement research informed public health policy, action is required by decision makers and researchers to address the barriers identified in this systematic review. There is an urgent need for evidence to support the use of research evidence to inform public health decision making to reduce inequalities. PMID:21818262

Metal transfer to plants grown on a dredged sediment: use of radioactive isotope 203Hg and titanium.

PubMed

Caille, Nathalie; Vauleon, Clotilde; Leyval, Corinne; Morel, Jean-Louis

2005-04-01

Improperly disposed of dredged sediments contaminated with metals may induce long-term leaching and an increase of metal concentrations in ground waters and vegetal cover plants. The objective of the study was to quantify the sediment-to-plant transfer of Cu, Pb, Hg and Zn with a particular focus on the pathway of Hg and to determine whether the establishment of vegetal cover modifies the metal availability. A pot experiment with rape (Brassica napus), cabbage (Brassica oleraccea) and red fescue (Festuca rubra) was set up using a sediment first spiked with the radioisotope 203Hg. Zinc concentrations (197-543 mg kg(-1) DM) in leaves were higher than Cu concentration (197-543 mg kg(-1) DM), Pb concentration (2.3-2.6 mg kg(-1) DM) and Hg concentration (0.9-1.7 mg kg(-1) DM). Leaves-to-sediment ratios decreased as follows: Zn > Cu > Hg > Pb. According to Ti measurements, metal contamination by dry deposition was less than 1%. Mercury concentration in plant leaves was higher than European and French thresholds. Foliar absorption of volatile Hg was a major pathway for Hg contamination with a root absorption of Hg higher in rape than in cabbage and red fescue. Growth of each species increased Cu solubility. Zinc solubility was increased only in the presence of rape. The highest increase of Cu solubility was observed for red fescue whereas this species largely decreased Zn solubility. Dissolved organic carbon (DOC) measurements suggested that Cu solubilisation could result from organic matter or release of natural plant exudates. Dissolved inorganic carbon (DIC) measures suggested that the high Zn solubility in the presence of rape could originate from a generation of acidity in rape rhizosphere and a subsequent dissolution of calcium carbonates. Consequently, emission of volatile Hg from contaminated dredged sediments and also the potential increase of metal solubility by a vegetal cover of grass when used in phytostabilisation must be taken into account by decision makers.

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

PubMed Central

Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

2016-01-01

In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

Surface transportation weather decision support requirements : user needs and appendices : advanced-integrated decision support using weather information for surface transportation decision makers

DOT National Transportation Integrated Search

2000-01-24

The Federal Highway Administration (FHWA) of the U.S. Department of Transportation (USDOT) : has a responsibility to coordinate and promote projects that will bring the best information on weather to decision makers, in order to improve performance o...

An Introduction to Solar Decision-Making Tools

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

Mow, Benjamin

2017-09-12

The National Renewable Energy Laboratory (NREL) offers a variety of models and analysis tools to help decision makers evaluate and make informed decisions about solar projects, policies, and programs. This fact sheet aims to help decision makers determine which NREL tool to use for a given solar project or policy question, depending on its scope.

User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

ERIC Educational Resources Information Center

Hartley, Roger; Almuhaidib, Saud M. Y.

2007-01-01

Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

HOSPITAL MANAGERS' NEED FOR INFORMATION ON HEALTH TECHNOLOGY INVESTMENTS.

PubMed

Ølholm, Anne Mette; Kidholm, Kristian; Birk-Olsen, Mette; Christensen, Janne Buck

2015-01-01

There is growing interest in implementing hospital-based health technology assessment (HB-HTA) as a tool to facilitate decision making based on a systematic and multidisciplinary assessment of evidence. However, the decision-making process, including the informational needs of hospital decision makers, is not well described. The objective was to review empirical studies analysing the information that hospital decision makers need when deciding about health technology (HT) investments. A systematic review of empirical studies published in English or Danish from 2000 to 2012 was carried out. The literature was assessed by two reviewers working independently. The identified informational needs were assessed with regard to their agreement with the nine domains of EUnetHTA's Core Model. A total of 2,689 articles were identified and assessed. The review process resulted in 14 relevant studies containing 74 types of information that hospital decision makers found relevant. In addition to information covered by the Core Model, other types of information dealing with political and strategic aspects were identified. The most frequently mentioned types of information in the literature related to clinical, economic and political/strategic aspects. Legal, social, and ethical aspects were seldom considered most important. Hospital decision makers are able to describe their information needs when deciding on HT investments. The different types of information were not of equal importance to hospital decision makers, however, and full agreement between EUnetHTA's Core Model and the hospital decision-makers' informational needs was not observed. They also need information on political and strategic aspects not covered by the Core Model.

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

PubMed

Leibfried, Felix; Braun, Daniel A

2015-08-01

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

Bridging the gap between science and decision making

PubMed Central

von Winterfeldt, Detlof

2013-01-01

All decisions, whether they are personal, public, or business-related, are based on the decision maker’s beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers’ information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making. PMID:23940310

Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus

PubMed Central

Davidson, Jaime A; Rosales, Aracely; Shillington, Alicia C; Bailey, Robert A; Kabir, Chris; Umpierrez, Guillermo E

2015-01-01

Purpose To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications. Patients and methods A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise. Results The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination. Conclusion High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study. PMID:25995623

Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus.

PubMed

Davidson, Jaime A; Rosales, Aracely; Shillington, Alicia C; Bailey, Robert A; Kabir, Chris; Umpierrez, Guillermo E

2015-01-01

To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications. A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise. The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination. High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.

Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates.

PubMed

Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip

2015-11-14

Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups- 'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p < 0.05). In the age, education and study group adjusted multiple linear regression analysis, lower age, female gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM (≤30) scores. This shows association of higher DM scores with lower age, lower comorbidity index score, higher executive brain function, belonging in the self-caring cohort and being unemployed. In the prospectively studied cohort of predialysis patients, there was no change in decision-making preference scores after commencement of dialysis. ESRD patients prefer to receive information, but this does not always imply active involvement in decision-making. By understanding modifiable and non-modifiable factors which affect patient preferences for involvement in healthcare decision-making, health professionals may acknowledge the need to accommodate individual patient preferences to the extent determined by the individual patient factors.

Beyond Prediction: the Many Ways in which Climate Science can Inform Adaptation Decisions

NASA Astrophysics Data System (ADS)

Lempert, R. J.

2017-12-01

Climate science provides an increasingly rich understanding of current and future climate, but this understanding is often not fully incorporated into climate adaptation decisions. In particular, the provision of climate information is still trapped in a narrow prediction-based framework, which envisions a sequential process that begins with model-based forecasts of future climate and decision makers then acting on those forecasts. Among its challenges, this framework can discourage action when climate predictions are deemed too uncertain, encourage overconfidence when climate scientists and decision makers fail to focus on decision-relevant but poorly understood extreme events, and offers a too-narrow communication path among climate scientists and decision makers. This talk will describe how robust decision approaches, organized around the idea of stress testing proposed adaptation decisions over a wide range of futures, can enable a richer flow information among climate scientists and decision makers. The talk illustrates these themes with two examples: 1) conservation management that explores the tradeoffs among alternative climate information products with different combinations of ensemble size and spatial resolution and 2) water quality implementation planning that focuses on the handling of extremes.

Bi-Level Decision Making for Supporting Energy and Water Nexus

NASA Astrophysics Data System (ADS)

Zhang, X.; Vesselinov, V. V.

2016-12-01

The inseparable relationship between energy production and water resources has led to the emerging energy-water nexus concept, which provides a means for integrated management and decision making of these two critical resources. However, the energy-water nexus frequently involves decision makers with different and competing management objectives. Furthermore, there is a challenge that decision makers and stakeholders might be making decisions sequentially from a higher level to a lower level, instead of at the same decision level, whereby the objective of a decision maker at a higher level should be satisfied first. In this study, a bi-level decision model is advanced to handle such decision-making situations for managing the energy-water nexus. The work represents a unique contribution to developing an integrated decision-support framework/tool to quantify and analyze the tradeoffs between the two-level energy-water nexus decision makers. Here, plans for electricity generation, fuel supply, water supply, capacity expansion of the power plants and environmental impacts are optimized to provide effective decision support. The developed decision-support framework is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is a part of the MADS (Model Analyses & Decision Support) framework (http://mads.lanl.gov). To demonstrate the capabilities of the developed methodology, a series of analyses are performed for synthetic problems consistent with actual real-world energy-water nexus management problems.

Evaluating the Implications of Climate Phenomenon Indices in Supporting Reservoir Operation Using the Artificial Neural Network and Decision-Tree Methods: A Case Study on Trinity Lake in Northern California

NASA Astrophysics Data System (ADS)

Yang, T.; Akbari Asanjan, A.; Gao, X.; Sorooshian, S.

2016-12-01

Reservoirs are fundamental human-built infrastructures that collect, store, and deliver fresh surface water in a timely manner for all kinds of purposes, including residential and industrial water supply, flood control, hydropower, and irrigation, etc. Efficient reservoir operation requires that policy makers and operators understand how reservoir inflows, available storage, and discharges are changing under different climatic conditions. Over the last decade, the uses of Artificial Intelligence and Data Mining (AI & DM) techniques in assisting reservoir management and seasonal forecasts have been increasing. Therefore, in this study, two distinct AI & DM methods, Artificial Neural Network (ANN) and Random Forest (RF), are employed and compared with respect to their capabilities of predicting monthly reservoir inflow, managing storage, and scheduling reservoir releases. A case study on Trinity Lake in northern California is conducted using long-term (over 50 years) reservoir operation records and 17 known climate phenomenon indices, i.e. PDO and ENSO, etc., as predictors. Results show that (1) both ANN and RF are capable of providing reasonable monthly reservoir storage, inflow, and outflow prediction with satisfactory statistics, and (2) climate phenomenon indices are useful in assisting monthly or seasonal forecasts of reservoir inflow and outflow. It is also found that reservoir storage has a consistent high autocorrelation effect, while inflow and outflow are more likely to be influenced by climate conditions. Using a Gini diversity index, RF method identifies that the reservoir discharges are associated with Southern Oscillation Index (SOI) and reservoir inflows are influenced by multiple climate phenomenon indices during different seasons. Furthermore, results also show that, during the winter season, reservoir discharges are controlled by the storage level for flood-control purposes, while, during the summer season, the flood-control operation is not as significant as that in the winter. With regard to the suitability of the AI & DM methods in support of reservoir operation, the Decision Tree method is suggested for future reservoir studies because of its transparency and non-parametric features over the "black-box" style ANN regression model.

Alternative Fuels Data Center: Telework

Science.gov Websites

for vehicle fleet managers and corporate decision makers to work with employees to conserve fuel . Telecommute Resources These resources can help corporate decision makers develop and support telework

'Holding the line': a qualitative study of the role of evidence in early phase decision-making in the reconfiguration of stroke services in London.

PubMed

Fraser, Alec; Baeza, Juan I; Boaz, Annette

2017-06-09

Health service reconfigurations are of international interest but remain poorly understood. This article focuses on the use of evidence by senior managerial decision-makers involved in the reconfiguration of stroke services in London 2008-2012. Recent work comparing stroke service reconfiguration in London and Manchester emphasises the ability of senior managerial decision-makers in London to 'hold the line' in the crucial early phases of the stroke reconfiguration programme. In this article, we explore in detail how these decision-makers 'held the line' and ask what the broader power implications of doing so are for the interaction between evidence, health policy and system redesign. The research combined semi-structured interviews (n = 20) and documentary analysis of historically relevant policy papers and contemporary stroke reconfiguration documentation published by NHS London and other interested parties (n = 125). We applied a critical interpretive and reflexive approach to the analysis of the data. We identified two forms of power which senior managerial decision-makers drew upon in order to 'hold the line'. Firstly, discursive power, which through an emphasis on evidence, better patient outcomes, professional support and clinical credibility alongside a tightly managed consultation process, helped to set an agenda that was broadly receptive to the overall decision to change stroke services in the capital in a radical way. Secondly, once the essential parameters of the decision to change services had been agreed, senior managerial decision-makers 'held the line' through hierarchical New Public Management style power to minimise the traditional pressures to de-radicalise the reconfiguration through 'top down' decision-making. We problematise the concept of 'holding the line' and explore the power implications of such managerial approaches in the early phases of health service reconfiguration. We highlight the importance of evidence for senior managerial decision-makers in agenda setting and the limitations of clinical research findings in guiding politically sensitive policy decisions which impact upon regional healthcare systems.

An Evaluation of Health Impact Assessments in the United States, 2011–2014

PubMed Central

Charbonneau, Diana; Cahill, Carol; Dannenberg, Andrew L.

2015-01-01

Introduction The Center for Community Health and Evaluation conducted a 3-year evaluation to assess results of health impact assessments (HIAs) in the United States and to identify elements critical for their success. Methods The study used a retrospective, mixed-methods comparative case study design, including a literature review; site visits; interviews with investigators, stakeholders, and decision makers for 23 HIAs in 16 states that were completed from 2005 through 2013; and a Web-based survey of 144 HIA practitioners. Results Analysis of interviews with decision makers suggests HIAs can directly influence decisions in nonhealth-related sectors. HIAs may also influence changes beyond the decision target, build consensus and relationships among decision makers and their constituents, and give community members a stronger voice in decisions that affect them. Factors that may increase HIA success include care in choosing a project or policy to be examined’ selecting an appropriate team to conduct the HIA; engaging stakeholders and decision makers throughout the process; crafting clear, actionable recommendations; delivering timely, compelling messages to appropriate audiences; and using multiple dissemination methods. Challenges to successful HIAs include underestimating the level of effort required, political changes during the conduct of the HIA, accessing relevant local data, engaging vulnerable populations, and following up on recommendations. Conclusion Results of this study suggest HIAs are a useful tool to promote public health because they can influence decisions in nonhealth-related sectors, strengthen cross-sector collaborations, and raise awareness of health issues among decision makers. PMID:25695261

Bringing science to the table: Case studies in science-informed decision making on climate change and beyond

NASA Astrophysics Data System (ADS)

Goldman, G. T.; Phartiyal, P.; Mulvey, K.

2016-12-01

Federal government officials often rely on the research and advice of scientists to inform their decision making around climate change and other complex topics. Decision makers, however, are constrained by the time and accessibility needed to obtain and incorporate scientific information. At the same time, scientists have limited capacity and incentive to devote significant time to communicating their science to decision makers. The Union of Concerned Scientists has employed several strategies to produce policy-relevant scientific work and to facilitate engagement between scientists and decision makers across research areas. This talk will feature lessons learned and key strategies for science-informed decision making around climate change and other areas of the geosciences. Case studies will include conducting targeted sea level rise studies to inform rulemaking at federal agencies, bringing science to policy discussions on hydraulic fracturing, and leveraging the voice of the scientific community on specific policy proposals around climate change disclosure of companies. Recommendations and lessons learned for producing policy-relevant science and effectively communicating it with decision makers will be offered.

Bridge over troubled waters: A Synthesis Session to connect scientific and decision making sectors

EPA Science Inventory

Lack of access to relevant scientific data has limited decision makers from incorporating scientific information into their management and policy schemes. Yet, there is increasing interest among decision makers and scientists to integrate coastal and marine science into the polic...

Robust DEA under discrete uncertain data: a case study of Iranian electricity distribution companies

NASA Astrophysics Data System (ADS)

Hafezalkotob, Ashkan; Haji-Sami, Elham; Omrani, Hashem

2015-06-01

Crisp input and output data are fundamentally indispensable in traditional data envelopment analysis (DEA). However, the real-world problems often deal with imprecise or ambiguous data. In this paper, we propose a novel robust data envelopment model (RDEA) to investigate the efficiencies of decision-making units (DMU) when there are discrete uncertain input and output data. The method is based upon the discrete robust optimization approaches proposed by Mulvey et al. (1995) that utilizes probable scenarios to capture the effect of ambiguous data in the case study. Our primary concern in this research is evaluating electricity distribution companies under uncertainty about input/output data. To illustrate the ability of proposed model, a numerical example of 38 Iranian electricity distribution companies is investigated. There are a large amount ambiguous data about these companies. Some electricity distribution companies may not report clear and real statistics to the government. Thus, it is needed to utilize a prominent approach to deal with this uncertainty. The results reveal that the RDEA model is suitable and reliable for target setting based on decision makers (DM's) preferences when there are uncertain input/output data.

Research-based-decision-making in Canadian health organizations: a behavioural approach.

PubMed

Jbilou, Jalila; Amara, Nabil; Landry, Réjean

2007-06-01

Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build networks, develop partnerships between professionals locally, regionally and nationally, and also act as change agents in the dissemination and adoption of knowledge and innovations in health services. However, the research focused on knowledge use as a support to decision-making, further research is needed to identify and evaluate effective incentives and strategies to implement so as to enhance RBDM adoption among health decision makers and more theoretical development are to complete in this perspective.

Clustering and group selection of multiple criteria alternatives with application to space-based networks.

PubMed

Malakooti, Behnam; Yang, Ziyong

2004-02-01

In many real-world problems, the range of consequences of different alternatives are considerably different. In addition, sometimes, selection of a group of alternatives (instead of only one best alternative) is necessary. Traditional decision making approaches treat the set of alternatives with the same method of analysis and selection. In this paper, we propose clustering alternatives into different groups so that different methods of analysis, selection, and implementation for each group can be applied. As an example, consider the selection of a group of functions (or tasks) to be processed by a group of processors. The set of tasks can be grouped according to their similar criteria, and hence, each cluster of tasks to be processed by a processor. The selection of the best alternative for each clustered group can be performed using existing methods; however, the process of selecting groups is different than the process of selecting alternatives within a group. We develop theories and procedures for clustering discrete multiple criteria alternatives. We also demonstrate how the set of alternatives is clustered into mutually exclusive groups based on 1) similar features among alternatives; 2) ideal (or most representative) alternatives given by the decision maker; and 3) other preferential information of the decision maker. The clustering of multiple criteria alternatives also has the following advantages. 1) It decreases the set of alternatives to be considered by the decision maker (for example, different decision makers are assigned to different groups of alternatives). 2) It decreases the number of criteria. 3) It may provide a different approach for analyzing multiple decision makers problems. Each decision maker may cluster alternatives differently, and hence, clustering of alternatives may provide a basis for negotiation. The developed approach is applicable for solving a class of telecommunication networks problems where a set of objects (such as routers, processors, or intelligent autonomous vehicles) are to be clustered into similar groups. Objects are clustered based on several criteria and the decision maker's preferences.

A Qualitative Study of Anticipated Decision Making around Type 2 Diabetes Genetic Testing: The Role of Scientifically Concordant and Discordant Expectations

PubMed Central

Carmichael, Alicia G.; Hulswit, Bailey B.; Moe, Emily J.; Jayaratne, Toby Epstein; Yashar, Beverly M.

2016-01-01

Type 2 diabetes mellitus (T2DM) genetic testing is undergoing clinical trials to measure the efficacy of genetic counseling for behavior-based risk reduction. The expectations patients bring to the testing process may play an important role in individual outcomes. We conducted a qualitative exploration of anticipated decision-making and expectations around T2DM genetic testing. Semi-structured interviews were completed with Mexican Americans (n = 34), non-Hispanic Black Americans (n = 39), and non-Hispanic White Americans (n = 39) at risk for T2DM. Transcripts were analyzed for themes. Most participants would accept T2DM genetic testing in order to motivate risk-reducing behaviors or apprise family members of their risk. Participants who would decline testing wished to avoid emotional distress or believed the test would not reveal new risk information. Non-Hispanic Whites and those with college education declined genetic testing more often than other groups. Those without college education were more likely to have testing expectations that were discordant with current science, such as conflating genetic testing with common ‘blood tests.’ Understanding expectations and decision-making factors around T2DM genetic testing will better prepare healthcare professionals to counsel their patients. This may lead to a higher efficacy of T2DM genetic testing and counseling. PMID:27465809

A Qualitative Study of Anticipated Decision Making around Type 2 Diabetes Genetic Testing: the Role of Scientifically Concordant and Discordant Expectations.

PubMed

Carmichael, Alicia G; Hulswit, Bailey B; Moe, Emily J; Jayaratne, Toby Epstein; Yashar, Beverly M

2017-06-01

Type 2 diabetes mellitus (T2DM) genetic testing is undergoing clinical trials to measure the efficacy of genetic counseling for behavior-based risk reduction. The expectations patients bring to the testing process may play an important role in individual outcomes. We conducted a qualitative exploration of anticipated decision-making and expectations around T2DM genetic testing. Semi-structured interviews were completed with Mexican Americans (n = 34), non-Hispanic Black Americans (n = 39), and non-Hispanic White Americans (n = 39) at risk for T2DM. Transcripts were analyzed for themes. Most participants would accept T2DM genetic testing in order to motivate risk-reducing behaviors or apprise family members of their risk. Participants who would decline testing wished to avoid emotional distress or believed the test would not reveal new risk information. Non-Hispanic Whites and those with college education declined genetic testing more often than other groups. Those without college education were more likely to have testing expectations that were discordant with current science, such as conflating genetic testing with common 'blood tests.' Understanding expectations and decision-making factors around T2DM genetic testing will better prepare healthcare professionals to counsel their patients. This may lead to a higher efficacy of T2DM genetic testing and counseling.

Alternative Fuels Data Center: Mass Transit

Science.gov Websites

traveled and fuel used by private vehicles. Vehicle fleet managers, corporate decision makers, and public effective incentives for fleet managers and corporate decision makers to build mass transit ridership

Alternative Fuels Data Center: Transportation System Efficiency

Science.gov Websites

energy use. Transportation planners and corporate decision makers can implement combinations of these corporate decision makers can help employees telework to conserve fuel. Maps & Data Average Annual Fuel

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.

Relevance of a Managerial Decision-Model to Educational Administration.

ERIC Educational Resources Information Center

Lundin, Edward.; Welty, Gordon

The rational model of classical economic theory assumes that the decision maker has complete information on alternatives and consequences, and that he chooses the alternative that maximizes expected utility. This model does not allow for constraints placed on the decision maker resulting from lack of information, organizational pressures,…

Educational Goods and Values: A Framework for Decision Makers

ERIC Educational Resources Information Center

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

2016-01-01

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

Teacher as Decision-Maker.

ERIC Educational Resources Information Center

Smith, Carl B.

The teacher as decisionmaker is a fairly new concept, and yet the choices teachers make--among alternative approaches--afffect the attitudes, knowledge, and skills students carry into adult life. This booklet's chapter titles are as follows: (1) New Image for Teachers--Decision-Maker; (2) Decisions Teachers Make; (3) A Rational Model; (4) Planning…

Sandia National Laboratories: Pathfinder Radar ISR and Synthetic Aperture

Science.gov Websites

Eyes for the Warfighter Actionable Intelligence for the Decision Maker Actionable Intelligence for the Decision Maker All Weather, Persistent, Optical Like All Weather, Persistent, Optical Like Real-time, High radar systems encompass the entire end-to-end connectivity needed for decision superiority to ensure

Negative Attitudes toward Older Workers and Hiring Decisions: Testing the Moderating Role of Decision Makers' Core Self-Evaluations.

PubMed

Fasbender, Ulrike; Wang, Mo

2016-01-01

Organizational hiring practices have been charged for unfair treatment on the grounds of age. Drawing on theories of planned behavior and core self-evaluations, this research investigated the impact of negative attitudes toward older workers on hiring decisions and examined the moderating role of decision-makers' core self-evaluations. We tested our hypotheses based on a structured online questionnaire and a vignette study using a sample of 102 participants working in human resource management across different industries. As predicted, negative attitudes toward older workers were positively related to avoidance of hiring older people, which in turn was negatively related to the likelihood to select the oldest candidate. Because hiring decisions are not only about the hiring subject but also about the decision-maker, we tested the moderating role of decision-makers' core self-evaluations. Results showed that core self-evaluations buffered the relationship between negative attitudes toward older workers and avoidance of hiring older people. Theoretical implications of the findings with regard to hiring decisions about older people and practical recommendations to improve diversity management strategies and age-balanced hiring practices in organizations are discussed.

Stochastic injection-strategy optimization for the preliminary assessment of candidate geological storage sites

NASA Astrophysics Data System (ADS)

Cody, Brent M.; Baù, Domenico; González-Nicolás, Ana

2015-09-01

Geological carbon sequestration (GCS) has been identified as having the potential to reduce increasing atmospheric concentrations of carbon dioxide (CO2). However, a global impact will only be achieved if GCS is cost-effectively and safely implemented on a massive scale. This work presents a computationally efficient methodology for identifying optimal injection strategies at candidate GCS sites having uncertainty associated with caprock permeability, effective compressibility, and aquifer permeability. A multi-objective evolutionary optimization algorithm is used to heuristically determine non-dominated solutions between the following two competing objectives: (1) maximize mass of CO2 sequestered and (2) minimize project cost. A semi-analytical algorithm is used to estimate CO2 leakage mass rather than a numerical model, enabling the study of GCS sites having vastly different domain characteristics. The stochastic optimization framework presented herein is applied to a feasibility study of GCS in a brine aquifer in the Michigan Basin (MB), USA. Eight optimization test cases are performed to investigate the impact of decision-maker (DM) preferences on Pareto-optimal objective-function values and carbon-injection strategies. This analysis shows that the feasibility of GCS at the MB test site is highly dependent upon the DM's risk-adversity preference and degree of uncertainty associated with caprock integrity. Finally, large gains in computational efficiency achieved using parallel processing and archiving are discussed.

Changing Patients' Treatment Preferences and Values with a Decision Aid for Type 2 Diabetes Mellitus: Results from the Treatment Arm of a Randomized Controlled Trial.

PubMed

Bailey, Robert A; Shillington, Alicia C; Harshaw, Qing; Funnell, Martha M; VanWingen, Jeffrey; Col, Nananda

2018-04-01

Failure to intensify treatment for type 2 diabetes mellitus (T2DM) when indicated, or clinical inertia, is a major obstacle to achieving optimal glucose control. This study investigates the impact of a values-focused patient decision aid (PDA) for T2DM antihyperglycemic agent intensification on patient values related to domains important in decision-making and preferred treatments. Patients with poorly controlled T2DM who were taking a metformin-containing regimen were recruited through physicians to access a PDA presenting evidence-based information on T2DM and antihyperglycemic agent class options. Participants' preferences for treatment, decision-making, and the relative importance they placed on various values related to treatment options (e.g., dosing, weight gain, side effects) were assessed before and after interacting with the PDA. Changes from baseline were calculated (post-PDA minus pre-PDA difference) and assessed in univariate generalized linear models exploring associations with patients' personal values. Analyses included 114 diverse patients from 27 clinics across the US. The importance of avoiding injections, concern about hypoglycemia, and taking medications only once a day significantly decreased after interacting with the PDA [- 1.1 (p = 0.002), - 1.3 (p < 0.001), - 1.1 (p = 0.004), respectively], while the importance of taking medications that avoided weight gain increased [0.8 (p = 0.004)]. Prior to viewing the PDA, most patients (58.8%) had not begun thinking about the decision of adding a medication, and few (12.3%) indicated that they had already made a decision. Post-PDA, 46.5% could state a medication preference. The values-focused PDA for T2DM medication intensification prepared patients to make a shared decision with their clinician and changed patients' values regarding what was important in making that decision. Helping patients understand their options and underlying values can promote shared decision-making and may reduce clinical inertia delaying treatment intensification. Janssen Scientific Affairs, LLC.

Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

PubMed

Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

2015-09-28

Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

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.

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

PubMed

van Dongen, Johanna M; Tompa, Emile; Clune, Laurie; Sarnocinska-Hart, Anna; Bongers, Paulien M; van Tulder, Maurits W; van der Beek, Allard J; van Wier, Marieke F

2013-06-03

Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this.

The Moderating Effects of Cannabis Use and Decision Making on the Relationship between Conduct Disorder and Risky Sexual Behavior

PubMed Central

Ross, J. Megan; Coxe, Stefany; Schuster, Randi M.; Rojas, Angelica; Gonzalez, Raul

2015-01-01

Risky sexual behavior (RSB) is a current public health concern affecting adolescents and young adults. Conduct disorder, cannabis use and decision making (DM) ability are interrelated constructs that are relevant to RSB; however, there is little research on the association of DM and RSB. Participants were 79 cannabis users assessed through self-report measures of RSB and mental health, and a timeline follow-back procedure for substance use. DM ability was assessed via the Iowa Gambling Task. We found that more conduct disorder symptoms accounted for unique variance in measures of overall RSB and an earlier initiation of oral sex, even when taking into account DM and cannabis use. Amount of cannabis use and DM ability moderated the relationships between number of conduct disorder symptoms and number of oral sex partners and age of initiation for vaginal sex. An increase in conduct disorder symptoms was associated with more oral sex partners when DM was poor and fewer partners when DM was better, however this relationship was only present at higher levels of cannabis use. Furthermore, when DM was poor, more conduct disorder symptoms predicted a younger age of initiation of vaginal sex, with the age decreasing as amount of cannabis use increased. Determining how DM influences RSB may assist in the identification of novel treatment approaches to reduce engagement in RSB. PMID:25832553

Value of information and pricing new healthcare interventions.

PubMed

Willan, Andrew R; Eckermann, Simon

2012-06-01

Previous application of value-of-information methods to optimal clinical trial design have predominantly taken a societal decision-making perspective, implicitly assuming that healthcare costs are covered through public expenditure and trial research is funded by government or donation-based philanthropic agencies. In this paper, we consider the interaction between interrelated perspectives of a societal decision maker (e.g. the National Institute for Health and Clinical Excellence [NICE] in the UK) charged with the responsibility for approving new health interventions for reimbursement and the company that holds the patent for a new intervention. We establish optimal decision making from societal and company perspectives, allowing for trade-offs between the value and cost of research and the price of the new intervention. Given the current level of evidence, there exists a maximum (threshold) price acceptable to the decision maker. Submission for approval with prices above this threshold will be refused. Given the current level of evidence and the decision maker's threshold price, there exists a minimum (threshold) price acceptable to the company. If the decision maker's threshold price exceeds the company's, then current evidence is sufficient since any price between the thresholds is acceptable to both. On the other hand, if the decision maker's threshold price is lower than the company's, then no price is acceptable to both and the company's optimal strategy is to commission additional research. The methods are illustrated using a recent example from the literature.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Making the Connection between Environmental Science and Decision Making

NASA Astrophysics Data System (ADS)

Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.

2011-12-01

As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and understanding between scientists and decision-makers, leading to enhanced outcomes in the fields of climate science, water resources, and ecosystem services.

Knowledge discovery in cardiology: A systematic literature review.

PubMed

Kadi, I; Idri, A; Fernandez-Aleman, J L

2017-01-01

Data mining (DM) provides the methodology and technology needed to transform huge amounts of data into useful information for decision making. It is a powerful process employed to extract knowledge and discover new patterns embedded in large data sets. Data mining has been increasingly used in medicine, particularly in cardiology. In fact, DM applications can greatly benefit all those involved in cardiology, such as patients, cardiologists and nurses. The purpose of this paper is to review papers concerning the application of DM techniques in cardiology so as to summarize and analyze evidence regarding: (1) the DM techniques most frequently used in cardiology; (2) the performance of DM models in cardiology; (3) comparisons of the performance of different DM models in cardiology. We performed a systematic literature review of empirical studies on the application of DM techniques in cardiology published in the period between 1 January 2000 and 31 December 2015. A total of 149 articles published between 2000 and 2015 were selected, studied and analyzed according to the following criteria: DM techniques and performance of the approaches developed. The results obtained showed that a significant number of the studies selected used classification and prediction techniques when developing DM models. Neural networks, decision trees and support vector machines were identified as being the techniques most frequently employed when developing DM models in cardiology. Moreover, neural networks and support vector machines achieved the highest accuracy rates and were proved to be more efficient than other techniques. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Group assessment of key indicators of sustainable waste management in developing countries.

PubMed

Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

2017-09-01

Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

Overcoming Fear: Helping Decision Makers Understand Risk in Outdoor Education

ERIC Educational Resources Information Center

Haras, Kathy

2010-01-01

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

49 CFR 1503.603 - Separation of functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Rules of Practice in TSA Civil Penalty Actions § 1503.603 Separation of functions. (a) Civil penalty... the ALJ or by the TSA decision maker on appeal, except as counsel or a witness in the public... advise the TSA decision maker regarding an initial decision or any appeal of a civil penalty action to...

Participation in treatment decision-making among Chinese-Australian women with breast cancer.

PubMed

Kwok, Cannas; Koo, Fung Kuen

2017-03-01

Using Confucian philosophy as a conceptual framework, this article examines the extent to which cultural values and language affect the participation preferences and experiences of the breast cancer treatment decision-making (TDM) process among Chinese women with breast cancer in Australia. Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Mandarin and Cantonese). Each interview was translated and transcribed. Content analysis was used to uncover the major themes. Four typologies emerged: the patient as an active decision maker, the patient as a passive decision maker, the patient as a reluctant decision maker and the patient as a reluctant passive decision maker. Language barriers, cultural expectation of doctor's role and family role in Chinese culture appear as influential factors in TDM process among this group of women. Intervention to improve doctors' cultural sensitivities in order to help them assess women's role preferences in TDM and the ability of doctors to communicate in a culturally appropriate manner, may improve the process of breast cancer TDM among women from Chinese background.

A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences.

PubMed

Smith, Michael A; Clayman, Marla L; Frader, Joel; Arenson, Melanie; Haber-Barker, Natalie; Ryan, Claire; Emanuel, Linda; Michelson, Kelly

2018-06-19

Little is known about how decision-making conversations occur during pediatric intensive care unit (PICU) family conferences (FCs). Describe the decision-making process and implementation of shared decision making (SDM) during PICU FCs. Observational study. University-based tertiary care PICU, including 31 parents and 94 PICU healthcare professionals involved in FCs. We recorded, transcribed, and analyzed 14 PICU FCs involving decision-making discussions. We used a modified grounded theory and content analysis approach to explore the use of traditionally described stages of decision making (DM) (information exchange, deliberation, and determining a plan). We also identified the presence or absence of predefined SDM elements. DM involved the following modified stages: information exchange; information-oriented deliberation; plan-oriented deliberation; and determining a plan. Conversations progressed through stages in a nonlinear manner. For the main decision discussed, all conferences included a presentation of the clinical issues, treatment alternatives, and uncertainty. A minority of FCs included assessing the family's understanding (21%), assessing the family's need for input from others (28%), exploring the family's desired decision-making role (35%), and eliciting the family's opinion (42%). In the FCs studied, we found that DM is a nonlinear process. We also found that several SDM elements that could provide information about parents' perspectives and needs did not always occur, identifying areas for process improvement.

Alpha-Fair Resource Allocation under Incomplete Information and Presence of a Jammer

NASA Astrophysics Data System (ADS)

Altman, Eitan; Avrachenkov, Konstantin; Garnaev, Andrey

In the present work we deal with the concept of alpha-fair resource allocation in the situation where the decision maker (in our case, the base station) does not have complete information about the environment. Namely, we develop a concept of α-fairness under uncertainty to allocate power resource in the presence of a jammer under two types of uncertainty: (a) the decision maker does not have complete knowledge about the parameters of the environment, but knows only their distribution, (b) the jammer can come into the environment with some probability bringing extra background noise. The goal of the decision maker is to maximize the α-fairness utility function with respect to the SNIR (signal to noise-plus-interference ratio). Here we consider a concept of the expected α-fairness utility function (short-term fairness) as well as fairness of expectation (long-term fairness). In the scenario with the unknown parameters of the environment the most adequate approach is a zero-sum game since it can also be viewed as a minimax problem for the decision maker playing against the nature where the decision maker has to apply the best allocation under the worst circumstances. In the scenario with the uncertainty about jamming being in the system the Nash equilibrium concept is employed since the agents have non-zero sum payoffs: the decision maker would like to maximize either the expected fairness or the fairness of expectation while the jammer would like to minimize the fairness if he comes in on the scene. For all the plots the equilibrium strategies in closed form are found. We have shown that for all the scenarios the equilibrium has to be constructed into two steps. In the first step the equilibrium jamming strategy has to be constructed based on a solution of the corresponding modification of the water-filling equation. In the second step the decision maker equilibrium strategy has to be constructed equalizing the induced by jammer background noise.

A new web-based framework development for fuzzy multi-criteria group decision-making.

PubMed

Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Fuzzy multi-criteria group decision making (FMCGDM) process is usually used when a group of decision-makers faces imprecise data or linguistic variables to solve the problems. However, this process contains many methods that require many time-consuming calculations depending on the number of criteria, alternatives and decision-makers in order to reach the optimal solution. In this study, a web-based FMCGDM framework that offers decision-makers a fast and reliable response service is proposed. The proposed framework includes commonly used tools for multi-criteria decision-making problems such as fuzzy Delphi, fuzzy AHP and fuzzy TOPSIS methods. The integration of these methods enables taking advantages of the strengths and complements each method's weakness. Finally, a case study of location selection for landfill waste in Morocco is performed to demonstrate how this framework can facilitate decision-making process. The results demonstrate that the proposed framework can successfully accomplish the goal of this study.

Communicating the Needs of Climate Change Policy Makers to Scientists

NASA Technical Reports Server (NTRS)

Brown, Molly E.; Escobar, Vanessa M.; Lovell, Heather

2012-01-01

This chapter will describe the challenges that earth scientists face in developing science data products relevant to decision maker and policy needs, and will describe strategies that can improve the two-way communication between the scientist and the policy maker. Climate change policy and decision making happens at a variety of scales - from local government implementing solar homes policies to international negotiations through the United Nations Framework Convention on Climate Change. Scientists can work to provide data at these different scales, but if they are not aware of the needs of decision makers or understand what challenges the policy maker is facing, they are likely to be less successful in influencing policy makers as they wished. This is because the science questions they are addressing may be compelling, but not relevant to the challenges that are at the forefront of policy concerns. In this chapter we examine case studies of science-policy partnerships, and the strategies each partnership uses to engage the scientist at a variety of scales. We examine three case studies: the global Carbon Monitoring System pilot project developed by NASA, a forest biomass mapping effort for Silvacarbon project, and a forest canopy cover project being conducted for forest management in Maryland. In each of these case studies, relationships between scientists and policy makers were critical for ensuring the focus of the science as well as the success of the decision-making.

Is Israel ready for disease management?

PubMed

Linden, Ariel

2006-10-01

Approximately 60% of all worldwide deaths are caused by chronic disease resulting from modifiable health behaviors. In the United States, structured programs tailored to identify and modify health behaviors of patients with chronic illness have grown into a robust industry called disease management. DM is premised upon the basic assumption that health services utilization and morbidity can be reduced for those with chronic illness by augmenting traditional episodic medical care services and support between physician visits. Given that Israel and the U.S. have similar demographics in their chronically ill populations, it would make intuitive sense for Israel to replicate efforts made in the U.S. to incorporate DM strategies. This paper provides a conceptual framework of how DM could be integrated within the current organizational structure of the Israeli healthcare system, which is uniquely conducive to the implementation of DM on a population-wide basis. While ultimately the decision to invest in DM lies with stakeholders at various institutional levels in Israel, this paper is intended to provide direction and support for that decision-making process.

Testing information to improve communication with communities and decision makers.

DOT National Transportation Integrated Search

2011-09-01

This work focuses on important concepts in making information available to decision makers and the : public, specifically focused on the Transportation Industry. The emphasis is on the PowerPoint : presentation and enhancing the message through this ...

Delegating Decisions to Experts

ERIC Educational Resources Information Center

Li, Hao; Suen, Wing

2004-01-01

We present a model of delegation with self-interested and privately informed experts. A team of experts with extreme but opposite biases is acceptable to a wide range of decision makers with diverse preferences, but the value of expertise from such a team is low. A decision maker wants to appoint experts who are less partisan than he is in order…

A Comparison between Decision Tree and Random Forest in Determining the Risk Factors Associated with Type 2 Diabetes.

PubMed

Esmaily, Habibollah; Tayefi, Maryam; Doosti, Hassan; Ghayour-Mobarhan, Majid; Nezami, Hossein; Amirabadizadeh, Alireza

2018-04-24

We aimed to identify the associated risk factors of type 2 diabetes mellitus (T2DM) using data mining approach, decision tree and random forest techniques using the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) Study program. A cross-sectional study. The MASHAD study started in 2010 and will continue until 2020. Two data mining tools, namely decision trees, and random forests, are used for predicting T2DM when some other characteristics are observed on 9528 subjects recruited from MASHAD database. This paper makes a comparison between these two models in terms of accuracy, sensitivity, specificity and the area under ROC curve. The prevalence rate of T2DM was 14% among these subjects. The decision tree model has 64.9% accuracy, 64.5% sensitivity, 66.8% specificity, and area under the ROC curve measuring 68.6%, while the random forest model has 71.1% accuracy, 71.3% sensitivity, 69.9% specificity, and area under the ROC curve measuring 77.3% respectively. The random forest model, when used with demographic, clinical, and anthropometric and biochemical measurements, can provide a simple tool to identify associated risk factors for type 2 diabetes. Such identification can substantially use for managing the health policy to reduce the number of subjects with T2DM .

Priority setting: what constitutes success? A conceptual framework for successful priority setting.

PubMed

Sibbald, Shannon L; Singer, Peter A; Upshur, Ross; Martin, Douglas K

2009-03-05

The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual framework for successful priority setting. Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries). This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism. The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting. The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts.

Identifying research priorities for health care priority setting: a collaborative effort between managers and researchers

PubMed Central

Smith, Neale; Mitton, Craig; Peacock, Stuart; Cornelissen, Evelyn; MacLeod, Stuart

2009-01-01

Background To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation. Methods The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthesized into a set of qualitative themes. Results Forum participants suggested that future research into healthcare priority setting would benefit from studies that were longitudinal, comparative, and/or interdisciplinary. As well, participants identified two broad theme areas in which specific research projects were deemed desirable. First, future research might usefully consider how formal priority setting and resource allocation projects are situated within a larger organizational and political context. Second, additional research efforts should be devoted to better understanding and improving the actual implementation of priority setting frameworks, particularly with respect to issues of change management and the resolution of impediments to action on recommendations for resource allocation. Conclusion We were able to validate the importance of initial areas posed to the group and observed emergence of additional concerns and directions of critical importance to these decision-makers at this time. It is likely that the results are broadly applicable to other healthcare contexts. The implementation of this research agenda in British Columbia will depend upon the ability of the researchers and decision-makers to develop particular projects that fit within the constraints of existing funding opportunities. The process of engagement itself had benefits in terms of connecting decision-makers with their peers and sparking increased interest in the use and refinement of priority setting frameworks. PMID:19754969

Fuzzy risk explicit interval linear programming model for end-of-life vehicle recycling planning in the EU.

PubMed

Simic, Vladimir

2015-01-01

End-of-life vehicles (ELVs) are vehicles that have reached the end of their useful lives and are no longer registered or licensed for use. The ELV recycling problem has become very serious in the last decade and more and more efforts are made in order to reduce the impact of ELVs on the environment. This paper proposes the fuzzy risk explicit interval linear programming model for ELV recycling planning in the EU. It has advantages in reflecting uncertainties presented in terms of intervals in the ELV recycling systems and fuzziness in decision makers' preferences. The formulated model has been applied to a numerical study in which different decision maker types and several ELV types under two EU ELV Directive legislative cases were examined. This study is conducted in order to examine the influences of the decision maker type, the α-cut level, the EU ELV Directive and the ELV type on decisions about vehicle hulks procuring, storing unprocessed hulks, sorting generated material fractions, allocating sorted waste flows and allocating sorted metals. Decision maker type can influence quantity of vehicle hulks kept in storages. The EU ELV Directive and decision maker type have no influence on which vehicle hulk type is kept in the storage. Vehicle hulk type, the EU ELV Directive and decision maker type do not influence the creation of metal allocation plans, since each isolated metal has its regular destination. The valid EU ELV Directive eco-efficiency quotas can be reached even when advanced thermal treatment plants are excluded from the ELV recycling process. The introduction of the stringent eco-efficiency quotas will significantly reduce the quantities of land-filled waste fractions regardless of the type of decision makers who will manage vehicle recycling system. In order to reach these stringent quotas, significant quantities of sorted waste need to be processed in advanced thermal treatment plants. Proposed model can serve as the support for the European vehicle recycling managers in creating more successful ELV recycling plans. Copyright © 2014 Elsevier Ltd. All rights reserved.

Barriers to electric energy efficiency in Ghana

NASA Astrophysics Data System (ADS)

Berko, Joseph Kofi, Jr.

Development advocates argue that sustainable development strategies are the best means to permanently improve living standards in developing countries. Advocates' arguments are based on the technical, financial, and environmental advantages of sustainable development. However, they have not addressed the organizational and administrative decision-making issues which are key to successful implementation of sustainable development in developing countries. Using the Ghanaian electricity industry as a case study, this dissertation identifies and analyzes organizational structures, administrative mechanisms, and decision-maker viewpoints that critically affect the success of adoption and implementation of energy efficiency within a sustainable development framework. Utilizing semi-structured interviews in field research, decision-makers' perceptions of the pattern of the industry's development, causes of the electricity supply shortfall, and barriers to electricity-use efficiency were identified. Based on the initial findings, the study formulated a set of policy initiatives to establish support for energy use efficiency. In a second set of interviews, these policy suggestions were presented to some of the top decision-makers to elicit their reactions. According to the decision-makers, the electricity supply shortfall is due to rapid urbanization and increased industrial consumption as a result of the structural adjustment program, rural electrification, and the sudden release of suppressed loads. The study found a lack of initiative and collaboration among industry decision-makers, and a related divergence in decision-makers' concerns and viewpoints. Also, lacking are institutional support systems and knowledge of proven energy efficiency strategies and technologies. As a result, planning, and even the range of perceived solutions to choose from are supply-side oriented. The final chapter of the study presents implications of its findings and proposes that any implementation strategy will have to address the different decision-makers' concerns and viewpoints. These include the need for national policies to promote electric energy efficiency and institutional development to provide support, guidance and direction to an energy efficiency effort. It also proposes structural changes within the industry to reduce government influence by creating an independent regulatory board. Finally, it proposes the adoption of integrated resource planning strategies and changes in the supply-side dominated culture within the electric utilities.

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

PubMed Central

2010-01-01

Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be improved. PMID:20504357

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

PubMed

McCaughey, Deirdre; Bruning, Nealia S

2010-05-26

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

Linking science, public values, and decision-making: Case study development for public deliberations about climate change resilience

NASA Astrophysics Data System (ADS)

Weller, N.; Bennett, I.; Bernstein, M.; Farooque, M.; Lloyd, J.; Lowenthal, C.; Sittenfeld, D.

2016-12-01

Actionable science seeks to align scientific inquiry with decision-making priorities to overcome rifts between scientific knowledge and the needs of decision makers. Combining actionable science with explorations of public values and priorities creates useful support for decision makers facing uncertainty, tradeoffs, and limited resources. As part of a broader project to create public forums about climate change resilience, we convened workshops with decision makers, resilience experts, and community stakeholders to discuss climate change resilience. Our goals were 1) to create case studies of resilience strategies for use in public deliberations at science museums across 8 U.S. cities; and 2) to build relationships with decision makers and stakeholders interested in these public deliberations. Prior to workshops, we created summaries of resilience strategies using academic literature, government assessments, municipal resilience plans, and conversations with workshop participants. Workshops began with example deliberation activities followed by semi-structured discussions of resilience strategies centered on 4 questions: 1) What are the key decisions to be made regarding each strategy? 2) What stakeholders and perspectives are relevant to each strategy? 3) What available data are relevant to each strategy? 4) What visualizations or other resources are useful for communicating things about each strategy? Workshops yielded actionable dialogue regarding issues of justice, feasibility, and the socio-ecological-technical systems impacted by climate change hazards and resilience strategies. For example, discussions of drought revealed systemic and individual-level challenges and opportunities; discussions of sea level rise included ways to account for the cultural significance of many coastal communities. The workshops provide a model for identifying decision-making priorities and tradeoffs and building partnerships among stakeholders, scientists, and decision makers.

Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

PubMed Central

Shillington, Alicia C; Col, Nananda; Bailey, Robert A; Jewell, Mark A

2015-01-01

Purpose To describe the process used to develop an evidence-based patient decision aid (PDA) that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM) consistent with International Patient Decision Aids Standards. Methods A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot. Results Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language/readability, testing, and eliciting patient values. Conclusion A PDA was developed to help T2DM patients make decisions regarding medication choice. This approach may be applicable to other chronic conditions. PMID:25995622

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

ERIC Educational Resources Information Center

Beaudoin, Michael

2016-01-01

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

The effect of prognostic data presentation format on perceived risk among surrogate decision makers of critically ill patients: a randomized comparative trial.

PubMed

Chapman, Andy R; Litton, Edward; Chamberlain, Jenny; Ho, Kwok M

2015-04-01

The purpose of this study is to determine whether varying the format used to present prognostic data alters the perception of risk among surrogate decision makers in the intensive care unit (ICU). This was a prospective randomized comparative trial conducted in a 23-bed adult tertiary ICU. Enrolled surrogate decision makers were randomized to 1 of 2 questionnaires, which presented hypothetical ICU scenarios, identical other than the format in which prognostic data were presented (eg, frequencies vs percentages). Participants were asked to rate the risk associated with each prognostic statement. We enrolled 141 surrogate decision makers. The perception of risk varied significantly dependent on the presentation format. For "quantitative data," risks were consistently perceived as higher, when presented as frequencies (eg, 1 in 50) compared with equivalent percentages (eg, 2%). Framing "qualitative data" in terms of chance of "death" rather than "survival" led to a statistically significant increase in perceived risks. Framing "quantitative" data in this way did not significantly affect risk perception. Data format had a significant effect on how surrogate decision makers interpreted risk. Qualitative statements are interpreted widely and affected by framing. Where possible, multiple quantitative formats should be used for presenting prognostic information. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Research of Simple Multi-Attribute Rating Technique for Decision Support

NASA Astrophysics Data System (ADS)

Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi

2017-12-01

One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

HIV/AIDS prevention funds are often allocated at multiple levels of decision-making. Optimal allocation of HIV prevention funds maximizes the number of HIV infections averted. However, decision makers often allocate using simple heuristics such as proportional allocation. We evaluate the impact of using incentives to encourage optimal allocation in a two-level decision-making process. We model an incentive based decision-making process consisting of an upper-level decision maker allocating funds to a single lower-level decision maker who then distributes funds to local programs. We assume that the lower-level utility function is linear in the amount of the budget received from the upper-level, the fraction of funds reserved for proportional allocation, and the number of infections averted. We assume that the upper level objective is to maximize the number of infections averted. We illustrate with an example using data from California, U.S. PMID:23766551

Do probabilistic forecasts lead to better decisions?

NASA Astrophysics Data System (ADS)

Ramos, M. H.; van Andel, S. J.; Pappenberger, F.

2012-12-01

The last decade has seen growing research in producing probabilistic hydro-meteorological forecasts and increasing their reliability. This followed the promise that, supplied with information about uncertainty, people would take better risk-based decisions. In recent years, therefore, research and operational developments have also start putting attention to ways of communicating the probabilistic forecasts to decision makers. Communicating probabilistic forecasts includes preparing tools and products for visualization, but also requires understanding how decision makers perceive and use uncertainty information in real-time. At the EGU General Assembly 2012, we conducted a laboratory-style experiment in which several cases of flood forecasts and a choice of actions to take were presented as part of a game to participants, who acted as decision makers. Answers were collected and analyzed. In this paper, we present the results of this exercise and discuss if indeed we make better decisions on the basis of probabilistic forecasts.

Do probabilistic forecasts lead to better decisions?

NASA Astrophysics Data System (ADS)

Ramos, M. H.; van Andel, S. J.; Pappenberger, F.

2013-06-01

The last decade has seen growing research in producing probabilistic hydro-meteorological forecasts and increasing their reliability. This followed the promise that, supplied with information about uncertainty, people would take better risk-based decisions. In recent years, therefore, research and operational developments have also started focusing attention on ways of communicating the probabilistic forecasts to decision-makers. Communicating probabilistic forecasts includes preparing tools and products for visualisation, but also requires understanding how decision-makers perceive and use uncertainty information in real time. At the EGU General Assembly 2012, we conducted a laboratory-style experiment in which several cases of flood forecasts and a choice of actions to take were presented as part of a game to participants, who acted as decision-makers. Answers were collected and analysed. In this paper, we present the results of this exercise and discuss if we indeed make better decisions on the basis of probabilistic forecasts.

Addressing diabetes mellitus as part of the strategy for ending TB

PubMed Central

Harries, Anthony D.; Kumar, Ajay M.V.; Satyanarayana, Srinath; Lin, Yan; Zachariah, Rony; Lönnroth, Knut; Kapur, Anil

2016-01-01

As we enter the new era of Sustainable Development Goals, the international community has committed to ending the TB epidemic by 2030 through implementation of an ambitious strategy to reduce TB-incidence and TB-related mortality and avoiding catastrophic costs for TB-affected families. Diabetes mellitus (DM) triples the risk of TB and increases the probability of adverse TB treatment outcomes such as failure, death and recurrent TB. The rapidly escalating global epidemic of DM means that DM needs to be addressed if TB-related milestones and targets are to be achieved. WHO and the International Union Against Tuberculosis and Lung Disease's Collaborative Framework for Care and Control of Tuberculosis and Diabetes, launched in 2011, provides a template to guide policy makers and implementers to combat the epidemics of both diseases. However, more evidence is required to answer important questions about bi-directional screening, optimal ways of delivering treatment, integration of DM and TB services, and infection control. This should in turn contribute to better and earlier TB case detection, and improved TB treatment outcomes and prevention. DM and TB collaborative care can also help guide the development of a more effective and integrated public health approach for managing non-communicable diseases. PMID:26884497

Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

PubMed

Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

2008-05-01

Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

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

ERIC Educational Resources Information Center

Polito, Vincent A., Jr.

2010-01-01

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

On avoiding framing effects in experienced decision makers.

PubMed

Garcia-Retamero, Rocio; Dhami, Mandeep K

2013-01-01

The present study aimed to (a) demonstrate the effect of positive-negative framing on experienced criminal justice decision makers, (b) examine the debiasing effect of visually structured risk messages, and (c) investigate whether risk perceptions mediate the debiasing effect of visual aids on decision making. In two phases, 60 senior police officers estimated the accuracy of a counterterrorism technique in identifying whether a known terror suspect poses an imminent danger and decided whether they would recommend the technique to policy makers. Officers also rated their confidence in this recommendation. When information about the effectiveness of the counterterrorism technique was presented in a numerical format, officers' perceptions of accuracy and recommendation decisions were susceptible to the framing effect: The technique was perceived to be more accurate and was more likely to be recommended when its effectiveness was presented in a positive than in a negative frame. However, when the information was represented visually using icon arrays, there were no such framing effects. Finally, perceptions of accuracy mediated the debiasing effect of visual aids on recommendation decisions. We offer potential explanations for the debiasing effect of visual aids and implications for communicating risk to experienced, professional decision makers.

Linking Space Weather Science and Decision Making (Invited)

NASA Astrophysics Data System (ADS)

Fisher, G. M.

2009-12-01

Linking scientific knowledge to decision making is a challenge for both the science and policy communities. In particular, in the field of space weather, there are unique challenges such as decision makers may not know that space has weather that poses risks to our technologically-dependent economy. Additionally, in an era of limited funds for scientific research, hazards posed by other natural disasters such as flooding and earthquakes are by contrast well known to policy makers, further making the importance of space weather research and monitoring a tough sell. Today, with industries and individuals more dependent on the Global Positioning System, wireless technology, and satellites than ever before, any disruption or inaccuracy can result in severe economic impacts. Therefore, it is highly important to understand how space weather science can most benefit society. The key to connecting research to decision making is to ensure that the information is salient, credible, and legitimate. To achieve this, scientists need to understand the decision makers' perspectives, including their language and culture, and recognize that their needs may evolve. This presentation will take a closer look at the steps required to make space weather research, models, and forecasts useful to decision makers and ultimately, benefit society.

A cortical network model of cognitive and emotional influences in human decision making.

PubMed

Nazir, Azadeh Hassannejad; Liljenström, Hans

2015-10-01

Decision making (DM)(2) is a complex process that appears to involve several brain structures. In particular, amygdala, orbitofrontal cortex (OFC) and lateral prefrontal cortex (LPFC) seem to be essential in human decision making, where both emotional and cognitive aspects are taken into account. In this paper, we present a computational network model representing the neural information processing of DM, from perception to behavior. We model the population dynamics of the three neural structures (amygdala, OFC and LPFC), as well as their interaction. In our model, the neurodynamic activity of amygdala and OFC represents the neural correlates of secondary emotion, while the activity of certain neural populations in OFC alone represents the outcome expectancy of different options. The cognitive/rational aspect of DM is associated with LPFC. Our model is intended to give insights on the emotional and cognitive processes involved in DM under various internal and external contexts. Different options for actions are represented by the oscillatory activity of cell assemblies, which may change due to experience and learning. Knowledge and experience of the outcome of our decisions and actions can eventually result in changes in our neural structures, attitudes and behaviors. Simulation results may have implications for how we make decisions for our individual actions, as well as for societal choices, where we take examples from transport and its impact on CO2 emissions and climate change. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Hospital self-management policy in Chile: perceptions of decision-makers].

PubMed

Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

2013-01-01

To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Creating Ecosystem Services Indices with EnviroAtlas Metrics

EPA Science Inventory

To support the well-being of future generations, ecosystem services (ES) need to be fully understood and evaluated by decision-makers. Geospatial tools, such as the EnviroAtlas, allow decision-makers, urban planners, public health professionals, and other stakeholders to view and...

Study protocol: DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE).

PubMed

Turner, Simon; Morris, Stephen; Sheringham, Jessica; Hudson, Emma; Fulop, Naomi J

2016-04-05

A range of evidence informs healthcare decision-making, from formal research findings to 'soft intelligence' or local data, as well as practical experience or tacit knowledge. However, cultural and organisational factors often prevent the translation of such evidence into practice. Using a multi-level framework, this project will analyse how interactions between the evidence available and processes at the micro (individual/group) and meso (organisational/system) levels influence decisions to introduce or diffuse innovations in acute and primary care within the National Health Service in the UK. This study will use a mixed methods design, combining qualitative and quantitative methods, and involves four interdependent work streams: (1) rapid evidence synthesis of relevant literature with stakeholder feedback; (2) in-depth case studies of 'real-world' decision-making in acute and primary care; (3) a national survey and discrete choice experiment; and (4) development of guidance for decision-makers and evaluators to support the use of evidence in decision-making. This study will enhance the understanding of decision-makers' use of diverse forms of evidence. The findings will provide insights into how and why some evidence does inform decisions to introduce healthcare innovations, and why barriers persist in other cases. It will also quantify decision-makers' preferences, including the 'tipping point' of evidence needed to shift stakeholders' views. Practical guidance will be shared with healthcare decision-makers and evaluators on uses of evidence to enable the introduction and diffusion of innovation.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities.

PubMed

López-Rodríguez, M D; Castro, H; Arenas, M; Requena-Mullor, J M; Cano, A; Valenzuela, E; Cabello, J

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

Equilibrium approach towards water resource management and pollution control in coal chemical industrial park.

PubMed

Xu, Jiuping; Hou, Shuhua; Xie, Heping; Lv, Chengwei; Yao, Liming

2018-08-01

In this study, an integrated water and waste load allocation model is proposed to assist decision makers in better understanding the trade-offs between economic growth, resource utilization, and environmental protection of coal chemical industries which characteristically have high water consumption and pollution. In the decision framework, decision makers in a same park, each of whom have different goals and preferences, work together to seek a collective benefit. Similar to a Stackelberg-Nash game, the proposed approach illuminates the decision making interrelationships and involves in the conflict coordination between the park authority and the individual coal chemical company stockholders. In the proposed method, to response to climate change and other uncertainties, a risk assessment tool, Conditional Value-at-Risk (CVaR) and uncertainties through reflecting parameters and coefficients using probability and fuzzy set theory are integrated in the modeling process. Then a case study from Yuheng coal chemical park is presented to demonstrate the practicality and efficiency of the optimization model. To reasonable search the potential consequences of different responses to water and waste load allocation strategies, a number of scenario results considering environmental uncertainty and decision maker' attitudes are examined to explore the tradeoffs between economic development and environmental protection and decision makers' objectives. The results are helpful for decision/police makers to adjust current strategies adapting for current changes. Based on the scenario analyses and discussion, some propositions and operational policies are given and sensitive adaptation strategies are presented to support the efficient, balanced and sustainable development of coal chemical industrial parks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities

NASA Astrophysics Data System (ADS)

López-Rodríguez, M. D.; Castro, H.; Arenas, M.; Requena-Mullor, J. M.; Cano, A.; Valenzuela, E.; Cabello, J.

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

The Art of Influencing Decision Makers.

ERIC Educational Resources Information Center

Diegmueller, Karen

1992-01-01

Influencing educational decision makers requires creating ongoing relationships, keeping everyone informed, and developing persuasive skills. Persuasion requires preparation, refinement, hard work, and a sound understanding of the people being lobbied. Lobbying must be factual and relevant to the audience. The article looks at influence from the…

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

EPA Science Inventory

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

Innovative environmental education contributes to improved management practices in the Mid-Atlantic region of the United States.

PubMed

Bradley, M Patricia; Hanson, Royce; Walbeck, Eric S

2004-06-01

The Mid-Atlantic Integrated Assessment (MAIA) and its partner, University of Maryland, Baltimore County (UMBC) have developed a graduate-level course focused on successful application of science by decision-makers to address a particular problem. Students conduct a literature review, interview the decision-makers and scientists, and synthesize and document the management problem, the science that was applied to that problem, and other issues that might constrain or drive the solution (e.g., legalities, social pressures, expense, politics, personalities, etc.). Students also quantify the results, evaluate who the intended audience is and how they most appropriately target them, and determine if there are other management problems that could be addressed with the science. The final products are short publications geared towards other decision-makers who might have a similar problem and might be seeking successful innovative solutions. MAIA is distributing these short publications to decision-makers throughout the Mid-Atlantic Region. The publications have been very positively received by state and local governments and watershed groups.

Multiple sclerosis decreases explicit counterfactual processing and risk taking in decision making.

PubMed

Simioni, Samanta; Schluep, Myriam; Bault, Nadège; Coricelli, Giorgio; Kleeberg, Joerg; Du Pasquier, Renaud A; Gschwind, Markus; Vuilleumier, Patrik; Annoni, Jean-Marie

2012-01-01

Deficits in decision making (DM) are commonly associated with prefrontal cortical damage, but may occur with multiple sclerosis (MS). There are no data concerning the impact of MS on tasks evaluating DM under explicit risk, where different emotional and cognitive components can be distinguished. We assessed 72 relapsing-remitting MS (RRMS) patients with mild to moderate disease and 38 healthy controls in two DM tasks involving risk with explicit rules: (1) The Wheel of Fortune (WOF), which probes the anticipated affects of decisions outcomes on future choices; and (2) The Cambridge Gamble Task (CGT) which measures risk taking. Participants also underwent a neuropsychological and emotional assessment, and skin conductance responses (SCRs) were recorded. In the WOF, RRMS patients showed deficits in integrating positive counterfactual information (p<0.005) and greater risk aversion (p<0.001). They reported less negative affect than controls (disappointment: p = 0.007; regret: p = 0.01), although their implicit emotional reactions as measured by post-choice SCRs did not differ. In the CGT, RRMS patients differed from controls in quality of DM (p = 0.01) and deliberation time (p = 0.0002), the latter difference being correlated with attention scores. Such changes did not result in overall decreases in performance (total gains). The quality of DM under risk was modified by MS in both tasks. The reduction in the expression of disappointment coexisted with an increased risk aversion in the WOF and alexithymia features. These concomitant emotional alterations may have implications for better understanding the components of explicit DM and for the clinical support of MS patients.

Priority setting: what constitutes success? A conceptual framework for successful priority setting

PubMed Central

Sibbald, Shannon L; Singer, Peter A; Upshur, Ross; Martin, Douglas K

2009-01-01

Background The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual framework for successful priority setting. Methods Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries). Results This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism. Conclusion The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting. The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts. PMID:19265518

Information and Decision Superiority: Right Concept, Right Tools, Right Training

DTIC Science & Technology

2007-01-01

individual services, and numerous defense contractors have spoken of " information dominance " and "information superiority." Both, particularly the former...technologies will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however, are fundamentally...other futuristic sensors will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however

Climate modeling with decision makers in mind

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

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

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

Making Invasion models useful for decision makers; incorporating uncertainty, knowledge gaps, and decision-making preferences

Treesearch

Denys Yemshanov; Frank H Koch; Mark Ducey

2015-01-01

Uncertainty is inherent in model-based forecasts of ecological invasions. In this chapter, we explore how the perceptions of that uncertainty can be incorporated into the pest risk assessment process. Uncertainty changes a decision maker’s perceptions of risk; therefore, the direct incorporation of uncertainty may provide a more appropriate depiction of risk. Our...

A Systems Thinking Framework for Assessing and Addressing Malaria Locally: An Alternative to the Globalization of Anti-Malaria Policies

ERIC Educational Resources Information Center

Willis, Derek W.

2010-01-01

This dissertation analyzes a decision system that was used in the early 1900s in the Federated Malay States (FMS) by Malcolm Watson in order to make anti-malaria program recommendations to decision makers in a wide range of ecological settings. Watson's recommendations to decision makers throughout the FMS led to a dramatic suppression of malaria…

Climate modeling with decision makers in mind

DOE PAGES

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

2016-04-27

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

Nature of Science and Decision-Making

NASA Astrophysics Data System (ADS)

Khishfe, Rola

2012-01-01

The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were taught by their regular science teacher. The treatment comprised a four-week unit about genetic engineering. Two groups (one regular and one honors), referred to as comparison groups, received instruction in genetic engineering and how to formulate arguments and make decisions related to this controversial issue. The other two groups (one regular and one honors), referred to as treatment groups, received instruction in genetic engineering and how to apply NOS aspects as they formulate arguments and make decisions in relation to this controversial issue. Chi-square analyses showed significant differences between the comparison and the treatment groups in relation to the understandings of four NOS aspects. There were no differences in their decisions, but there were differences in their DM factors in the context of the controversial socioscientific issue about genetically modified food. These results are discussed in light of the relationship between students' understandings of NOS and their DM related to controversial socioscientific issues.

Improving the Slum Planning Through Geospatial Decision Support System

NASA Astrophysics Data System (ADS)

Shekhar, S.

2014-11-01

In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.

System and method for integrating hazard-based decision making tools and processes

DOEpatents

Hodgin, C Reed [Westminster, CO

2012-03-20

A system and method for inputting, analyzing, and disseminating information necessary for identified decision-makers to respond to emergency situations. This system and method provides consistency and integration among multiple groups, and may be used for both initial consequence-based decisions and follow-on consequence-based decisions. The system and method in a preferred embodiment also provides tools for accessing and manipulating information that are appropriate for each decision-maker, in order to achieve more reasoned and timely consequence-based decisions. The invention includes processes for designing and implementing a system or method for responding to emergency situations.

Evaluation and Selection of Predicaments in Pharmaceutical Supply Chain using AHP under Fuzzy Environment

NASA Astrophysics Data System (ADS)

Nikhil, E. V. S.; Sai Ram, V.; Charan Yadav, V.; Kiran Kumar, Kalla; Nagaraju, Dega

2017-05-01

Pharmaceutical sector plays an important role in the medical and health system. Due to the globalization of the business, increasing demand and supply for drugs, growing regulatory requirements, all stages of the pharmaceutical supply chain (SC) are facing numerous predicaments. The traditional way of selection and evaluation of these predicaments is customarily done using technical information. This approach lacks the ability to project the burning issue that to be addressed first. Hence, a computing method of selecting the crucial issue from the existing issues is essential in a pharmaceutical supply chain. This paper considers seven different predicaments as criteria and five sub-criteria under each main predicament of a pharmaceutical supply chain. The intention of this project is to manifest the process of assessing and selecting the issue that to be addressed first by using multi-criteria decision making technique (MCDM), i.e., fuzzy analytical hierarchy process (FAHP). The criteria and sub-criteria weights are calculated and priority assessment of the predicaments is done by using FAHP. Finally, from the findings of this work, the predicaments are ranked from most important to least important. This gives information to the decision maker (DM) to solve the issue that is affecting the SC the most with respect to the others.

Discounting of Delayed Rewards Is Not Hyperbolic

ERIC Educational Resources Information Center

Luhmann, Christian C.

2013-01-01

Delay discounting refers to decision-makers' tendency to value immediately available goods more than identical goods available only after some delay. In violation of standard economic theory, decision-makers frequently exhibit dynamic inconsistency; their preferences change simply due to the passage of time. The standard explanation for this…

Doubt and belief in physicians' ability to prognosticate during critical illness: The perspective of surrogate decision makers

PubMed Central

Zier, Lucas S.; Burack, Jeffrey H.; Micco, Guy; Chipman, Anne K.; Frank, James A.; Luce, John M.; White, Douglas B.

2009-01-01

Objectives: Although discussing a prognosis is a duty of physicians caring for critically ill patients, little is known about surrogate decision-makers' beliefs about physicians' ability to prognosticate. We sought to determine: 1) surrogates' beliefs about whether physicians can accurately prognosticate for critically ill patients; and 2) how individuals use prognostic information in their role as surrogate decision-makers. Design, Setting, and Patients: Multicenter study in intensive care units of a public hospital, a tertiary care hospital, and a veterans' hospital. We conducted semistructured interviews with 50 surrogate decision-makers of critically ill patients. We analyzed the interview transcripts using grounded theory methods to inductively develop a framework to describe surrogates' beliefs about physicians' ability to prognosticate. Validation methods included triangulation by multidisciplinary analysis and member checking. Measurements and Main Results: Overall, 88% (44 of 50) of surrogates expressed doubt about physicians' ability to prognosticate for critically ill patients. Four distinct themes emerged that explained surrogates' doubts about prognostic accuracy: a belief that God could alter the course of the illness, a belief that predicting the future is inherently uncertain, prior experiences where physicians' prognostications were inaccurate, and experiences with prognostication during the patient's intensive care unit stay. Participants also identified several factors that led to belief in physicians' prognostications, such as receiving similar prognostic estimates from multiple physicians and prior experiences with accurate prognostication. Surrogates' doubts about prognostic accuracy did not prevent them from wanting prognostic information. Instead, most surrogate decision-makers view physicians' prognostications as rough estimates that are valuable in informing decisions, but are not determinative. Surrogates identified the act of prognostic disclosure as a key step in preparing emotionally and practically for the possibility that a patient may not survive. Conclusions: Although many surrogate decision-makers harbor some doubt about the accuracy of physicians' prognostications, they highly value discussions about prognosis and use the information for multiple purposes. (Crit Care Med 2008; 36: 2341–2347) PMID:18596630

Structural barriers to coping with type 1 diabetes mellitus in Ghana: experiences of diabetic youth and their families.

PubMed

Kratzer, J

2012-06-01

To explore the structural barriers faced by families coping with type 1 diabetes mellitus (T1DM) in Ghana, and to provide insight for policy development. Qualitative study conducted with families with a child with T1DM, receiving care in the greater Accra area. Total of 17 individuals were interviewed using individual and dyadic approaches: 7 youth with T1DM, 9 parents of children with T1DM, and one medical doctor. 5 key barriers emerged from the data: primary care, schools, financial burden, lack of formal support, and access to information. Participants expressed concern over the misdiagnosis of T1DM at primary care facilities, resulting in some of the children going into a diabetic coma before receiving proper care. Children and parents noted discrimination and poor care at school. Financial burden was due to the high costs of medications and appliances needed for proper diabetes management. A lack of formal support was credited by participants to be the result of the lethargy of advocacy groups or resource centers. Finally, there was a lack of readily available and accessible information for children and parents on T1DM. Awareness of T1DM needs to be increased, by incorporating lessons on recognition into already existing campaigns for type 2 diabetes mellitus (T2DM). Schools need to be more engaged with their responsibility for children with diabetes. Pressuring policy makers and pharmaceutical companies to make diabetes supplies more affordable and accessible could ease the financial burden. Social support networks need to be explored and strengthened. Study into the experiences of youth with T1DM in rural settings and other parts of Ghana, as well as, youth from low socioeconomic backgrounds is necessary.

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

PubMed Central

2013-01-01

Background Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. Methods An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. Results The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Conclusions Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. PMID:23731570

Clinical and genetic correlates of decision making in anorexia nervosa.

PubMed

Tenconi, Elena; Degortes, Daniela; Clementi, Maurizio; Collantoni, Enrico; Pinato, Claudia; Forzan, Monica; Cassina, Matteo; Santonastaso, Paolo; Favaro, Angela

2016-01-01

Decision-making (DM) abilities have been found to be impaired in anorexia nervosa (AN), but few data are available about the characteristics and correlates of this cognitive function. The aim of the present study was to provide data on DM functioning in AN using both veridical and adaptive paradigms. While in veridical DM tasks, the individual's ability to predict a true/false response is measured, adaptive DM is the ability to consider both internal and external demands in order to make a good choice, in the absence of a single true "correct" answer. The participants were 189 women, of whom 91 were eating-disordered patients with a lifetime diagnosis of anorexia nervosa, and 98 were healthy women. All the participants underwent clinical, neuropsychological, and genetic assessment. The cognitive evaluation included a set of neuropsychological tasks and two decision-making tests: The Iowa Gambling Task and the Cognitive Bias Task. Anorexia nervosa patients showed significantly poorer performances on both decision-making tasks than healthy women. The Cognitive Bias Task revealed that anorexia nervosa patients employed significantly more context-independent decision-making strategies, which were independent from diagnostic subtype, handedness, education, and psychopathology. In the whole sample (patients and controls), Cognitive Bias Task performance was independently predicted by lifetime anorexia nervosa diagnosis, body mass index at assessment, and 5-HTTLPR genotype. Patients displayed poor decision-making functioning in both veridical and adaptive situations. The difficulties detected in anorexia nervosa individuals may affect not only the ability to consider the future outcomes of their actions (leading to "myopia for the future"), but also the capacity to update and review one's own mindset according to new environmental stimuli.

Finding the numerical compensation in multiple criteria decision-making problems under fuzzy environment

NASA Astrophysics Data System (ADS)

Gupta, Mahima; Mohanty, B. K.

2017-04-01

In this paper, we have developed a methodology to derive the level of compensation numerically in multiple criteria decision-making (MCDM) problems under fuzzy environment. The degree of compensation is dependent on the tranquility and anxiety level experienced by the decision-maker while taking the decision. Higher tranquility leads to the higher realisation of the compensation whereas the increased level of anxiety reduces the amount of compensation in the decision process. This work determines the level of tranquility (or anxiety) using the concept of fuzzy sets and its various level sets. The concepts of indexing of fuzzy numbers, the risk barriers and the tranquility level of the decision-maker are used to derive his/her risk prone or risk averse attitude of decision-maker in each criterion. The aggregation of the risk levels in each criterion gives us the amount of compensation in the entire MCDM problem. Inclusion of the compensation leads us to model the MCDM problem as binary integer programming problem (BIP). The solution to BIP gives us the compensatory decision to MCDM. The proposed methodology is illustrated through a numerical example.

Adaptation Planning for Water Resources Management in the Context of Scientific Uncertainty

NASA Astrophysics Data System (ADS)

Lowrey, J.; Kenney, D.

2008-12-01

Several municipalities are beginning to create policies and plans in order to adapt to potential impacts from climate change. A 2007 report from the Heinz Center for Science, Economics, and the Environment, 'A Survey of Climate Change Adaptation Planning,' surveyed fourteen cities or counties across the U.S. and Canada that have created or are working towards creating climate change adaptation plans. Informal interactions with water managers in the Intermountain West indicate an eagerness to learn from those who have already begun adapting to potential climate change. Many of those without plans do not feel comfortable making potentially expensive long-term policy decisions based on impacts derived from uncertain climate change projections. This research identifies how decision makers currently consider climate change in adaptation planning despite imperfect information about climate change impacts, particularly in the water sector. Insights are offered into how best to provide information on climate change projections to regional decision makers so that they can begin adaptation planning for a changing climate. This research analyzes how a subset of the fourteen municipalities justified adaptive planning in the face of scientific uncertainty, paying particular attention to water resource adaptation, using the adaptation approaches studied in the 2007 Heinz Center Report. Interviews will be conducted with decision makers to learn how policies will be implemented and evaluated, and to explore resulting changes in policy or planning. Adaptation strategies are not assessed, but are used to identify how the decision makers plan to evaluate their own adaptation policies. In addition to looking at information use in adaptation plans, we compare how the plans orient themselves (adapting to projected impacts vs. increasing resiliency to current climate variability), how they address barriers and opportunities for adaptation, and whether they follow some key steps for successful adaptation as outlined in the literature. This part of the study will identify any consensus among the municipalities already adapting, and see of the decision makers tend to agree with the points of views expressed in the literature. The conclusions here will not only help decision makers trying to adapt, but it will help researchers orient future research to the informational needs of the decision makers. The work is intended to provide useful information for the Western Water Assessment, a NOAA-funded research boundary organization, which provides climate information to water resource managers in the Intermountain West, including the Colorado River Basin.

Incentivizing Decentralized Sanitation: The Role of Discount Rates.

PubMed

Wood, Alison; Blackhurst, Michael; Garland, Jay L; Lawler, Desmond F

2016-06-21

In adoption decisions for decentralized sanitation technologies, two decision makers are involved: the public utility and the individual homeowner. Standard life cycle cost is calculated from the perspective of the utility, which uses a market-based discount rate in these calculations. However, both decision-makers must be considered, including their differing perceptions of the time trade-offs inherent in a stream of costs and benefits. This study uses the discount rate as a proxy for these perceptions and decision-maker preferences. The results in two case studies emphasize the dependence on location of such analyses. Falmouth, Massachusetts, appears to be a good candidate for incentivizing decentralized sanitation while the Allegheny County Sanitary Authority service area in Pennsylvania appears to have no need for similar incentives. This method can be applied to any two-party decision in which the parties are expected to have different discount rates.

Exploring Scientific Information for Policy Making under Deep Uncertainty

NASA Astrophysics Data System (ADS)

Forni, L.; Galaitsi, S.; Mehta, V. K.; Escobar, M.; Purkey, D. R.; Depsky, N. J.; Lima, N. A.

2016-12-01

Each actor evaluating potential management strategies brings her/his own distinct set of objectives to a complex decision space of system uncertainties. The diversity of these objectives require detailed and rigorous analyses that responds to multifaceted challenges. However, the utility of this information depends on the accessibility of scientific information to decision makers. This paper demonstrates data visualization tools for presenting scientific results to decision makers in two case studies, La Paz/ El Alto, Bolivia, and Yuba County,California. Visualization output from the case studies combines spatiotemporal, multivariate and multirun/multiscenario information to produce information corresponding to the objectives defined by key actors and stakeholders. These tools can manage complex data and distill scientific information into accessible formats. Using the visualizations, scientists and decision makers can navigate the decision space and potential objective trade-offs to facilitate discussion and consensus building. These efforts can support identifying stable negotiatedagreements between different stakeholders.

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

PubMed

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

2014-07-01

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

Moral Hazard in Pediatrics.

PubMed

Brunnquell, Donald; Michaelson, Christopher M

2016-07-01

"Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties.

Overview of EPA tools for supporting local- and regional-scale decision makers addressing energy and environmental issues

EPA Science Inventory

EPA’s Office of Research and Development (ORD) has been developing tools and illustrative case studies for decision makers in local and regional authorities who are facing challenges of establishing resilience to extreme weather events, aging built environment and infrastru...

The Two-Communities Theory and Knowledge Utilization.

ERIC Educational Resources Information Center

Caplan, Nathan

1979-01-01

Discusses strategies to improve policy makers' utilization of research based on the "two-communities" theory that social scientists and policy makers live in two different worlds. Notes that for high level decision making, collaboration must involve more general problems and a decision to use either data-based or nonresearch knowledge for solving…

Putting Educational Forecasts into Perspective: A Guide for Decisionmakers.

ERIC Educational Resources Information Center

Dede, Christopher; Kierstead, Fred

This paper focuses on how educational decision-makers can make use of futures research through a better understanding of forecasters' perspectives. Eight problems in communicating that are significant in contributing to poor usage of forecasts by educational decision-makers are: (1) overuse of jargon, (2) preoccupation with technological…

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

USDA-ARS?s Scientific Manuscript database

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

Modelling a Network of Decision Makers

DTIC Science & Technology

2004-06-01

DATES COVERED 00-00-2004 to 00-00-2004 4. TITLE AND SUBTITLE Modelling a Netowrk of Decision Makers (Briefing Charts) 5a. CONTRACT NUMBER 5b...contains color images. 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 31 19a

The Others: Equitable Access, International Students, and the Community College

ERIC Educational Resources Information Center

Viggiano, Tiffany; López Damián, Ariadna I.; Morales Vázquez, Evelyn; Levin, John S.

2018-01-01

This qualitative investigation explains the ways in which community college decision makers justify the inclusion of international students at three community colleges in the United States. We identify and explain the ways in which decision makers rationalize institutional policy--particularly recruitment strategies and motivations--related to…

Adolescent pediatric decision-making: a critical reconsideration in the light of the data.

PubMed

Partridge, Brian

2014-12-01

Adolescents present a puzzle. There are foundational unclarities about how they should be regarded as decision-makers. Although superficially adolescents may appear to have mature decisional capacity, their decision-making is in many ways unlike that of adults. Despite this seemingly obvious fact, a concern for the claims of autonomy has led to the development of the legal doctrine of the mature minor. This legal construct considers adolescents, as far as possible, as equivalent to adults for the purpose of medical decision-making. The movement to support independent decision-making by adolescents through providing information to them and securing their consent apart from their parents is encouraged by those legal understandings that hold that unemancipated minors should generally be considered as possessing effective decisional capacity. Such legal structures, however, do not adequately take account of the wide variations in adolescent capacities, the immaturity of most adolescent decision-makers, or the important contributions made by parents to the development of their adolescents through parental partnering in the adolescent's decision-making. The data available indicate that in general adolescents should be regarded as apprentice decision-makers who should make decisions in collaboration with their parents until at least the age of 18. Steps should not be taken pre-emptively to isolate adolescents from the guidance of their parents. As a general rule, what Piker has referred to as "collaborative paternalism" appears most likely both to protect adolescents from their own untoward choices, while also very importantly helping them with parental guidance to develop into mature decision-makers with the capacity to make medical choices on their own.

A decision framework for coordinating bioterrorism planning: lessons from the BioNet program.

PubMed

Manley, Dawn K; Bravata, Dena M

2009-01-01

Effective disaster preparedness requires coordination across multiple organizations. This article describes a detailed framework developed through the BioNet program to facilitate coordination of bioterrorism preparedness planning among military and civilian decision makers. The authors and colleagues conducted a series of semistructured interviews with civilian and military decision makers from public health, emergency management, hazardous material response, law enforcement, and military health in the San Diego area. Decision makers used a software tool that simulated a hypothetical anthrax attack, which allowed them to assess the effects of a variety of response actions (eg, issuing warnings to the public, establishing prophylaxis distribution centers) on performance metrics. From these interviews, the authors characterized the information sources, technologies, plans, and communication channels that would be used for bioterrorism planning and responses. The authors used influence diagram notation to describe the key bioterrorism response decisions, the probabilistic factors affecting these decisions, and the response outcomes. The authors present an overview of the response framework and provide a detailed assessment of two key phases of the decision-making process: (1) pre-event planning and investment and (2) incident characterization and initial responsive measures. The framework enables planners to articulate current conditions; identify gaps in existing policies, technologies, information resources, and relationships with other response organizations; and explore the implications of potential system enhancements. Use of this framework could help decision makers execute a locally coordinated response by identifying the critical cues of a potential bioterrorism event, the information needed to make effective response decisions, and the potential effects of various decision alternatives.

Multi-Metric Sustainability Analysis

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

Cowlin, Shannon; Heimiller, Donna; Macknick, Jordan

2014-12-01

A readily accessible framework that allows for evaluating impacts and comparing tradeoffs among factors in energy policy, expansion planning, and investment decision making is lacking. Recognizing this, the Joint Institute for Strategic Energy Analysis (JISEA) funded an exploration of multi-metric sustainability analysis (MMSA) to provide energy decision makers with a means to make more comprehensive comparisons of energy technologies. The resulting MMSA tool lets decision makers simultaneously compare technologies and potential deployment locations.

Corporate financial decision makers' perceptions of their company's safety performance, programs and personnel: Do company size and industry injury risk matter?

PubMed

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

2010-01-01

Top-level managers make important decisions about safety-related issues, yet little research has been done involving these individuals. The current study explored corporate financial decisions makers' perceptions of their company's safety and their justifications for these perceptions. This study also explored whether their perceptions and justifications varied as a function of company size or industry injury risk. A total of 404 individuals who were the most senior managers responsible for making decisions about property and casualty risk at their companies participated in this study. The participants took part in a telephone survey. The results suggest that corporate financial decision makers have positive views of safety at their companies relative to safety at other companies within their industries. Further, many believe their company's safety is influenced by the attention/emphasis placed on safety and the selection and training of safety personnel. Participants' perceptions varied somewhat based on the size of their company and the level of injury risk in their industry. While definitive conclusions about corporate financial decision makers' perceptions of safety cannot be reached as a result of this single study, this work does lay groundwork for future research aimed at better understanding the perceptions top-level managers.

The Role of Dysfunctional Myths in a Decision-Making Process under Bounded Rationality: A Complex Dynamical Systems Perspective.

PubMed

Stamovlasis, Dimitrios; Vaiopoulou, Julie

2017-07-01

The present study examines the factors influencing a decision-making process, with specific focus on the role of dysfunctional myths (DM). DM are thoughts or beliefs that are rather irrational, however influential to people's decisions. In this paper a decision-making process regarding the career choice of university students majoring in natural sciences and education (N=496) is examined by analyzing survey data taken via Career Decision Making Difficulties Questionnaire (CDDQ). The difficulty of making the choice and the certainty about one's decision were the state variables, while the independent variables were factors related to the lack of information or knowledge needed, which actually reflect a bounded rationality. Cusp catastrophe analysis, based on both least squares and maximum likelihood procedures, showed that the nonlinear models predicting the two state variables were superior to linear alternatives. Factors related to lack of knowledge about the steps involved in the process of career decision-making, lack of information about the various occupations, lack of information about self and lack of motivation acted as asymmetry, while dysfunctional myths acted as bifurcation factor for both state variables. The catastrophe model, grounded in empirical data, revealed a unique role for DM and a better interpretation within the context of complexity and the notion of bounded rationality. The analysis opens the nonlinear dynamical systems (NDS) perspective in studying decision-making processes. Theoretical and practical implications are discussed.

Producing More Actionable Science Isn't the Problem; It's Providing Decision-Makers with Access to Right Actionable Knowledge

NASA Astrophysics Data System (ADS)

Trexler, M.

2017-12-01

Policy-makers today have almost infinite climate-relevant scientific and other information available to them. The problem for climate change decision-making isn't missing science or inadequate knowledge of climate risks; the problem is that the "right" climate change actionable knowledge isn't getting to the right decision-maker, or is getting there too early or too late to effectively influence her decision-making. Actionable knowledge is not one-size-fit-all, and for a given decision-maker might involve scientific, economic, or risk-based information. Simply producing more and more information as we are today is not the solution, and actually makes it harder for individual decision-makers to access "their" actionable knowledge. The Climatographers began building the Climate Web five years ago to test the hypothesis that a knowledge management system could help navigate the gap between infinite information and individual actionable knowledge. Today the Climate Web's more than 1,500 index terms allow instant access to almost any climate change topic. It is a curated public-access knowledgebase of more than 1,000 books, 2,000 videos, 15,000 reports and articles, 25,000 news stories, and 3,000 websites. But it is also much more, linking together tens of thousands of individually extracted ideas and graphics, and providing Deep Dives into more than 100 key topics from changing probability distributions of extreme events to climate communications best practices to cognitive dissonance in climate change decision-making. The public-access Climate Web is uniquely able to support cross-silo learning, collaboration, and actionable knowledge dissemination. The presentation will use the Climate Web to demonstrate why knowledge management should be seen as a critical component of science and policy-making collaborations.

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

USGS Publications Warehouse

Sohl, Terry L.; Claggett, Peter

2013-01-01

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

Establishment of Peripheral Nerve Injury Data Repository to Monitor and Support Population Health Decisions

DTIC Science & Technology

2017-07-01

AWARD NUMBER: W81XWH-16-0-DM167033 TITLE: Establishment of Peripheral Nerve Injury Data Repository to Monitor and Support Population Health...Injury Data Repository to Monitor and Support Population Health Decisions 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-0-DM167033 5c. PROGRAM...patient enrollment. Collected data will be utilized to 1) describe the outcomes of various PNI and 2) suggest outcomes that support population health

Consortium for Atlantic Regional Assessment: information tools for community adaptation to changes in climate or land use.

PubMed

Dempsey, Rachael; Fisher, Ann

2005-12-01

To inform local and regional decisions about protecting short-term and long-term quality of life, the Consortium for Atlantic Regional Assessment (CARA) provides data and tools (for the northeastern United States) that can help decision makers understand how outcomes of their decisions could be affected by potential changes in both climate and land use. On an interactive, user-friendly website, CARA has amassed data on climate (historical records and future projections for seven global climate models), land cover, and socioeconomic and environmental variables, along with tools to help decision makers tailor the data for their own decision types and locations. CARA Advisory Council stakeholders help identify what information and tools stakeholders would find most useful and how to present these; they also provide in-depth feedback for subregion case studies. General lessons include: (1) decision makers want detailed local projections for periods short enough to account for extreme events, in contrast to the broader spatial and temporal observations and projections that are available or consistent at a regional level; (2) stakeholders will not use such a website unless it is visually appealing and easy to find the information they want; (3) some stakeholders need background while others want to go immediately to data, and some want maps while others want text or tables. This article also compares what has been learned across case studies of Cape May County, New Jersey, Cape Cod, Massachusetts, and Hampton Roads, Virginia, relating specifically to sea-level rise. Lessons include: (1) groups can be affected differently by physical dangers compared with economic dangers; (2) decisions will differ according to decision makers' preferences about waiting and risk tolerance; (3) future scenarios and maps can help assess the impacts of dangers to emergency evacuation routes, homes, and infrastructure, and the natural environment; (4) residents' and decision makers' perceptions are affected by information about potential local impacts from global climate change.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

Priority setting in the provincial health services authority: survey of key decision makers

PubMed Central

Teng, Flora; Mitton, Craig; MacKenzie, Jennifer

2007-01-01

Background In recent years, decision makers in Canada and elsewhere have expressed a desire for more explicit, evidence-based approaches to priority setting. To achieve this aim within health care organizations, knowledge of both the organizational context and stakeholder attitudes towards priority setting are required. The current work adds to a limited yet growing body of international literature describing priority setting practices in health organizations. Methods A qualitative study was conducted using in-depth, face-to-face interviews with 25 key decision makers of the Provincial Health Services Authority (PHSA) of British Columbia. Major themes and sub-themes were identified through content analysis. Results Priorities were described by decision makers as being set in an ad hoc manner, with resources generally allocated along historical lines. Participants identified the Strategic Plan and a strong research base as strengths of the organization. The main areas for improvement were a desire to have a more transparent process for priority setting, a need to develop a culture which supports explicit priority setting, and a focus on fairness in decision making. Barriers to an explicit allocation process included the challenge of providing specialized services for disparate patient groups, and a lack of formal training in priority setting amongst decision makers. Conclusion This study identified factors important to understanding organizational context and informed next steps for explicit priority setting for a provincial health authority. While the PHSA is unique in its organizational structure in Canada, lessons about priority setting should be transferable to other contexts. PMID:17565691

Training conservation practitioners to be better decision makers

USGS Publications Warehouse

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

2015-01-01

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

Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

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

Stern, Marc J., E-mail: mjstern@vt.ed; Predmore, S. Andrew, E-mail: sapredmo@vt.ed

2011-04-15

The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second withmore » the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.« less

Embedding health policy and systems research into decision-making processes in low- and middle-income countries

PubMed Central

2013-01-01

Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization’s Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

A meta-analysis of gender stereotypes and bias in experimental simulations of employment decision making.

PubMed

Koch, Amanda J; D'Mello, Susan D; Sackett, Paul R

2015-01-01

Gender bias continues to be a concern in many work settings, leading researchers to identify factors that influence workplace decisions. In this study we examine several of these factors, using an organizing framework of sex distribution within jobs (including male- and female-dominated jobs as well as sex-balanced, or integrated, jobs). We conducted random effects meta-analyses including 136 independent effect sizes from experimental studies (N = 22,348) and examined the effects of decision-maker gender, amount and content of information available to the decision maker, type of evaluation, and motivation to make careful decisions on gender bias in organizational decisions. We also examined study characteristics such as type of participant, publication year, and study design. Our findings revealed that men were preferred for male-dominated jobs (i.e., gender-role congruity bias), whereas no strong preference for either gender was found for female-dominated or integrated jobs. Second, male raters exhibited greater gender-role congruity bias than did female raters for male-dominated jobs. Third, gender-role congruity bias did not consistently decrease when decision makers were provided with additional information about those they were rating, but gender-role congruity bias was reduced when information clearly indicated high competence of those being evaluated. Fourth, gender-role congruity bias did not differ between decisions that required comparisons among ratees and decisions made about individual ratees. Fifth, decision makers who were motivated to make careful decisions tended to exhibit less gender-role congruity bias for male-dominated jobs. Finally, for male-dominated jobs, experienced professionals showed smaller gender-role congruity bias than did undergraduates or working adults. (c) 2015 APA, all rights reserved.

Embedding health policy and systems research into decision-making processes in low- and middle-income countries.

PubMed

Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul

2013-08-08

Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems.

Do violations of the axioms of expected utility theory threaten decision analysis?

PubMed

Nease, R F

1996-01-01

Research demonstrates that people violate the independence principle of expected utility theory, raising the question of whether expected utility theory is normative for medical decision making. The author provides three arguments that violations of the independence principle are less problematic than they might first appear. First, the independence principle follows from other more fundamental axioms whose appeal may be more readily apparent than that of the independence principle. Second, the axioms need not be descriptive to be normative, and they need not be attractive to all decision makers for expected utility theory to be useful for some. Finally, by providing a metaphor of decision analysis as a conversation between the actual decision maker and a model decision maker, the author argues that expected utility theory need not be purely normative for decision analysis to be useful. In short, violations of the independence principle do not necessarily represent direct violations of the axioms of expected utility theory; behavioral violations of the axioms of expected utility theory do not necessarily imply that decision analysis is not normative; and full normativeness is not necessary for decision analysis to generate valuable insights.

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study.

PubMed

Hafez, Dina; Nelson, Daniel B; Martin, Evan G; Cohen, Alicia J; Northway, Rebecca; Kullgren, Jeffrey T

2017-04-04

Early diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians' (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs' decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients. We conducted semi-structured chart-stimulated recall interviews with 20 University of Michigan Health System (UMHS) primary care physicians. PCPs were asked about their recent decisions to screen or not screen 134 purposively sampled non-diabetic patients who met American Diabetes Association criteria for screening for T2DM. Interviews were audio-recorded, transcribed, and analyzed using qualitative directed content analysis. Data on patient demographic characteristics and comorbidities were abstracted from the electronic health record. The most common reasons PCPs gave for not screening 63 patients for T2DM were knowledge of a previously normal screening test (49%) and a visit for reasons other than a health maintenance examination (48%). The most common reasons PCPs gave for screening 71 patients for T2DM were knowledge of a previously abnormal screening test (49%), and patients' weight (42%) and age (38%). PCPs correctly interpreted 89% of screening test results and communicated 95% of test results to patients. Among 24 patients found to have prediabetes, PCPs usually (58%) recommended weight loss and increased physical activity but never recommended participation in a Diabetes Prevention Program or use of metformin. Previous screening test results, visit types, and patients' weight and age influenced PCPs' decisions to screen for T2DM. When patients were screened, test results were generally correctly interpreted and consistently communicated. Recommendations to patients with prediabetes could better reflect evidence-based strategies to prevent T2DM.

Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses.

PubMed

Lovell, Geoff P; Smith, Trish; Kannis-Dymand, Lee

2015-01-01

This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.

The Roles of Decision Makers in Special Operations

DTIC Science & Technology

2016-12-01

question and hypotheses. 9 II. CASE STUDIES A. OPERATION THUNDERBOLT (THE RAID ON ENTEBBE) The Israeli Special Forces’ hostage rescue operation...Operations Warfare, 338. 28 Herzog, “The War Against Terrorism: Entebbe,” 338. 29 Chaitanya Arun Sathe, “A Case Study on Crisis Management with a...Assessment of the Roles of Decision Makers This assessment is based on this case study , and the decision makers’ roles in the three phases of a

Assessing Generalisability in Model-Based Economic Evaluation Studies: A Structured Review in Osteoporosis

PubMed Central

Urdahl, Hege; Manca, Andrea; Sculpher, Mark J

2008-01-01

Background To support decision making many countries have now introduced some formal assessment process to evaluate whether health technologies represent good ‘value for money’. These often take the form of decision models which can be used to explore elements of importance to generalisability of study results across clinical settings and jurisdictions. The objectives of the present review were to assess: (i) whether the published studies clearly defined the decision-making audience for the model; (ii) the transparency of the reporting in terms of study question, structure and data inputs; (iii) the relevance of the data inputs used in the model to the stated decision-maker or jurisdiction; and (iv) how fully the robustness of the model's results to variation in data inputs between locations was assessed. Methods Articles reporting decision-analytic models in the area of osteoporosis were assessed to establish the extent to which the information provided enabled decision makers in different countries/jurisdictions to fully appreciate the variability of results according to location, and the relevance to their own. Results Of the 18 articles included in the review, only three explicitly stated the decision-making audience. It was not possible to infer a decision-making audience in eight studies. Target population was well reported, as was resource and cost data, and clinical data used for estimates of relative risk reduction. However, baseline risk was rarely adapted to the relevant jurisdiction, and when no decision-maker was explicit it was difficult to assess whether the reported cost and resource use data was in fact relevant. A few studies used sensitivity analysis to explore elements of generalisability, such as compliance rates and baseline fracture risk rates, although such analyses were generally restricted to evaluating parameter uncertainty. Conclusion This review found that variability in cost-effectiveness across locations is addressed to a varying extent in modelling studies in the field of osteoporosis, limiting their use for decision-makers across different locations. Transparency of reporting is expected to increase as methodology develops, and decision-makers publish “reference case” type guidance. PMID:17129074

Learning by doing in practice: a roundtable discussion about stakeholder engagement in implementation research.

PubMed

Arwal, Said Habib; Aulakh, Bhupinder Kaur; Bumba, Ahmed; Siddula, Akshita

2017-12-28

Researchers and policy-makers alike increasingly recognise the importance of engaging diverse perspectives in implementation research. This roundtable discussion presents the experiences and perspectives of three decision-makers regarding the benefits and challenges of their engagement in implementation research. The first perspective comes from a rural district medical officer from Uganda and touches on the success of using data as evidence in a low-resource setting. The second perspective is from an Afghani Ministry of Health expert who used a community-based approach to improving healthcare services in remote regions. Finally, the third perspective highlights the successes and trials of a policy-maker from India who offers advice on how to grow the relationship between decision-makers and researchers. Overall, the stakeholders in this roundtable discussion saw important benefits to their engagement in research. In order to facilitate greater engagement in the future, they advise on closer dialogue between researchers and policy-makers and supporting the development of capacity to stimulate and facilitate engagement in research and the use of evidence in decision-making.

The Morality of University Decision-Makers

ERIC Educational Resources Information Center

Hatier, Cécile

2014-01-01

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

Reluctant to Change: Self-Enhancing Responses to Diverging Performance Measures

ERIC Educational Resources Information Center

Audia, Pino G.; Brion, Sebastien

2007-01-01

Although there is extensive evidence that past performance influences the propensity to make changes, research on how decision makers respond to diverging performance measures has been sparse. This paper addresses this gap in an experimental and a field study in which we examine how decision makers respond to the ambiguity introduced by two…

Students as Rational Decision-Makers: The Question of Beliefs and Attitudes

ERIC Educational Resources Information Center

Sullivan, Alice

2006-01-01

Rational choice theorists have analysed rates of participation in post-compulsory education, and, in particular, class differentials in these rates. Various claims have been made about the motivations of student decision-makers, but these claims have not been grounded empirically. This paper will assess the question of whether students' attitudes…

Reported Influence of Evaluation Data on Decision Makers' Actions: An Empirical Examination

ERIC Educational Resources Information Center

Christie, Christina A.

2007-01-01

Using a set of scenarios derived from actual evaluation studies, this simulation study examines the reported influence of evaluation information on decision makers' potential actions. Each scenario described a context where one of three types of evaluation information (large-scale study data, case study data, or anecdotal accounts) is presented…

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

ERIC Educational Resources Information Center

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

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

Children's Participation in Decision-Making in the Philippines: Understanding the Attitudes of Policy-Makers and Service Providers

ERIC Educational Resources Information Center

Bessell, Sharon

2009-01-01

This article explores the ideas about children's participation in decision-making held by government officials and non-government representatives engaged in promoting children's participation in the Philippines. It suggests that the ideas that policy-makers and service deliverers hold about children's participation are heterogeneous, diverse and…

I know why you voted for Trump: (Over)inferring motives based on choice.

PubMed

Barasz, Kate; Kim, Tami; Evangelidis, Ioannis

2018-05-10

People often speculate about why others make the choices they do. This paper investigates how such inferences are formed as a function of what is chosen. Specifically, when observers encounter someone else's choice (e.g., of political candidate), they use the chosen option's attribute values (e.g., a candidate's specific stance on a policy issue) to infer the importance of that attribute (e.g., the policy issue) to the decision-maker. Consequently, when a chosen option has an attribute whose value is extreme (e.g., an extreme policy stance), observers infer-sometimes incorrectly-that this attribute disproportionately motivated the decision-maker's choice. Seven studies demonstrate how observers use an attribute's value to infer its weight-the value-weight heuristic-and identify the role of perceived diagnosticity: more extreme attribute values give observers the subjective sense that they know more about a decision-maker's preferences, and in turn, increase the attribute's perceived importance. The paper explores how this heuristic can produce erroneous inferences and influence broader beliefs about decision-makers. Copyright © 2018 Elsevier B.V. All rights reserved.

Constrained optimization via simulation models for new product innovation

NASA Astrophysics Data System (ADS)

Pujowidianto, Nugroho A.

2017-11-01

We consider the problem of constrained optimization where the decision makers aim to optimize the primary performance measure while constraining the secondary performance measures. This paper provides a brief overview of stochastically constrained optimization via discrete event simulation. Most review papers tend to be methodology-based. This review attempts to be problem-based as decision makers may have already decided on the problem formulation. We consider constrained optimization models as there are usually constraints on secondary performance measures as trade-off in new product development. It starts by laying out different possible methods and the reasons using constrained optimization via simulation models. It is then followed by the review of different simulation optimization approach to address constrained optimization depending on the number of decision variables, the type of constraints, and the risk preferences of the decision makers in handling uncertainties.

Decision Making and Training: A Review of Theoretical and Empirical Studies of Decision Making and Their Implications for the Training of Decision Makers

DTIC Science & Technology

1975-08-01

34 of an outcome for the particular decisi’on maker involved. According to thio formulation the same decision outcome may appeal to dif- ferent...characterizing thes_ sources is in turmu of 1he two properties: degree of passivity and deoqreu of oopcrative,,’s. According to this conceptualizati on...procedure has been, however, is open to question. Data collected during field exercises have indicated that ratinqs often are omitted from spot reports, and

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

PubMed

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

2018-02-23

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

Implementing CER: what will it take?

PubMed

Biskupiak, Joseph E; Dunn, Jeffrey D; Holtorf, Anke-Peggy

2012-06-01

Comparative effectiveness research (CER) is undeniably changing how drugs are developed, launched, priced, and reimbursed in the United States. But most organizations are still evaluating what CER can do for them and how and when they can utilize the data. A roundtable of stakeholders, including formulary decision makers, evaluated CER's possible effects on managed care organizations (MCOs) and what it may take to fully integrate CER into decision making. To examine the role of CER in current formulary decision making, compare CER to modeling, discuss ways CER may be used in the future, and describe CER funding sources. While decision makers from different types of organizations, such as pharmacy benefit management (PBM) companies and MCOs, may have varying definitions and expectations of CER, most thought leaders from a roundtable of stakeholders, including formulary decision makers, see value in CER's ability to enhance their formulary decision making. Formulary decision makers may be able to use CER to better inform their coverage decisions in areas such as benefit design, contracting, conditional reimbursement, pay for performance, and other alternative pricing arrangements. Real-world CER will require improvement in the health information technology infrastructure to better capture value-related information. The federal government is viewed as a key driver and funding source behind CER, especially for infrastructure and methods development, while industry will adapt the clinical development and create increasing CER evidence. CER then needs to be applied to determining value (or cost efficacy). It is expected that CER will continue to grow as a valuable component of formulary decision making. Future integration of CER into formulary decision making will require federal government and academic leadership, improvements in the health information technology infrastructure, ongoing funding, and improved and more consistent methodologies.

Decision-Making Does not Moderate the Association between Cannabis Use and Body Mass Index among Adolescent Cannabis Users.

PubMed

Ross, J Megan; Graziano, Paulo; Pacheco-Colón, Ileana; Coxe, Stefany; Gonzalez, Raul

2016-10-01

Results from research conducted on the association between cannabis use and body mass index (BMI) reveal mixed findings. It is possible that individual differences in decision-making (DM) abilities may influence these associations. This study analyzed how amount of cannabis use, DM performance, and the interaction of these variables influenced BMI and clinical classifications of weight among adolescents (ages 14 to 18 years; 56% male; 77% Hispanic). The sample consisted primarily of cannabis users (n=238) without a history of significant developmental disorders, birth complications, neurological conditions, or history of mood, thought, or attention deficit/hyperactivity disorder at screening. Furthermore, few participants engaged frequently in other drug use (except for alcohol and nicotine). Analyses revealed that more lifetime cannabis use was associated with a higher BMI and greater likelihood of being overweight/obese. Interactions between DM and cannabis use on BMI were not significant, and DM was not directly associated with BMI. Our findings suggest that among adolescents, cannabis use is associated with a greater BMI regardless of DM abilities and this association is not accounted for by other potential factors, including depression, alcohol use, nicotine use, race, ethnicity, or IQ. (JINS, 2016, 22, 944-949).

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.

Cognitive and emotional factors predicting decisional conflict among high-risk breast cancer survivors who receive uninformative BRCA1/2 results.

PubMed

Rini, Christine; O'Neill, Suzanne C; Valdimarsdottir, Heiddis; Goldsmith, Rachel E; Jandorf, Lina; Brown, Karen; DeMarco, Tiffani A; Peshkin, Beth N; Schwartz, Marc D

2009-09-01

To investigate high-risk breast cancer survivors' risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test. Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months postdisclosure. Primary predictors were health beliefs and emotional responses to testing assessed 1-month postdisclosure. Main outcomes included women's perception of whether they had made a final risk management decision (decision status) and decisional conflict related to this issue. There were four patterns of decision making, depending on how long it took women to make a final decision and the stability of their decision status across assessments. Late decision makers and nondecision makers reported the highest decisional conflict; however, substantial numbers of women--even early and intermediate decision makers--reported elevated decisional conflict. Analyses predicting decisional conflict 1- and 12-months postdisclosure found that, after accounting for control variables and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important 1 month after test disclosure and emotional factors more important 1 year later. Many of these women may benefit from decision making assistance. Copyright 2009 APA, all rights reserved.

The database search problem: a question of rational decision making.

PubMed

Gittelson, S; Biedermann, A; Bozza, S; Taroni, F

2012-10-10

This paper applies probability and decision theory in the graphical interface of an influence diagram to study the formal requirements of rationality which justify the individualization of a person found through a database search. The decision-theoretic part of the analysis studies the parameters that a rational decision maker would use to individualize the selected person. The modeling part (in the form of an influence diagram) clarifies the relationships between this decision and the ingredients that make up the database search problem, i.e., the results of the database search and the different pairs of propositions describing whether an individual is at the source of the crime stain. These analyses evaluate the desirability associated with the decision of 'individualizing' (and 'not individualizing'). They point out that this decision is a function of (i) the probability that the individual in question is, in fact, at the source of the crime stain (i.e., the state of nature), and (ii) the decision maker's preferences among the possible consequences of the decision (i.e., the decision maker's loss function). We discuss the relevance and argumentative implications of these insights with respect to recent comments in specialized literature, which suggest points of view that are opposed to the results of our study. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The essential medicines list for a global patient population.

PubMed

Robertson, J; Hill, S R

2007-11-01

Thirty years after its inception, the role, audience, and contents of the global Essential Medicines List (EML) are reviewed. Challenges for decision makers in applying the principles of medicine selection based on efficacy, safety, burden of disease, and cost effectiveness are discussed and illustrated with recent decisions of the Expert Committee. Areas of controversy for decision makers are highlighted, and the advocacy role of the EML for both drug procurement and development of quality-assured products is described.

The Role of Information and Research in Educational Decision-Making: Some Questions. Le Role De L'Information Et De La Recherche Dans La Prise De Decisions En Matiere D'Education: Quelques Questions.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This paper, one of a series of Unesco technical information reports, looks at the educational decision makers in developing nations and examines their access to and use of information and research results. Written in English and in French, the paper consists of five parts. Part one discusses problems encountered by educational policy-makers and…

Finding common ground to achieve a "good death": family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study.

PubMed

Tan, Amy; Manca, Donna

2013-01-22

Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a "bad death" experience for the patient and family. We aim to describe Canadian family physicians' experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Eleven family physicians with a range of 3 to 40 years in clinical practice participated.The family physicians expressed a desire to achieve a "good death" and described their role in positively influencing the experience of death.Finding Common Ground to Achieve a "Good Death" for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. A novel framework for developing Common Ground to manage conflicts during end-of-life decision-making discussions may assist in achieving a "good death". These results could aid in educating physicians, learners, and the public on how to achieve productive collaborative relationships during end-of-life decision-making for dying patients, and ultimately improve their deaths.

Neural basis of quasi-rational decision making.

PubMed

Lee, Daeyeol

2006-04-01

Standard economic theories conceive homo economicus as a rational decision maker capable of maximizing utility. In reality, however, people tend to approximate optimal decision-making strategies through a collection of heuristic routines. Some of these routines are driven by emotional processes, and others are adjusted iteratively through experience. In addition, routines specialized for social decision making, such as inference about the mental states of other decision makers, might share their origins and neural mechanisms with the ability to simulate or imagine outcomes expected from alternative actions that an individual can take. A recent surge of collaborations across economics, psychology and neuroscience has provided new insights into how such multiple elements of decision making interact in the brain.

Adopting Cut Scores: Post-Standard-Setting Panel Considerations for Decision Makers

ERIC Educational Resources Information Center

Geisinger, Kurt F.; McCormick, Carina M.

2010-01-01

Standard-setting studies utilizing procedures such as the Bookmark or Angoff methods are just one component of the complete standard-setting process. Decision makers ultimately must determine what they believe to be the most appropriate standard or cut score to use, employing the input of the standard-setting panelists as one piece of information…

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

ERIC Educational Resources Information Center

Bertrand, Melanie

2014-01-01

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

Monitoring Values and Practices of Oak Woodland Decision Makers on the Urban Fringe

Treesearch

William Stewart

1991-01-01

Concern over oak woodlands has shifted away from ranch management towards residential areas. This shift has been accompanied by the involvement of decision makers who previously had little involvement with rangeland policies and practices. A survey of three recent Cooperative Extension workshops illustrates a number of important patterns regarding interest and...

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

ERIC Educational Resources Information Center

Morgan, Grayson B.

2013-01-01

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

Investigation of Education Databases in Four States To Support Policy Research on Resource Allocation. Policy Report

ERIC Educational Resources Information Center

Pan, Diane; Smith-Hansen, Lotte; Jones, Debra Hughes; Rudo, Zena H.; Alexander, Celeste; Kahlert, Rahel Kahlert, Rahel

2004-01-01

Information is one of the most important tools education decision makers need to help them effectively spend taxpayer money, allocate qualified staff, and determine the effectiveness of education investments. Decision makers must understand the role and influence of monetary and staff resources on the education system, and they must have…

Educational Marketing: A Business Approach to School-Community Relations.

ERIC Educational Resources Information Center

Holcomb, John H.

Public education suffers from a lack of public confidence. Strategies that public school decision-makers can use to turn around public opinion is the focus of this book. Decision-makers should use some of the marketing techniques learned from the private sector to "sell" the schools to the client system (the citizens being asked to support…

Assessment of Education for Sustainable Development in Universities in Costa Rica: Implications for Latin America and the Caribbean

ERIC Educational Resources Information Center

Garcia, Jairo H.

2010-01-01

Higher Education is a key factor for social change influencing future decision-makers in business, education, politics and science. As such, sustainable development requires creating awareness amongst these decision-makers of their responsibilities and opportunities in this area. Higher education for sustainable development is championed in…

Attention and attribute overlap in preferential choice.

PubMed

Bhatia, Sudeep

2017-07-01

Attributes that are common, or overlapping, across alternatives in two-alternative forced preferential choice tasks are often non-diagnostic. In many settings, attending to and evaluating these attributes does not help the decision maker determine which of the available alternatives is the most desirable. For this reason, many existing behavioural theories propose that decision makers ignore common attributes while deliberating. Across six experiments, we find that decision makers do direct their attention selectively and ignore attributes that are not present in or associated with either of the available alternatives. However, they are as likely to attend to common attributes as they are to attend to attributes that are unique to a single alternative. These results suggest the need for novel theories of attention in preferential choice.

Licensing Surrogate Decision-Makers.

PubMed

Rosoff, Philip M

2017-06-01

As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.

Approach of Decision Making Based on the Analytic Hierarchy Process for Urban Landscape Management

NASA Astrophysics Data System (ADS)

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

Approach of decision making based on the analytic hierarchy process for urban landscape management.

PubMed

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

Prioritization of engineering support requests and advanced technology projects using decision support and industrial engineering models

NASA Technical Reports Server (NTRS)

Tavana, Madjid

1995-01-01

The evaluation and prioritization of Engineering Support Requests (ESR's) is a particularly difficult task at the Kennedy Space Center (KSC) -- Shuttle Project Engineering Office. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant pieces of information concerning Safety, Supportability, O&M Cost Savings, Process Enhancement, Reliability, and Implementation. Various analytical and normative models developed over the past have helped decision makers at KSC utilize large volumes of information in the evaluation of ESR's. The purpose of this project is to build on the existing methodologies and develop a multiple criteria decision support system that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. The model utilizes the Analytic Hierarchy Process (AHP), subjective probabilities, the entropy concept, and Maximize Agreement Heuristic (MAH) to enhance the decision maker's intuition in evaluating a set of ESR's.

Design for sustainability of industrial symbiosis based on emergy and multi-objective particle swarm optimization.

PubMed

Ren, Jingzheng; Liang, Hanwei; Dong, Liang; Sun, Lu; Gao, Zhiqiu

2016-08-15

Industrial symbiosis provides novel and practical pathway to the design for the sustainability. Decision support tool for its verification is necessary for practitioners and policy makers, while to date, quantitative research is limited. The objective of this work is to present an innovative approach for supporting decision-making in the design for the sustainability with the implementation of industrial symbiosis in chemical complex. Through incorporating the emergy theory, the model is formulated as a multi-objective approach that can optimize both the economic benefit and sustainable performance of the integrated industrial system. A set of emergy based evaluation index are designed. Multi-objective Particle Swarm Algorithm is proposed to solve the model, and the decision-makers are allowed to choose the suitable solutions form the Pareto solutions. An illustrative case has been studied by the proposed method, a few of compromises between high profitability and high sustainability can be obtained for the decision-makers/stakeholders to make decision. Copyright © 2016 Elsevier B.V. All rights reserved.

Increasing the scale and adoption of population health interventions: experiences and perspectives of policy makers, practitioners, and researchers

PubMed Central

2014-01-01

Background Decisions to scale up population health interventions from small projects to wider state or national implementation is fundamental to maximising population-wide health improvements. The objectives of this study were to examine: i) how decisions to scale up interventions are currently made in practice; ii) the role that evidence plays in informing decisions to scale up interventions; and iii) the role policy makers, practitioners, and researchers play in this process. Methods Interviews with an expert panel of senior Australian and international public health policy-makers (n = 7), practitioners (n = 7), and researchers (n = 7) were conducted in May 2013 with a participation rate of 84%. Results Scaling up decisions were generally made through iterative processes and led by policy makers and/or practitioners, but ultimately approved by political leaders and/or senior executives of funding agencies. Research evidence formed a component of the overall set of information used in decision-making, but its contribution was limited by the paucity of relevant intervention effectiveness research, and data on costs and cost effectiveness. Policy makers, practitioners/service managers, and researchers had different, but complementary roles to play in the process of scaling up interventions. Conclusions This analysis articulates the processes of how decisions to scale up interventions are made, the roles of evidence, and contribution of different professional groups. More intervention research that includes data on the effectiveness, reach, and costs of operating at scale and key service delivery issues (including acceptability and fit of interventions and delivery models) should be sought as this has the potential to substantially advance the relevance and ultimately usability of research evidence for scaling up population health action. PMID:24735455

Social Priorities as Data

NASA Astrophysics Data System (ADS)

Grubert, E.

2015-12-01

Decision makers' responses to local risks and expected changes to a community from circumstances like natural hazards, human developments, and demographic changes can greatly affect social and environmental outcomes in a community. Translating physical data based in disciplines like engineering and geosciences into positive outcomes for communities can be challenging and often results in conflict that appears to pit "science" against "the public." Scientists can be reluctant to offer recommendations for action based on their work, often (and often correctly) noting that their role is not to make value judgments for a community - particularly for a community that is not their own. Conversely, decision makers can be frustrated by the lack of guidance they receive to help translate data into effective and acceptable action. The solution posed by this submission, given the goal of co-production of knowledge by scientists and decision makers to foster better community outcomes, is to involve the community directly by integrating social scientific methods that address decision making and community engagement to the scientist-decision maker interaction. Specifically, the missing dataset in many scientist-decision maker interactions is the nature of community priorities. Using scientifically valid methods to rigorously collect and characterize community priorities to help recommend tradeoffs between different outcomes indicated by the work of physical and natural scientists can bridge the gap between science and action by involving the community in the process. This submission presents early work on US preferences for different types of social and environmental outcomes designed to integrate directly with engineering and physical science frameworks like Life Cycle Assessment and Environmental Impact Statements. Cardinal preference data are based on surveys of US adults using tools like the Analytical Hierarchy Process, budget allocation, and ranking.

Focusing biodiversity research on the needs of decision makers

NASA Astrophysics Data System (ADS)

Smythe, Katie D.; Bernabo, J. Christopher; Carter, Thomas B.; Jutro, Peter R.

1996-11-01

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

Sustaining Clinical Programs During Difficult Economic Times: A Case Series from the Hospital Elder Life Program

PubMed Central

SteelFisher, Gillian K.; Martin, Lauren A.; Dowal, Sarah L.; Inouye, Sharon K.

2013-01-01

OBJECTIVES To explore strategies used by clinical programs to justify operations to decision-makers using the example of the Hospital Elder Life Program (HELP), an evidence-based, cost-effective program to improve care for hospitalized older adults. DESIGN Qualitative study design utilizing 62 in-depth, semi-structured interviews conducted with HELP staff members and hospital administrators between September 2008 and August 2009. SETTING 19 HELP sites in hospitals across the U.S. and Canada that had been recruiting patients for at least 6 months. PARTICIPANTS and MEASUREMENTS HELP staff and hospital administrator experiences sustaining the program in the face of actual or perceived financial threats, with a focus on factors they believe are effective in justifying the program to decision-makers in the hospital or health system. RESULTS Using the constant comparative method, a standard qualitative analysis technique, three major themes were identified across interviews. Each focuses on a strategy for successfully justifying the program and securing funds for continued operations: 1) interact meaningfully with decision-makers, including formal presentations that showcase operational successes, and also informal means that highlight the benefits of HELP to the hospital or health system; 2) document day-to-day, operational successes in metrics that resonate with decision-maker priorities; and 3) garner support from influential hospital staff that feed into administrative decision-making, particularly nurses and physicians. CONCLUSION As clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision-makers. Strategies described here may help clinically-effective and cost-effective programs sustain themselves, and thus may help improve care in their institutions. PMID:22091501

Decision makers' experiences of prioritisation and views about how to finance healthcare costs.

PubMed

Werntoft, Elisabet; Edberg, Anna-Karin

2009-10-01

Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians. The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was analysed using both quantitative and qualitative methods. A majority of the decision makers (55%) suggested that increasing costs should be financed through higher taxation but more physicians than politicians thought that higher patient fees, private health insurance and a reduction in social expenditure were better alternatives. Prioritisation aroused anxiety; politicians were afraid of displeasing voters while physicians were afraid of making medically incorrect decisions. This study do not answer the question about how to make prioritisation in health care but the result highlights the different ways that the decision makers view the subject and thereby elicit that publicly elected politicians and physicians perhaps not always work with the same goal ahead. There are needs for more research but also more media focus on the subject so the citizens will be aware and take part in the debate.

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

USGS Publications Warehouse

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

2011-01-01

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

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

PubMed

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

2010-02-01

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

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

PubMed Central

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

2010-01-01

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

Health technology assessment in Saudi Arabia.

PubMed

Al-Aqeel, Sinaa

2018-05-16

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

A multiattribute index for assessing environmental impacts of regional development projects: a case study of Korea.

PubMed

Kwak, Seung-Jun; Yoo, Seung-Hoon; Shin, Chol-Oh

2002-02-01

Evaluating environmental impacts has become an increasingly vital part of environmental management. In the present study, a methodological procedure based on multiattribute utility theory (MAUT) has been applied to obtain a decision-maker's value index on assessment of the environmental impacts. The paper begins with an overview of MAUT. Next, we elicited strategic objectives and several important attributes, and then structured them into a hierarchy, with the aim of structuring and quantifying the basic values for the assessment. An environmental multiattribute index is constructed as a multiattribute utility function, based on value judgements provided by a decision-maker at the Korean Ministry of Environment (MOE). The implications of the results are useful for many aspects of MOE's environmental policies; identifying the strategic objectives and basic values; facilitating communication about the organization's priorities; and recognizing decision opportunities that face decision-makers of Korea.

The optimal retailer's ordering policies with trade credit financing and limited storage capacity in the supply chain system

NASA Astrophysics Data System (ADS)

Yen, Ghi-Feng; Chung, Kun-Jen; Chen, Tzung-Ching

2012-11-01

The traditional economic order quantity model assumes that the retailer's storage capacity is unlimited. However, as we all know, the capacity of any warehouse is limited. In practice, there usually exist various factors that induce the decision-maker of the inventory system to order more items than can be held in his/her own warehouse. Therefore, for the decision-maker, it is very practical to determine whether or not to rent other warehouses. In this article, we try to incorporate two levels of trade credit and two separate warehouses (own warehouse and rented warehouse) to establish a new inventory model to help the decision-maker to make the decision. Four theorems are provided to determine the optimal cycle time to generalise some existing articles. Finally, the sensitivity analysis is executed to investigate the effects of the various parameters on ordering policies and annual costs of the inventory system.

Answer or Publish - Energizing Online Democracy

NASA Astrophysics Data System (ADS)

Antal, Miklós; Mikecz, Dániel

Enhanced communication between citizens and decision makers furthering participation in public decision making is essential to ease today's democratic deficit. However, it is difficult to sort out the most important public inputs from a large number of comments and questions. We propose an online solution to the selection problem by utilizing the general publicity of the internet. In the envisioned practice, decision makers are obliged either to answer citizens' questions or initiatives or to publish the letter received on a publicly accessible web page. The list of unaddressed questions would mean a motivation to consider public inputs without putting unnecessary burdens on decision makers - due to the reliance on the public, their workload would converge to the societal optimum. The proposed method is analyzed in the course of the existing Hungarian e-practices. The idea is found valuable as a restriction for representatives and a relief for some other officials.

Health services research: building capacity to meet the needs of the health care system

PubMed Central

Barratt, Helen; Shaw, Jay; Simpson, Lisa; Bhatia, Sacha; Fulop, Naomi

2017-01-01

Health services researchers have an important role to play in helping health care systems around the world provide high quality, affordable services. However, gaps between the best evidence and current practice suggest that researchers need to work in new ways. The production of research that meets the needs and priorities of the health system requires researchers to work in partnership with decision-makers to conduct research and then mobilize the findings. To do this effectively, researchers require a new set of skills that are not conventionally taught as part of doctoral research programmes. In addition to wider contextual changes, researchers need to understand better the needs of decision-makers, for example through short placements in health system decision-making settings. Second, researchers need to learn to accommodate those needs throughout the research process, including identifying research needs; conducting research collaboratively with decision-makers and producing effective research products. PMID:28786700

Scientific second-order 'nudging' or lobbying by interest groups: the battle over abdominal aortic aneurysm screening programmes.

PubMed

Ploug, Thomas; Holm, Søren; Brodersen, John

2014-11-01

The idea that it is acceptable to 'nudge' people to opt for the 'healthy choice' is gaining currency in health care policy circles. This article investigates whether researchers evaluating Abdominal Aortic Aneurysm Screening Programmes (AAASP) attempt to influence decision makers in ways that are similar to popular 'nudging' techniques. Comparing two papers on the health economics of AAASP both published in the BMJ within the last 3 years, it is shown that the values chosen for the health economics modelling are not representative of the literature and consistently favour the conclusions of the articles. It is argued (1) that this and other features of these articles may be justified within a Libertarian Paternalist framework as 'nudging' like ways of influencing decision makers, but also (2) that these ways of influencing decision makers raise significant ethical issues in the context of democratic decision making.

Foundations for context-aware information retrieval for proactive decision support

NASA Astrophysics Data System (ADS)

Mittu, Ranjeev; Lin, Jessica; Li, Qingzhe; Gao, Yifeng; Rangwala, Huzefa; Shargo, Peter; Robinson, Joshua; Rose, Carolyn; Tunison, Paul; Turek, Matt; Thomas, Stephen; Hanselman, Phil

2016-05-01

Intelligence analysts and military decision makers are faced with an onslaught of information. From the now ubiquitous presence of intelligence, surveillance, and reconnaissance (ISR) platforms providing large volumes of sensor data, to vast amounts of open source data in the form of news reports, blog postings, or social media postings, the amount of information available to a modern decision maker is staggering. Whether tasked with leading a military campaign or providing support for a humanitarian mission, being able to make sense of all the information available is a challenge. Due to the volume and velocity of this data, automated tools are required to help support reasoned, human decisions. In this paper we describe several automated techniques that are targeted at supporting decision making. Our approaches include modeling the kinematics of moving targets as motifs; developing normalcy models and detecting anomalies in kinematic data; automatically classifying the roles of users in social media; and modeling geo-spatial regions based on the behavior that takes place in them. These techniques cover a wide-range of potential decision maker needs.

Computational Complexity and Human Decision-Making.

PubMed

Bossaerts, Peter; Murawski, Carsten

2017-12-01

The rationality principle postulates that decision-makers always choose the best action available to them. It underlies most modern theories of decision-making. The principle does not take into account the difficulty of finding the best option. Here, we propose that computational complexity theory (CCT) provides a framework for defining and quantifying the difficulty of decisions. We review evidence showing that human decision-making is affected by computational complexity. Building on this evidence, we argue that most models of decision-making, and metacognition, are intractable from a computational perspective. To be plausible, future theories of decision-making will need to take into account both the resources required for implementing the computations implied by the theory, and the resource constraints imposed on the decision-maker by biology. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anchor effects in decision making can be reduced by the interaction between goal monitoring and the level of the decision maker's executive functions.

PubMed

Schiebener, Johannes; Wegmann, Elisa; Pawlikowski, Mirko; Brand, Matthias

2012-11-01

Models of decision making postulate that interactions between contextual conditions and characteristics of the decision maker determine decision-making performance. We tested this assumption by using a possible positive contextual influence (goals) and a possible negative contextual influence (anchor) in a risky decision-making task (Game of Dice Task, GDT). In this task, making advantageous choices is well known to be closely related to a specific decision maker variable: the individual level of executive functions. One hundred subjects played the GDT in one of four conditions: with self-set goal for final balance (n = 25), with presentation of an anchor (a fictitious Top 10 list, showing high gains of other participants; n = 25), with anchor and goal definition (n = 25), and with neither anchor nor goal setting (n = 25). Subjects in the conditions with anchor made more risky decisions irrespective of the negative feedback, but this anchor effect was influenced by goal monitoring and moderated by the level of the subjects' executive functions. The findings imply that impacts of situational influences on decision making as they frequently occur in real life depend upon the individual's cognitive abilities. Anchor effects can be overcome by subjects with good cognitive abilities.

Relational autonomy: moving beyond the limits of isolated individualism.

PubMed

Walter, Jennifer K; Ross, Lainie Friedman

2014-02-01

Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.

DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

PubMed

Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

2015-01-01

Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

The Insertion of Human Factors Concerns into NextGen Programmatic Decisions

NASA Technical Reports Server (NTRS)

Beard, Bettina L.; Holbrook, Jon Brian; Seely, Rachel

2013-01-01

Since the costs of proposed improvements in air traffic management exceed available funding, FAA decision makers must select and prioritize what actually gets implemented. We discuss a set of methods to help forecast operational and human performance issues and benefits before new automation is introduced. This strategy could minimize the impact of politics, assist decision makers in selecting and prioritizing potential improvements, make the process more transparent and strengthen the link between the engineering and human factors domains.

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

PubMed

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

2015-09-01

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

Taking risks and taking advice: The role of experience in airline pilot diversions

NASA Technical Reports Server (NTRS)

Cohen, Marvin S.

1993-01-01

The research asks how pilots make diversion decisions, what factors determine whether they are make well or poorly, and how they may be improved. The results support the view that experienced decision makers may solve problems in a way that is qualitatively different from the approaches of less experienced decision makers. The results also support a concept of expertise that goes beyond a stock of specialized recognitional templates, to include domain-specific methods for processing information. Such metacognitive skills evolve through long experience. They may enhance both the accuracy and the efficiency of decision processes.

Providing Climate Policy Makers With a Strong Scientific Base (Invited)

NASA Astrophysics Data System (ADS)

Struzik, E.

2009-12-01

Scientists can and should inform public policy decisions in the Arctic. But the pace of climate change in the polar world has been occurring far more quickly than most scientists have been able to predict. This creates problems for decision-makers who recognize that difficult management decisions have to be made in matters pertaining to wildlife management, cultural integrity and economic development. With sea ice melting, glaciers receding, permafrost thawing, forest fires intensifying, and disease and invasive species rapidly moving north, the challenge for scientists to provide climate policy makers with a strong scientific base has been daunting. Clashing as this data sometimes does with the “traditional knowledge” of indigenous peoples in the north, it can also become very political. As a result the need to effectively communicate complex data is more imperative now than ever before. Here, the author describes how the work of scientists can often be misinterpreted or exploited in ways that were not intended. Examples include the inappropriate use of scientific data in decision-making on polar bears, caribou and other wildlife populations; the use of scientific data to debunk the fact that greenhouse gases are driving climate change, and the use of scientific data to position one scientist against another when there is no inherent conflict. This work will highlight the need for climate policy makers to increase support for scientists working in the Arctic, as well as illustrate why it is important to find new and more effective ways of communicating scientific data. Strategies that might be considered by granting agencies, scientists and climate policy decision-makers will also be discussed.

Youth advocacy as a tool for environmental and policy changes that support physical activity and nutrition: an evaluation study in San Diego County.

PubMed

Linton, Leslie S; Edwards, Christine C; Woodruff, Susan I; Millstein, Rachel A; Moder, Cheryl

2014-03-27

As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention. San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers. In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative's half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers. Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts. Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change.

From science to decision-making: taking the risk to communicate on risks

NASA Astrophysics Data System (ADS)

Leroi, Eric

2015-04-01

Geoscientists and decision-makers have the same responsibility toward the society: reducing the damaging consequences induced by natural phenomena. They have to work together, geoscientists to improve the knowledge and decision-makers to take the "best" decision, both to design and implement balanced solutions, both to communicate. Feedback shows that if the collaboration between them has already improved, a lot has still to be done, especially in terms of communication; endless litany, geoscientists don't communicate in the right way! In a hyperspecialized technological and segmented society with sophisticated methods of communication, geoscientists don't use appropriate tools and terminology. It's true, and a lot of examples can be shown that highlight this! Risks is based on complex concepts, on notions that are poorly understood, even by scientists themselves, especially the concepts of probability and occurrence of phenomena. But the problem rest as well on the role and on the responsibility of the geoscientists. Risk management experts address geosciences and technology to identify problems and define protection, including prohibitive measures (such as not allowing building in hazardous areas). Policy makers and local planners want to know where to develop territories. On one hand the identification of problems, on the other hand the needs of solutions. Dialectic is not the same. When responsibility, money and image are the three main pillars of decision-making, long-term modeling and uncertainty, are the basic ones for geosciences. In our participative democracies people want to be actor of the development of their own territories; they want more freedom, more protection and less tax. Face to unrealistic political answers geoscientists have to explain and convince. It's not possible to gain on everything and some are going to loose. Shall geoscientists let decision-makers communicate on topics they hardly understand? No. Shall geoscientists communicate on sociology, economy, politics…? Yes. But they have to learn how to better communicate, with decision-makers and with the population. They have to address new domains; they need and have to develop new approaches and new tools for communicating; they finally have to take responsibilities and risk! The presentation will address the general problems of communication between geoscientists, decision-makers and population and propose approaches and examples to reduce the gap.

Developing decision-relevant data and information systems for California water through listening and collaboration

NASA Astrophysics Data System (ADS)

Bales, R. C.; Bernacchi, L.; Conklin, M. H.; Viers, J. H.; Fogg, G. E.; Fisher, A. T.; Kiparsky, M.

2017-12-01

California's historic drought of 2011-2015 provided excellent conditions for researchers to listen to water-management challenges from decision makers, particularly with regard to data and information needs for improved decision making. Through the UC Water Security and Sustainability Research Initiative (http://ucwater.org/) we began a multi-year dialog with water-resources decision makers and state agencies that provide data and technical support for water management. Near-term products of that collaboration will be both a vision for a 21st-century water data and information system, and near-term steps to meet immediate legislative deadlines in a way that is consistent with the longer-term vision. While many university-based water researchers engage with state and local agencies on both science and policy challenges, UC Water's focus was on: i) integrated system management, from headwaters through groundwater and agriculture, and on ii) improved decision making through better water information systems. This focus aligned with the recognition by water leaders that fundamental changes in the way the state manages water were overdue. UC Water is focused on three "I"s: improved water information, empowering Institutions to use and to create new information, and enabling decision makers to make smart investments in both green and grey Infrastructure. Effective communication with water decision makers has led to engagement on high-priority programs where large knowledge gaps remain, including more-widespread groundwater recharge of storm flows, restoration of mountain forests in important source-water areas, governance structures for groundwater sustainability, and filling information gaps by bringing new technology to bear on measurement and data programs. Continuing engagement of UC Water researchers in public dialog around water resources, through opinion pieces, feature articles, blogs, white papers, social media, video clips and a feature documentary film have also been key to our continuing engagement. These novel partnerships are leading to decision-relevant tools and an improved integrated praxis in on-the-ground water-resources management. Our research is becoming more embedded in policies and our network remains interconnected with decision makers at multiple levels.

Better Decisions through Consultation and Collaboration

EPA Pesticide Factsheets

This manual discusses the benefits of public involvement to agency decision makers, including expanding shared baseline knowledge, generating support for the decision, and developing ongoing relationships that will help in implementing decisions.

A Social Report for Carroll County: Social Indicators for Rural Development. Sociology Report 134G.

ERIC Educational Resources Information Center

Marshall, Chris; And Others

Since the burden of improving quality of life is often squarely placed on the shoulders of public decision makers, this report (one of the products of Project 2142) provides a basis for assisting county-level decision makers in the planning process. Statistics that "indicate" the social well being or quality of life experienced by people…

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

DTIC Science & Technology

2004-06-01

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

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

ERIC Educational Resources Information Center

Guzel, Pinar

2015-01-01

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

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

EPA Science Inventory

EPA announced the availability of the final contractor report entitled, Development of an Analytic Approach to Determine How Environmental Protection Agency’s Integrated Risk Information System (IRIS) Is Used By Non EPA Decision Makers. This contractor report analyzed how ...

The GRADE Evidence to Decision (EtD) framework for health system and public health decisions.

PubMed

Moberg, Jenny; Oxman, Andrew D; Rosenbaum, Sarah; Schünemann, Holger J; Guyatt, Gordon; Flottorp, Signe; Glenton, Claire; Lewin, Simon; Morelli, Angela; Rada, Gabriel; Alonso-Coello, Pablo

2018-05-29

To describe a framework for people making and using evidence-informed health system and public health recommendations and decisions. We developed the GRADE Evidence to Decision (EtD) framework for health system and public health decisions as part of the DECIDE project, in which we simultaneously developed frameworks for these and other types of healthcare decisions, including clinical recommendations, coverage decisions and decisions about diagnostic tests. Building on GRADE EtD tables, we used an iterative approach, including brainstorming, consultation of the literature and with stakeholders, and an international survey of policy-makers. We applied the framework to diverse examples, conducted workshops and user testing with health system and public health guideline developers and policy-makers, and observed and tested its use in real-life guideline panels. All the GRADE EtD frameworks share the same basic structure, including sections for formulating the question, making an assessment and drawing conclusions. Criteria listed in the assessment section of the health system and public health framework cover the important factors for making these types of decisions; in addition to the effects and economic impact of an option, the priority of the problem, the impact of the option on equity, and its acceptability and feasibility are important considerations that can inform both whether and how to implement an option. Because health system and public health interventions are often complex, detailed implementation considerations should be made when making a decision. The certainty of the evidence is often low or very low, but decision-makers must still act. Monitoring and evaluation are therefore often important considerations for these types of decisions. We illustrate the different components of the EtD framework for health system and public health decisions by presenting their application in a framework adapted from a real-life guideline. This framework provides a structured and transparent approach to support policy-making informed by the best available research evidence, while making the basis for decisions accessible to those whom they will affect. The health system and public health EtD framework can also be used to facilitate dissemination of recommendations and enable decision-makers to adopt, and adapt, recommendations or decisions.

Slower Perception Followed by Faster Lexical Decision in Longer Words: A Diffusion Model Analysis

PubMed Central

Oganian, Yulia; Froehlich, Eva; Schlickeiser, Ulrike; Hofmann, Markus J.; Heekeren, Hauke R.; Jacobs, Arthur M.

2016-01-01

Effects of stimulus length on reaction times (RTs) in the lexical decision task are the topic of extensive research. While slower RTs are consistently found for longer pseudo-words, a finding coined the word length effect (WLE), some studies found no effects for words, and yet others reported faster RTs for longer words. Moreover, the WLE depends on the orthographic transparency of a language, with larger effects in more transparent orthographies. Here we investigate processes underlying the WLE in lexical decision in German-English bilinguals using a diffusion model (DM) analysis, which we compared to a linear regression approach. In the DM analysis, RT-accuracy distributions are characterized using parameters that reflect latent sub-processes, in particular evidence accumulation and decision-independent perceptual encoding, instead of typical parameters such as mean RT and accuracy. The regression approach showed a decrease in RTs with length for pseudo-words, but no length effect for words. However, DM analysis revealed that the null effect for words resulted from opposing effects of length on perceptual encoding and rate of evidence accumulation. Perceptual encoding times increased with length for words and pseudo-words, whereas the rate of evidence accumulation increased with length for real words but decreased for pseudo-words. A comparison between DM parameters in German and English suggested that orthographic transparency affects perceptual encoding, whereas effects of length on evidence accumulation are likely to reflect contextual information and the increase in available perceptual evidence with length. These opposing effects may account for the inconsistent findings on WLEs. PMID:26779075

Slower Perception Followed by Faster Lexical Decision in Longer Words: A Diffusion Model Analysis.

PubMed

Oganian, Yulia; Froehlich, Eva; Schlickeiser, Ulrike; Hofmann, Markus J; Heekeren, Hauke R; Jacobs, Arthur M

2015-01-01

Effects of stimulus length on reaction times (RTs) in the lexical decision task are the topic of extensive research. While slower RTs are consistently found for longer pseudo-words, a finding coined the word length effect (WLE), some studies found no effects for words, and yet others reported faster RTs for longer words. Moreover, the WLE depends on the orthographic transparency of a language, with larger effects in more transparent orthographies. Here we investigate processes underlying the WLE in lexical decision in German-English bilinguals using a diffusion model (DM) analysis, which we compared to a linear regression approach. In the DM analysis, RT-accuracy distributions are characterized using parameters that reflect latent sub-processes, in particular evidence accumulation and decision-independent perceptual encoding, instead of typical parameters such as mean RT and accuracy. The regression approach showed a decrease in RTs with length for pseudo-words, but no length effect for words. However, DM analysis revealed that the null effect for words resulted from opposing effects of length on perceptual encoding and rate of evidence accumulation. Perceptual encoding times increased with length for words and pseudo-words, whereas the rate of evidence accumulation increased with length for real words but decreased for pseudo-words. A comparison between DM parameters in German and English suggested that orthographic transparency affects perceptual encoding, whereas effects of length on evidence accumulation are likely to reflect contextual information and the increase in available perceptual evidence with length. These opposing effects may account for the inconsistent findings on WLEs.

Revealing Neurocomputational Mechanisms of Reinforcement Learning and Decision-Making With the hBayesDM Package

PubMed Central

Ahn, Woo-Young; Haines, Nathaniel; Zhang, Lei

2017-01-01

Reinforcement learning and decision-making (RLDM) provide a quantitative framework and computational theories with which we can disentangle psychiatric conditions into the basic dimensions of neurocognitive functioning. RLDM offer a novel approach to assessing and potentially diagnosing psychiatric patients, and there is growing enthusiasm for both RLDM and computational psychiatry among clinical researchers. Such a framework can also provide insights into the brain substrates of particular RLDM processes, as exemplified by model-based analysis of data from functional magnetic resonance imaging (fMRI) or electroencephalography (EEG). However, researchers often find the approach too technical and have difficulty adopting it for their research. Thus, a critical need remains to develop a user-friendly tool for the wide dissemination of computational psychiatric methods. We introduce an R package called hBayesDM (hierarchical Bayesian modeling of Decision-Making tasks), which offers computational modeling of an array of RLDM tasks and social exchange games. The hBayesDM package offers state-of-the-art hierarchical Bayesian modeling, in which both individual and group parameters (i.e., posterior distributions) are estimated simultaneously in a mutually constraining fashion. At the same time, the package is extremely user-friendly: users can perform computational modeling, output visualization, and Bayesian model comparisons, each with a single line of coding. Users can also extract the trial-by-trial latent variables (e.g., prediction errors) required for model-based fMRI/EEG. With the hBayesDM package, we anticipate that anyone with minimal knowledge of programming can take advantage of cutting-edge computational-modeling approaches to investigate the underlying processes of and interactions between multiple decision-making (e.g., goal-directed, habitual, and Pavlovian) systems. In this way, we expect that the hBayesDM package will contribute to the dissemination of advanced modeling approaches and enable a wide range of researchers to easily perform computational psychiatric research within different populations. PMID:29601060

A rough set approach for determining weights of decision makers in group decision making.

PubMed

Yang, Qiang; Du, Ping-An; Wang, Yong; Liang, Bin

2017-01-01

This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs' decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member' decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs' evaluations and selections.

Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

EPA Science Inventory

Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

An innovative approach to addressing childhood obesity: a knowledge-based infrastructure for supporting multi-stakeholder partnership decision-making in Quebec, Canada.

PubMed

Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L; Dubé, Laurette

2015-01-23

Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a "portrait", which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity.

An Innovative Approach to Addressing Childhood Obesity: A Knowledge-Based Infrastructure for Supporting Multi-Stakeholder Partnership Decision-Making in Quebec, Canada

PubMed Central

Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L.; Dubé, Laurette

2015-01-01

Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a “portrait”, which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity. PMID:25625409

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

PubMed Central

2011-01-01

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

Psychological defense, ideological hideaway, or rational reckoning? The role of uncertainty in local adaptation to climate change

NASA Astrophysics Data System (ADS)

Moser, S. C.

2011-12-01

As adaptation planning is rising rapidly on the agenda of decision-makers, the need for adequate information to inform those decisions is growing. Locally relevant climate change (as well as related impacts and vulnerability) information, however, is difficult to obtain and that which can be obtained carries the burden of significant scientific uncertainty. This paper aims to assess how important such uncertainty is in adaptation planning, decision-making, and related stakeholder engagement. Does uncertainty actually hinder adaptation planning? Is scientific uncertainty used to postpone decisions reflecting ideologically agendas? Or is it a convenient defense against cognitive and affective engagement with the emerging and projected - and in some cases daunting - climate change risks? To whom does such uncertainty matter and how important is it relative to other challenges decision-makers and stakeholders face? The paper draws on four sources of information to answer these questions: (1) a statewide survey of California coastal managers conducted in summer 2011, (2) years of continual engagement with, and observation of, decision-makers in local adaptation efforts, (3) findings from focus groups with lay individuals in coastal California; and (4) a review of relevant adaptation literature to guide and contextualize the empirical research. The findings entail some "inconvenient truths" for those claiming critical technical or political importance. Rather, the insights suggest that some uncertainties matter more than others; they matter at certain times, but not at others; and they matter to some decision-makers, but not to others. Implications for scientists communicating and engaging with communities are discussed.

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

PubMed Central

Schuurman, Nadine; Leight, Margo; Berube, Myriam

2008-01-01

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

Advancing the use of performance evaluation in health care.

PubMed

Traberg, Andreas; Jacobsen, Peter; Duthiers, Nadia Monique

2014-01-01

The purpose of this paper is to develop a framework for health care performance evaluation that enables decision makers to identify areas indicative of corrective actions. The framework should provide information on strategic pro-/regress in an operational context that justifies the need for organizational adjustments. The study adopts qualitative methods for constructing the framework, subsequently implementing the framework in a Danish magnetic resonance imaging (MRI) unit. Workshops and interviews form the basis of the qualitative construction phase, and two internal and five external databases are used for a quantitative data collection. By aggregating performance outcomes, collective measures of performance are achieved. This enables easy and intuitive identification of areas not strategically aligned. In general, the framework has proven helpful in an MRI unit, where operational decision makers have been struggling with extensive amounts of performance information. The implementation of the framework in a single case in a public and highly political environment restricts the generalizing potential. The authors acknowledge that there may be more suitable approaches in organizations with different settings. The strength of the framework lies in the identification of performance problems prior to decision making. The quality of decisions is directly related to the individual decision maker. The only function of the framework is to support these decisions. The study demonstrates a more refined and transparent use of performance reporting by combining strategic weight assignment and performance aggregation in hierarchies. In this way, the framework accentuates performance as a function of strategic progress or regress, thus assisting decision makers in exerting operational effort in pursuit of strategic alignment.

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

USGS Publications Warehouse

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

2015-01-01

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

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

PubMed

Moore, Bethany; Bone, Eric A

2017-01-01

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

From products to processes: Academic events to foster interdisciplinary and iterative dialogue in a changing climate

NASA Astrophysics Data System (ADS)

Addor, Nans; Ewen, Tracy; Johnson, Leigh; Ćöltekin, Arzu; Derungs, Curdin; Muccione, Veruska

2015-08-01

In the context of climate change, both climate researchers and decision makers deal with uncertainties, but these uncertainties differ in fundamental ways. They stem from different sources, cover different temporal and spatial scales, might or might not be reducible or quantifiable, and are generally difficult to characterize and communicate. Hence, a mutual understanding between current and future climate researchers and decision makers must evolve for adaptation strategies and planning to progress. Iterative two-way dialogue can help to improve the decision making process by bridging current top-down and bottom-up approaches. One way to cultivate such interactions is by providing venues for these actors to interact and exchange on the uncertainties they face. We use a workshop-seminar series involving academic researchers, students, and decision makers as an opportunity to put this idea into practice and evaluate it. Seminars, case studies, and a round table allowed participants to reflect upon and experiment with uncertainties. An opinion survey conducted before and after the workshop-seminar series allowed us to qualitatively evaluate its influence on the participants. We find that the event stimulated new perspectives on research products and communication processes, and we suggest that similar events may ultimately contribute to the midterm goal of improving support for decision making in a changing climate. Therefore, we recommend integrating bridging events into university curriculum to foster interdisciplinary and iterative dialogue among researchers, decision makers, and students.

The Role of Human Expertise in Enhancing Data Mining

ERIC Educational Resources Information Center

Kaddouri, Abdelaaziz

2011-01-01

Current data mining (DM) technology is not domain-specific and therefore rarely generates reliable, business actionable knowledge that can be used to improve the effectiveness of the decision-making process in the banking industry. DM is mainly an autonomous, data-driven process with little focus on domain expertise, constraints, or requirements…

Inter-individual differences in decision-making, flexible and goal-directed behaviors: novel insights within the prefronto-striatal networks.

PubMed

Fitoussi, Aurélie; Renault, Prisca; Le Moine, Catherine; Coutureau, Etienne; Cador, Martine; Dellu-Hagedorn, Françoise

2018-03-01

Inflexible behavior is a hallmark of several decision-making-related disorders such as ADHD and addiction. As in humans, a subset of healthy rats makes poor decisions and prefers immediate larger rewards despite suffering large losses in a rat gambling task (RGT). They also display a combination of traits reminiscent of addiction, notably inflexible behavior and perseverative responses. The goal of the present work was twofold: (1) to elucidate if behavioral inflexibility of poor decision-makers could be related to a lower quality of goal-directed behavior (action-outcome associations); (2) to uncover the neural basis of inter-individual differences in goal-directed behavior. We specifically assessed inter-individual differences in decision-making in the RGT, flexibility in the RGT-reversed version and goal-directed behavior in a contingency degradation test, i.e., response adaptation when dissociating reward delivery from the animal's action. The contributions of the medial prefrontal cortex and the dorsal striatum to action-outcome associations were assessed using Zif268 immunodetection. Inflexible behavior was related to a lower sensitivity to contingency degradation in all poor decision-makers and only in a few good decision-makers. This poorer sensitivity was associated with a lower immunoreactivity in prelimbic and infralimbic cortices and a higher one in the dorsomedial and dorsolateral striatum. These findings suggest that an imbalanced prefronto-striatal activity could underlie inaccurate goal representation in changing environments and may promote maladaptive habit formation among poor decision-makers. These data strengthen our previous work identifying biomarkers of vulnerability to develop psychiatric disorders and demonstrate the relevance of inter-individual differences to model maladaptive behaviors.

Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

NASA Technical Reports Server (NTRS)

Christie, Vanessa L.; Landess, David J.

2012-01-01

In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

Modelling ADHD: A review of ADHD theories through their predictions for computational models of decision-making and reinforcement learning.

PubMed

Ziegler, Sigurd; Pedersen, Mads L; Mowinckel, Athanasia M; Biele, Guido

2016-12-01

Attention deficit hyperactivity disorder (ADHD) is characterized by altered decision-making (DM) and reinforcement learning (RL), for which competing theories propose alternative explanations. Computational modelling contributes to understanding DM and RL by integrating behavioural and neurobiological findings, and could elucidate pathogenic mechanisms behind ADHD. This review of neurobiological theories of ADHD describes predictions for the effect of ADHD on DM and RL as described by the drift-diffusion model of DM (DDM) and a basic RL model. Empirical studies employing these models are also reviewed. While theories often agree on how ADHD should be reflected in model parameters, each theory implies a unique combination of predictions. Empirical studies agree with the theories' assumptions of a lowered DDM drift rate in ADHD, while findings are less conclusive for boundary separation. The few studies employing RL models support a lower choice sensitivity in ADHD, but not an altered learning rate. The discussion outlines research areas for further theoretical refinement in the ADHD field. Copyright © 2016 Elsevier Ltd. All rights reserved.

Racioethnicity, community makeup, and potential employees' reactions to organizational diversity management approaches.

PubMed

Olsen, Jesse E; Martins, Luis L

2016-05-01

We draw on the values literature from social psychology and the acculturation literature from cross-cultural psychology to develop and test a theory of how signals about an organization's diversity management (DM) approach affect perceptions of organizational attractiveness among potential employees. We examine the mediating effects of individuals' merit-based attributions about hiring decisions at the organization, as well as the moderating effects of their racioethnicity and the racioethnic composition of their home communities. We test our theory using a within-subject policy-capturing experimental design that simulates organizational DM approaches, supplemented with census data for the participants' home communities. Results of hierarchical linear modeling (HLM) analyses suggest that the manipulated instrumental value for diversity leads to higher perceptions of organizational attractiveness, in part through heightened expectations of merit-based hiring decisions. Further, the manipulated assimilative and integrative DM approach signals are positively related to organizational attractiveness and the effect of integrative DM is strongest for racioethnic minorities from communities with especially high proportions of Whites and Whites from communities with especially low proportions of Whites. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Integrated approach using data mining-based decision tree and object-based image analysis for high-resolution urban mapping of WorldView-2 satellite sensor data

NASA Astrophysics Data System (ADS)

Hamedianfar, Alireza; Shafri, Helmi Zulhaidi Mohd

2016-04-01

This paper integrates decision tree-based data mining (DM) and object-based image analysis (OBIA) to provide a transferable model for the detailed characterization of urban land-cover classes using WorldView-2 (WV-2) satellite images. Many articles have been published on OBIA in recent years based on DM for different applications. However, less attention has been paid to the generation of a transferable model for characterizing detailed urban land cover features. Three subsets of WV-2 images were used in this paper to generate transferable OBIA rule-sets. Many features were explored by using a DM algorithm, which created the classification rules as a decision tree (DT) structure from the first study area. The developed DT algorithm was applied to object-based classifications in the first study area. After this process, we validated the capability and transferability of the classification rules into second and third subsets. Detailed ground truth samples were collected to assess the classification results. The first, second, and third study areas achieved 88%, 85%, and 85% overall accuracies, respectively. Results from the investigation indicate that DM was an efficient method to provide the optimal and transferable classification rules for OBIA, which accelerates the rule-sets creation stage in the OBIA classification domain.

Dying cancer patients talk about physician and patient roles in DNR decision making.

PubMed

Eliott, Jaklin A; Olver, Ian

2011-06-01

Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do-not-resuscitate or do-not-resuscitate (DNR) decision], but there is little analysis of patient perspectives. Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Discursive analysis of qualitative data gathered during semi-structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Participants' descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision-making process. Participants' endorsement of physicians as decision makers rested upon physicians' enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. When patients' and physicians' understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. © 2010 Blackwell Publishing Ltd.

Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure.

PubMed

Khemka, Ishita; Hickson, Linda; Mallory, Sarah B

2016-07-01

This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from self-contained special education classes to an intervention group (n = 22) or a wait-list control group (n = 20). ANCOVA analyses, using pretest scores as covariates, indicated that students who were trained on PEER-DM had significantly higher effective decision-making action and correct risk perception scores, relative to participants in the control group. This study provides supporting evidence that PEER-DM is a promising intervention for students with disabilities, including those with identified autism spectrum disorders, during transition years to help them develop a better understanding of positive and negative peer relationships and learn systematic decision-making skills for improved handling of social situations in the school and community, especially situations involving negative peer pressure. The study adds credence to using systematic, strategy-based decision making interventions designed to address the cognitive, emotional and motivational processes underlying adolescent decision making in sensitive interpersonal situations involving peer pressure. The study points to the lack of preparedness to handle situations of negative peer pressure as a serious social and health risk for adolescents with disabilities that deserves urgent and concerted attention in transition services programming. Implications for future curriculum-development efforts and replication of treatment findings are discussed. Future research examining disability-specific patterns of decision-making in peer situations and comparisons with typically developing populations is recommended.

Problem Formulation in Knowledge Discovery via Data Analytics (KDDA) for Environmental Risk Management

PubMed Central

Li, Yan; Thomas, Manoj; Osei-Bryson, Kweku-Muata; Levy, Jason

2016-01-01

With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM3 ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs. PMID:27983713

Enhancing the informed consent process for critical care research: strategies from a thromboprophylaxis trial.

PubMed

Smith, Orla M; McDonald, Ellen; Zytaruk, Nicole; Foster, Denise; Matte, Andrea; Clarke, France; Fleury, Suzie; Krause, Katie; McArdle, Tracey; Skrobik, Yoanna; Cook, Deborah J

2013-12-01

Critically ill patients lack capacity for decisions about research participation. Consent to enrol these patients in studies is typically obtained from substitute decision-makers. To present strategies that may optimise the process of obtaining informed consent from substitute decision-makers for participation of critically ill patients in trials. We use examples from a randomised trial of heparin thromboprophylaxis in the intensive care unit (PROTECT, clinicaltrials.gov NCT00182143). 3764 patients were randomised, with an informed consent rate of 82%; 90% of consents were obtained from substitute decision-makers. North American PROTECT research coordinators attended three meetings to discuss enrolment: (1) Trial start-up (January 2006); (2) Near trial closure (January 2010); and (3) Post-publication (April 2011). Data were derived from slide presentations, field notes from break-out groups and plenary discussions, then analysed inductively. We derived three phases for the informed consent process: (1) Preparation for the Consent Encounter; (2) The Consent Encounter; and (3) Follow-up to the Consent Encounter. Specific strategies emerged for each phase: Phase 1 (four strategies); Phase 2 (six strategies); and Phase 3 (three strategies). We identified 13 strategies that may improve the process of obtaining informed consent from substitute decision-makers and be generalisable to other settings and studies. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Game theory and neural basis of social decision making

PubMed Central

Lee, Daeyeol

2008-01-01

Decision making in a social group displays two unique features. First, humans and other animals routinely alter their behaviors in response to changes in their physical and social environment. As a result, the outcomes of decisions that depend on the behaviors of multiple decision makers are difficult to predict, and this requires highly adaptive decision-making strategies. Second, decision makers may have other-regarding preferences and therefore choose their actions to improve or reduce the well-beings of others. Recently, many neurobiological studies have exploited game theory to probe the neural basis of decision making, and found that these unique features of social decision making might be reflected in the functions of brain areas involved in reward evaluation and reinforcement learning. Molecular genetic studies have also begun to identify genetic mechanisms for personal traits related to reinforcement learning and complex social decision making, further illuminating the biological basis of social behavior. PMID:18368047

Data mining of routine laboratory tests can predict liver disease progression in Egyptian diabetic patients with hepatitis C virus (G4) infection: a cohort study of 71 806 patients.

PubMed

Saad, Yasmin; Awad, Abobakr; Alakel, Wafaa; Doss, Wahid; Awad, Tahany; Mabrouk, Mahasen

2018-02-01

Hepatitis C virus (HCV) and diabetes mellitus (DM) are prevalent diseases worldwide, associated with significant morbidity, mortality, and mutual association. The aims of this study were as follows: (i) find the prevalence of DM among 71 806 Egyptian patients with chronic HCV infection and its effect on liver disease progression and (ii) using data mining of routine tests to predict hepatic fibrosis in diabetic patients with HCV infection. A retrospective multicentered study included laboratory and histopathological data of 71 806 patients with HCV infection collected by Egyptian National Committee for control of viral hepatitis. Using data mining analysis, we constructed decision tree algorithm to assess predictors of fibrosis progression in diabetic patients with HCV. Overall, 12 018 (16.8%) patients were diagnosed as having diabetes [6428: fasting blood glucose ≥126 mg/dl (9%) and 5590: fasting blood glucose ≥110-126 mg/dl (7.8%)]. DM was significantly associated with advanced age, high BMI and α-fetoprotein (AFP), and low platelets and serum albumin (P≤0.001). Advanced liver fibrosis (F3-F4) was significantly correlated with DM (P≤0.001) irrespective of age. Of 16 attributes, decision tree model for fibrosis showed AFP was most decisive with cutoff of 5.25 ng/ml as starting point of fibrosis. AFP level greater than cutoff in patients was the first important splitting attribute; age and platelet count were second important splitting attributes. (i) Chronic HCV is significantly associated with DM (16.8%). (ii) Advanced age, high BMI and AFP, low platelets count and albumin show significant association with DM in HCV. (iii) AFP cutoff of 5.25 is a starting point of fibrosis development and integrated into mathematical model to predict development of liver fibrosis in diabetics with HCV (G4) infection.

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

ERIC Educational Resources Information Center

Stroup, Jay Walter

2014-01-01

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

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

ERIC Educational Resources Information Center

Corson, Alan; And Others

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

Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion.

PubMed

Hourieh, Shamshiri-Milani; Abolghasem, Pourreza; Feizollah, Akbari

2010-10-01

Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights.

Dying cancer patients talk about physician and patient roles in DNR decision making

PubMed Central

Eliott, Jaklin A.; Olver, Ian

2011-01-01

Abstract Background  Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do‐not‐resuscitate or do‐not‐resuscitate (DNR) decision], but there is little analysis of patient perspectives. Objective  Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Design and participants  Discursive analysis of qualitative data gathered during semi‐structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Results  Participants’ descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision‐making process. Participants’ endorsement of physicians as decision makers rested upon physicians’ enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. Conclusion  When patients’ and physicians’ understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. PMID:20860782

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

PubMed

Halevy, Nir; Chou, Eileen Y

2014-03-01

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

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

PubMed

Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

2015-01-01

To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment. Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture. A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

Prediction of alcohol and gambling problems in young adults by using a measure of decision making.

PubMed

Harvanko, Arit M; Schreiber, Liana R N; Grant, Jon E

2013-01-01

Individuals who regularly gamble, regularly consume alcohol, or meet criteria for an alcohol-use disorder or pathological gambling may make riskier decisions on cognitive tasks. What remains unclear in the literature is whether these decision-making deficits precede or result from these addictive behaviors. This study aimed to determine whether risky decision making on a cognitive task is predictive of increasing gambling behaviors and alcohol use. Fifty-eight young adults (aged 18-29 years) free from Axis I disorders and reporting no symptoms of at-risk gambling behavior or alcohol consumption, who were participating in a longitudinal study of impulsivity, were grouped as either high-risk decision makers (n = 29) or low-risk decision makers (n = 29) by using the Cambridge Gamble Task. Subjects were assessed at 1-year follow-up to examine gambling frequency, alcohol consumption, at-risk alcohol-use criteria, alcohol-use disorder criteria, at-risk gambling criteria, and pathological gambling criteria. High-risk decision makers were found to be more likely to meet at-risk criteria for alcohol use after 1 year. Decision-making group membership was not significantly correlated with frequency of gambling or development of pathological gambling or alcohol-use disorder over 1 year. A variable measuring risky decision making on the Cambridge Gambling Task may be able to predict who is more likely to increase alcohol use per session later in life.

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles

PubMed Central

Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

2015-01-01

Aim To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders’ decision making roles in localized prostate cancer (PCa) treatment. Methods Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Findings The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients’ decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient’s treatment due to Malaysia’s close-knit family culture. Conclusions A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa. PMID:26559947

TIUPAM: A Framework for Trustworthiness-Centric Information Sharing

NASA Astrophysics Data System (ADS)

Xu, Shouhuai; Sandhu, Ravi; Bertino, Elisa

Information is essential to decision making. Nowadays, decision makers are often overwhelmed with large volumes of information, some of which may be inaccurate, incorrect, inappropriate, misleading, or maliciously introduced. With the advocated shift of information sharing paradigm from “need to know” to “need to share” this problem will be further compounded. This poses the challenge of achieving assured information sharing so that decision makers can always get and utilize the up-to-date information for making the right decisions, despite the existence of malicious attacks and without breaching privacy of honest participants. As a first step towards answering this challenge this paper proposes a systematic framework we call TIUPAM, which stands for “Trustworthiness-centric Identity, Usage, Provenance, and Attack Management.” The framework is centered at the need of trustworthiness and risk management for decision makers, and supported by four key components: identity management, usage management, provenance management and attack management. We explore the characterization of both the core functions and the supporting components in the TIUPAM framework, which may guide the design and realization of concrete schemes in the future.

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

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

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

From science to action: Principles for undertaking environmental research that enables knowledge exchange and evidence-based decision-making.

PubMed

Cvitanovic, C; McDonald, J; Hobday, A J

2016-12-01

Effective conservation requires knowledge exchange among scientists and decision-makers to enable learning and support evidence-based decision-making. Efforts to improve knowledge exchange have been hindered by a paucity of empirically-grounded guidance to help scientists and practitioners design and implement research programs that actively facilitate knowledge exchange. To address this, we evaluated the Ningaloo Research Program (NRP), which was designed to generate new scientific knowledge to support evidence-based decisions about the management of the Ningaloo Marine Park in north-western Australia. Specifically, we evaluated (1) outcomes of the NRP, including the extent to which new knowledge informed management decisions; (2) the barriers that prevented knowledge exchange among scientists and managers; (3) the key requirements for improving knowledge exchange processes in the future; and (4) the core capacities that are required to support knowledge exchange processes. While the NRP generated expansive and multidisciplinary science outputs directly relevant to the management of the Ningaloo Marine Park, decision-makers are largely unaware of this knowledge and little has been integrated into decision-making processes. A range of barriers prevented efficient and effective knowledge exchange among scientists and decision-makers including cultural differences among the groups, institutional barriers within decision-making agencies, scientific outputs that were not translated for decision-makers and poor alignment between research design and actual knowledge needs. We identify a set of principles to be implemented routinely as part of any applied research program, including; (i) stakeholder mapping prior to the commencement of research programs to identify all stakeholders, (ii) research questions to be co-developed with stakeholders, (iii) implementation of participatory research approaches, (iv) use of a knowledge broker, and (v) tailored knowledge management systems. Finally, we articulate the individual, institutional and financial capacities that must be developed to underpin successful knowledge exchange strategies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effective Decision Maker-Scientist Engagement:Climate Change Vulnerability Analysis of California's Water System to Using Decision Scaling.

NASA Astrophysics Data System (ADS)

Schwarz, A. M.; Ray, P.; Brown, C.; Wi, S.

2016-12-01

For nearly 2 years the California Department of Water Resources (CDWR) has been working with the University of Massachusetts Amherst (UMass) to evaluate climate change vulnerabilities to the California State Water Project. Working cooperatively, the team has developed tools and methods to employ a decision scaling approach to CDWR's existing water system model (CalSim-II/CalLite 3.0). This presentation will discuss how and why this partnership came to be, the co-production model the team has developed to share expertise, the new understanding of the system that has been gained through the process, and current and future efforts to influence planning and investments based on the findings of the work. This cooperative decision-maker-with-scientist engagement is unique in that CDWR has not outsourced the application of the science to their systems, and instead has worked directly with UMass researchers to develop the process, produce results, and interpret findings. Further, CDWR staff has worked with UMass researchers to present results in ways that are more useable and actionable for decision-makers. As will be shown, many of these graphics allow the team to use the science differently to improve decision making.

Finding common ground to achieve a “good death”: family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study

PubMed Central

2013-01-01

Background Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a “bad death” experience for the patient and family. We aim to describe Canadian family physicians’ experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Methods Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Results Eleven family physicians with a range of 3 to 40 years in clinical practice participated. The family physicians expressed a desire to achieve a “good death” and described their role in positively influencing the experience of death. Finding Common Ground to Achieve a “Good Death” for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. Conclusions A novel framework for developing Common Ground to manage conflicts during end-of-life decision-making discussions may assist in achieving a “good death”. These results could aid in educating physicians, learners, and the public on how to achieve productive collaborative relationships during end-of-life decision-making for dying patients, and ultimately improve their deaths. PMID:23339822

Why do verification and validation?

DOE PAGES

Hu, Kenneth T.; Paez, Thomas L.

2016-02-19

In this discussion paper, we explore different ways to assess the value of verification and validation (V&V) of engineering models. We first present a literature review on the value of V&V and then use value chains and decision trees to show how value can be assessed from a decision maker's perspective. In this context, the value is what the decision maker is willing to pay for V&V analysis with the understanding that the V&V results are uncertain. As a result, the 2014 Sandia V&V Challenge Workshop is used to illustrate these ideas.

Is diabetes mellitus correctly registered and classified in primary care? A population-based study in Catalonia, Spain.

PubMed

Mata-Cases, Manel; Mauricio, Dídac; Real, Jordi; Bolíbar, Bonaventura; Franch-Nadal, Josep

2016-11-01

To assess the prevalence of miscoding, misclassification, misdiagnosis and under-registration of diabetes mellitus (DM) in primary health care in Catalonia (Spain), and to explore use of automated algorithms to identify them. In this cross-sectional, retrospective study using an anonymized electronic general practice database, data were collected from patients or users with a diabetes-related code or from patients with no DM or prediabetes code but treated with antidiabetic drugs (unregistered DM). Decision algorithms were designed to classify the true diagnosis of type 1 DM (T1DM), type 2 DM (T2DM), and undetermined DM (UDM), and to classify unregistered DM patients treated with antidiabetic drugs. Data were collected from a total of 376,278 subjects with a DM ICD-10 code, and from 8707 patients with no DM or prediabetes code but treated with antidiabetic drugs. After application of the algorithms, 13.9% of patients with T1DM were identified as misclassified, and were probably T2DM; 80.9% of patients with UDM were reclassified as T2DM, and 19.1% of them were misdiagnosed as DM when they probably had prediabetes. The overall prevalence of miscoding (multiple codes or UDM) was 2.2%. Finally, 55.2% of subjects with unregistered DM were classified as prediabetes, 35.7% as T2DM, 8.5% as UDM treated with insulin, and 0.6% as T1DM. The prevalence of inappropriate codification or classification and under-registration of DM is relevant in primary care. Implementation of algorithms could automatically flag cases that need review and would substantially decrease the risk of inappropriate registration or coding. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Youth Advocacy as a Tool for Environmental and Policy Changes That Support Physical Activity and Nutrition: An Evaluation Study in San Diego County

PubMed Central

Edwards, Christine C.; Woodruff, Susan I.; Millstein, Rachel A.; Moder, Cheryl

2014-01-01

Background As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention. Community Context San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers. Methods In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative’s half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers. Outcomes Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts. Interpretation Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change. PMID:24674636

Framing bioremediation decision making as negotiation: Rationale & guidelineFraming bioremediation decision making as negotiation: Rationale & guidelines

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

Bjornstad, David J.; Wolfe, Amy K.

Framing remediation decision making as negotiation: (1) social choice, not technology choice; (2) prompts decision makers to identify interested and affected parties, anticipate objections, effectively address and ameliorate objections, and avoid unacceptable decisions.

Using an innovative criteria weighting tool for stakeholders involvement to rank MSW facility sites with the AHP.

PubMed

De Feo, Giovanni; De Gisi, Sabino

2010-11-01

The main aim of this study was to verify the efficacy of using an innovative criteria weighting tool (the "priority scale") for stakeholders involvement to rank a list of suitable municipal solid waste (MSW) facility sites with the multi-criteria decision-making (MCDM) technique known as analytic hierarchy process (AHP). One of the main objectives of the study was to verify the behaviour of the "priority scale" with both technical and non-technical decision-makers. All over the world, the siting of MSW treatment or disposal plants is a complex process involving politicians, technicians as well as citizens, where stakeholders who are not effectively involved strongly oppose (or even obstruct) the realization of new facilities. In this study, in order to pursue both the technical (select the best site) and social aims (all the stakeholders have to give their aware contribution), the use of the "priority scale" is suggested as a tool to easily collect non-contradictory criteria preferences by the various decision-makers. Every decision-maker filled in "priority scale", which was subsequently uploaded in the AHP tool in order to indirectly calculate the individual priority of alternatives given by each stakeholder (not using group aggregation techniques). The proposed method was applied to the siting of a composting plant in an area suffering from a serious MSW emergency, which has lasted for over 15 years, in the Campania Region, in Southern Italy. The best site (the "first choice") was taken as the one that appeared the most times at the first place of each decision-maker ranking list. The involved technical and non-technical decision-makers showed the same behaviour in (indirectly) selecting the best site as well as in terms of the most appraised criteria ("absence of areas of the highest value for natural habitats and species of plants and animals"). Moreover, they showed the same AHP inconsistency ratio as well as the same behaviour in comparison with a "balanced decision-maker" (who assigns identical weights to all the considered criteria). Therefore, the proposed criteria weighting tool could be widely as well as easily used for stakeholders involvement to rank MSW facility sites (or other kinds of alternatives) with the AHP or with other MCDM techniques, taking or not into consideration group aggregation methods. Copyright © 2010 Elsevier Ltd. All rights reserved.

Prevalence and types of disease management programs in community pharmacies in California.

PubMed

Law, Anandi V; Okamoto, Mark P; Chang, Peter S

2005-01-01

To (1) evaluate the prevalence and types of disease management (DM) programs provided by independent and chain community pharmacies in the state of California, (2) examine the interest among community pharmacists in establishing programs, and (3) assess perceived barriers to developing a successful DM program in community pharmacy. An exploratory telephone survey was conducted from February 2003 to February 2004 to collect data from community (primarily independent and chainstore) pharmacies across California. The survey evaluated existence (or lack of) and types of DM programs in community pharmacies in California. Pharmacies that did not have a DM program were queried on their interest and decisionmaking authority in establishing new programs. Pharmacies that had existing DM programs were sent a follow-up survey to determine the details of the DM programs, including challenges in establishing DM programs, reimbursement issues, and program effectiveness. The sample comprised 1,875 pharmacies, 60 (3.2%) of which had existing DM programs. There were significantly more independent pharmacies (37) with DM programs than chain-store pharmacies (23), P<0.001. There was a statistically significant difference between independent and chain pharmacies in operating hours, number of pharmacist and nonpharmacist staff members per day, and proximity to a clinic or hospital (P<0.05). The most common type of DM program was diabetes, and the second most common type was asthma. Limited time, limited staff, and limited reimbursement were the 3 most commonly reported barriers to establishing new DM programs. About 20% of the sample that did not have a DM program reported interest in developing DM programs, and an equal percentage reported having the decision-making authority to start a program. There were no differences between independent and chain pharmacies on interest (P = 0.234); however, there were significantly more chain pharmacists that did not have the decision-making authority. Of the 18 of 60 pharmacies (30%) that had DM programs and responded to the follow-up survey, 9 respondents (50%) reported monitoring medications as part of their DM program. Fifteen of 18 (83%) perceived lack of reimbursement as a challenge to implementing DM programs. Only 2 pharmacies reported an increase in revenue as a gain from the program, and 2 reported cost savings. Improved patient satisfaction was reported by 16 of 18 respondents (89%) with DM programs, but only 8 (44%) reported that patient satisfaction was being measured. The study found that the prevalence of DM programs was very low among California community pharmacies and the interest in developing these programs moderate, attributable to several barriers such as lack of time, lack of reimbursement, and lack of trained personnel. Some of these barriers could be addressed to encourage the development and proliferation of DM programs that would improve patient outcomes and expand practice roles of pharmacists.

Analysis of Multi-Criteria Evaluation Method of Landfill Site Selection for Municipal Solid Waste Management

NASA Astrophysics Data System (ADS)

Mohammed, Habiba Ibrahim; Majid, Zulkepli; Yusof, Norhakim Bin; Bello Yamusa, Yamusa

2018-03-01

Landfilling remains the most common systematic technique of solid waste disposal in most of the developed and developing countries. Finding a suitable site for landfill is a very challenging task. Landfill site selection process aims to provide suitable areas that will protect the environment and public health from pollution and hazards. Therefore, various factors such as environmental, physical, socio-economic, and geological criteria must be considered before siting any landfill. This makes the site selection process vigorous and tedious because it involves the processing of large amount of spatial data, rules and regulations from different agencies and also policy from decision makers. This allows the incorporation of conflicting objectives and decision maker preferences into spatial decision models. This paper particularly analyzes the multi-criteria evaluation (MCE) method of landfill site selection for solid waste management by means of literature reviews and surveys. The study will help the decision makers and waste management authorities to choose the most effective method when considering landfill site selection.

Data and monitoring needs for a more ecological agriculture

NASA Astrophysics Data System (ADS)

Zaks, David P. M.; Kucharik, Christopher J.

2011-01-01

Information on the life-cycle environmental impacts of agricultural production is often limited. As demands grow for increasing agricultural output while reducing its negative environmental impacts, both existing and novel data sources can be leveraged to provide more information to producers, consumers, scientists and policy makers. We review the components and organization of an agroecological sensor web that integrates remote sensing technologies and in situ sensors with models in order to provide decision makers with effective management options at useful spatial and temporal scales for making more informed decisions about agricultural productivity while reducing environmental burdens. Several components of the system are already in place, but by increasing the extent and accessibility of information, decision makers will have the opportunity to enhance food security and environmental quality. Potential roadblocks to implementation include farmer acceptance, data transparency and technology deployment.

A critical review of recent US market level health care strategy literature.

PubMed

Wells, R; Banaszak-Holl, J

2000-09-01

In this review, we argue that it would be profitable if the neoclassical economic theories that have dominated recent US market level health care strategy research could be complemented by greater use of sociological frameworks. Sociological theory can address three central questions that neoclassical economic theories have tended to slight: (1) how decision-makers' preferences are determined; (2) who the decision-makers are; and (3) how decision-makers' plans are translated into organizational action. We suggest five sociological frameworks that would enable researchers to address these issues better relative to market level strategy in health care. The frameworks are (1) institutional theory, (2) organizational ecology, (3) social movements, (4) social networks, and (5) internal organizational change. A recent global trend toward privatization of health care provision makes US market level strategy research increasingly applicable to non-US readers.

Water Planning in Phoenix: Managing Risk in the Face of Climatic Uncertainty

NASA Astrophysics Data System (ADS)

Gober, P.

2009-12-01

The Decision Center for a Desert City (DCDC) was founded in 2004 to develop scientifically-credible support tools to improve water management decisions in the face of growing climatic uncertainty and rapid urbanization in metropolitan Phoenix. At the center of DCDC's effort is WaterSim, a model that integrates information about water supply from groundwater, the Colorado River, and upstream watersheds and water demand from land use change and population growth. Decision levers enable users to manipulate model outcomes in response to climate change scenarios, drought conditions, population growth rates, technology innovations, lifestyle changes, and policy decisions. WaterSim allows users to examine the risks of water shortage from global climate change, the tradeoffs between groundwater sustainability and lifestyle choices, the effects of various policy decisions, and the consequences of delaying policy for the exposure to risk. WaterSim is an important point of contact for DCDC’s relationships with local decision makers. Knowledge, tools, and visualizations are co-produced—by scientists and policy makers, and the Center’s social scientists mine this co-production process for new insights about model development and application. WaterSim is less a static scientific product and more a dynamic process of engagement between decision makers and scientists.

Bayesian techniques for analyzing group differences in the Iowa Gambling Task: A case study of intuitive and deliberate decision-makers.

PubMed

Steingroever, Helen; Pachur, Thorsten; Šmíra, Martin; Lee, Michael D

2018-06-01

The Iowa Gambling Task (IGT) is one of the most popular experimental paradigms for comparing complex decision-making across groups. Most commonly, IGT behavior is analyzed using frequentist tests to compare performance across groups, and to compare inferred parameters of cognitive models developed for the IGT. Here, we present a Bayesian alternative based on Bayesian repeated-measures ANOVA for comparing performance, and a suite of three complementary model-based methods for assessing the cognitive processes underlying IGT performance. The three model-based methods involve Bayesian hierarchical parameter estimation, Bayes factor model comparison, and Bayesian latent-mixture modeling. We illustrate these Bayesian methods by applying them to test the extent to which differences in intuitive versus deliberate decision style are associated with differences in IGT performance. The results show that intuitive and deliberate decision-makers behave similarly on the IGT, and the modeling analyses consistently suggest that both groups of decision-makers rely on similar cognitive processes. Our results challenge the notion that individual differences in intuitive and deliberate decision styles have a broad impact on decision-making. They also highlight the advantages of Bayesian methods, especially their ability to quantify evidence in favor of the null hypothesis, and that they allow model-based analyses to incorporate hierarchical and latent-mixture structures.

A preliminary psychometric evaluation of the eight-item cognitive load scale.

PubMed

Pignatiello, Grant A; Tsivitse, Emily; Hickman, Ronald L

2018-04-01

The aim of this article is to report the psychometric properties of the eight-item cognitive load scale. According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings. A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS). The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89). The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

PubMed

Carpenter, Stephanie M; Yates, J Frank; Preston, Stephanie D; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting

PubMed Central

Carpenter, Stephanie M.; Yates, J. Frank; Preston, Stephanie D.; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional “coherence shifting,” the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed. PMID:26986752

The Effect of Achievement Test Selection on Identification of Learning Disabilities within a Patterns of Strengths and Weaknesses Framework

ERIC Educational Resources Information Center

Miciak, Jeremy; Taylor, W. Pat; Denton, Carolyn A.; Fletcher, Jack M.

2015-01-01

Few empirical investigations have evaluated learning disabilities (LD) identification methods based on a pattern of cognitive strengths and weaknesses (PSW). This study investigated the reliability of LD classification decisions of the concordance/discordance method (C/DM) across different psychoeducational assessment batteries. C/DM criteria were…

Type 1 Diabetes Mellitus Case Decisions: Health-Related Service Considerations for School Psychologists

ERIC Educational Resources Information Center

Schmitt, Ara J.; Wodrich, David L.; Lazar, Susan

2010-01-01

Type 1 diabetes mellitus (T1DM) is a chronic illness that can impact learning and often requires medical management in the school setting. School psychologists must therefore be knowledgeable of special service eligibility criteria associated with T1DM, the health-related services often required of such students, and what health-related services…

Decision making in recurrent neuronal circuits.

PubMed

Wang, Xiao-Jing

2008-10-23

Decision making has recently emerged as a central theme in neurophysiological studies of cognition, and experimental and computational work has led to the proposal of a cortical circuit mechanism of elemental decision computations. This mechanism depends on slow recurrent synaptic excitation balanced by fast feedback inhibition, which not only instantiates attractor states for forming categorical choices but also long transients for gradually accumulating evidence in favor of or against alternative options. Such a circuit endowed with reward-dependent synaptic plasticity is able to produce adaptive choice behavior. While decision threshold is a core concept for reaction time tasks, it can be dissociated from a general decision rule. Moreover, perceptual decisions and value-based economic choices are described within a unified framework in which probabilistic choices result from irregular neuronal activity as well as iterative interactions of a decision maker with an uncertain environment or other unpredictable decision makers in a social group.

Creating dialogue: a workshop on "Uncertainty in Decision Making in a Changing Climate"

NASA Astrophysics Data System (ADS)

Ewen, Tracy; Addor, Nans; Johnson, Leigh; Coltekin, Arzu; Derungs, Curdin; Muccione, Veruska

2014-05-01

Uncertainty is present in all fields of climate research, spanning from projections of future climate change, to assessing regional impacts and vulnerabilities, to adaptation policy and decision-making. In addition to uncertainties, managers and planners in many sectors are often confronted with large amounts of information from climate change research whose complex and interdisciplinary nature make it challenging to incorporate into the decision-making process. An overarching issue in tackling this problem is the lack of institutionalized dialogue between climate researchers, decision-makers and user groups. Forums that facilitate such dialogue would allow climate researchers to actively engage with end-users and researchers in different disciplines to better characterize uncertainties and ultimately understand which ones are critically considered and incorporated into decisions made. We propose that the introduction of students to these challenges at an early stage of their education and career is a first step towards improving future dialogue between climate researchers, decision-makers and user groups. To this end, we organized a workshop at the University of Zurich, Switzerland, entitled "Uncertainty in Decision Making in a Changing Climate". It brought together 50 participants, including Bachelor, Master and PhD students and academic staff, and nine selected speakers from academia, industry, government, and philanthropy. Speakers introduced participants to topics ranging from uncertainties in climate model scenarios to managing uncertainties in development and aid agencies. The workshop consisted of experts' presentations, a panel discussion and student group work on case studies. Pedagogical goals included i) providing participants with an overview of the current research on uncertainty and on how uncertainty is dealt with by decision-makers, ii) fostering exchange between practitioners, students, and scientists from different backgrounds, iii) exposing students, at an early stage of their professional life, to multidisciplinary collaborations and real-world problems involving decisions under uncertainty. An opinion survey conducted before and after the workshop enabled us to observe changes in participants' perspectives on what information and tools should be exchanged between researchers and decision-makers to better address uncertainty. Responses demonstrated a marked shift from a pre-workshop vertical conceptualizations of researcher—user group interaction to a post-workshop horizontal mode: in the former, researchers were portrayed as bestowing data-based products to decision-makers, while in the latter, both sets of actors engaged in institutionalized dialogues and frequent communication, exchanging their needs, expertise, and personnel. In addition to the survey, we will draw on examples from the course evaluation to illustrate the strengths and weaknesses of our approach. By doing so, we seek to encourage the organization of similar events by other universities, with the mid-term goal to improve future dialogue. From a pedagogical perspective, introducing students to these ideas at a very early stage in their research careers is an ideal opportunity to establish new modes of communication with an interdisciplinary perspective and strengthen dialogue between climate researchers, decision-makers and user groups.

Quality Psychological Advice for Teachers, Parents/Carers and LEA Decision-Makers with Respect to Children and Young People with Special Needs

ERIC Educational Resources Information Center

Cameron, R. J. (Sean); Monsen, Jeremy J.

2005-01-01

The main aim of this paper is to describe a working protocol which can offer practising educational psychologists a rational framework within which to investigate and understand the complex problems of children and young people in school and to provide appropriate advice to teachers, parents/carers and LEA decision makers on how they can best…

Work-Based Learning: A Practical Approach for Learning to Work and Working to Learn. A Case Study on Decision-Makers' Professional Development in Iran

ERIC Educational Resources Information Center

Arani, Mohammad Reza Sarkar; Alagamandan, Jafar; Tourani, Heidar

2004-01-01

The work-based learning model of human resource development has captured a great deal of attention and has gained increasing importance in higher education in recent years. Work-based learning is a powerful phenomenon that attempts to help policy-makers, managers and curriculum developers improve the quality of the decision and organizational…

Shrinking Sea Ice, Thawing Permafrost, Bigger Storms, and Extremely Limited Data - Addressing Information Needs of Stakeholders in Western Alaska Through Participatory Decisions and Collaborative Science.

NASA Astrophysics Data System (ADS)

Murphy, K. A.; Reynolds, J.

2015-12-01

Communities, Tribes, and decision makers in coastal western Alaska are being impacted by declining sea ice, sea level rise, changing storm patterns and intensities, and increased rates of coastal erosion. Relative to their counterparts in the contiguous USA, their ability to plan for and respond to these changes is constrained by the region's generally meager or non-existent information base. Further, the information needs and logistic challenges are of a scale that perhaps can be addressed only through strong, strategic collaboration. Landscape Conservation Cooperatives (LCCs) are fundamentally about applied science and collaboration, especially collaborative decision making. The Western Alaska LCC has established a process of participatory decision making that brings together researchers, agency managers, local experts from Tribes and field specialists to identify and prioritize shared information needs; develop a course of action to address them by using the LCC's limited resources to catalyze engagement, overcome barriers to progress, and build momentum; then ensure products are delivered in a manner that meets decision makers' needs. We briefly review the LCC's activities & outcomes from the stages of (i) collaborative needs assessment (joint with the Alaska Climate Science Center and the Alaska Ocean Observing System), (ii) strategic science activities, and (iii) product refinement and delivery. We discuss lessons learned, in the context of our recent program focused on 'Changes in Coastal Storms and Their Impacts' and current collaborative efforts focused on delivery of Coastal Resiliency planning tools and results from applied science projects. Emphasis is given to the various key interactions between scientists and decision makers / managers that have been promoted by this process to ensure alignment of final products to decision maker needs.

Achieving conservation science that bridges the knowledge-action boundary.

PubMed

Cook, Carly N; Mascia, Michael B; Schwartz, Mark W; Possingham, Hugh P; Fuller, Richard A

2013-08-01

There are many barriers to using science to inform conservation policy and practice. Conservation scientists wishing to produce management-relevant science must balance this goal with the imperative of demonstrating novelty and rigor in their science. Decision makers seeking to make evidence-based decisions must balance a desire for knowledge with the need to act despite uncertainty. Generating science that will effectively inform management decisions requires that the production of information (the components of knowledge) be salient (relevant and timely), credible (authoritative, believable, and trusted), and legitimate (developed via a process that considers the values and perspectives of all relevant actors) in the eyes of both researchers and decision makers. We perceive 3 key challenges for those hoping to generate conservation science that achieves all 3 of these information characteristics. First, scientific and management audiences can have contrasting perceptions about the salience of research. Second, the pursuit of scientific credibility can come at the cost of salience and legitimacy in the eyes of decision makers, and, third, different actors can have conflicting views about what constitutes legitimate information. We highlight 4 institutional frameworks that can facilitate science that will inform management: boundary organizations (environmental organizations that span the boundary between science and management), research scientists embedded in resource management agencies, formal links between decision makers and scientists at research-focused institutions, and training programs for conservation professionals. Although these are not the only approaches to generating boundary-spanning science, nor are they mutually exclusive, they provide mechanisms for promoting communication, translation, and mediation across the knowledge-action boundary. We believe that despite the challenges, conservation science should strive to be a boundary science, which both advances scientific understanding and contributes to decision making. © 2013 Society for Conservation Biology.

Seeing the forests and the trees—innovative approaches to exploring heterogeneity in systematic reviews of complex interventions to enhance health system decision-making: a protocol

PubMed Central

2014-01-01

Background To improve quality of care and patient outcomes, health system decision-makers need to identify and implement effective interventions. An increasing number of systematic reviews document the effects of quality improvement programs to assist decision-makers in developing new initiatives. However, limitations in the reporting of primary studies and current meta-analysis methods (including approaches for exploring heterogeneity) reduce the utility of existing syntheses for health system decision-makers. This study will explore the role of innovative meta-analysis approaches and the added value of enriched and updated data for increasing the utility of systematic reviews of complex interventions. Methods/Design We will use the dataset from our recent systematic review of 142 randomized trials of diabetes quality improvement programs to evaluate novel approaches for exploring heterogeneity. These will include exploratory methods, such as multivariate meta-regression analyses and all-subsets combinatorial meta-analysis. We will then update our systematic review to include new trials and enrich the dataset by surveying authors of all included trials. In doing so, we will explore the impact of variables not, reported in previous publications, such as details of study context, on the effectiveness of the intervention. We will use innovative analytical methods on the enriched and updated dataset to identify key success factors in the implementation of quality improvement interventions for diabetes. Decision-makers will be involved throughout to help identify and prioritize variables to be explored and to aid in the interpretation and dissemination of results. Discussion This study will inform future systematic reviews of complex interventions and describe the value of enriching and updating data for exploring heterogeneity in meta-analysis. It will also result in an updated comprehensive systematic review of diabetes quality improvement interventions that will be useful to health system decision-makers in developing interventions to improve outcomes for people with diabetes. Systematic review registration PROSPERO registration no. CRD42013005165 PMID:25115289

Extension of a Computer Assisted Decision Support (CADS) Study to Improve Outcomes in Patients with Type 2 DM Treated Primary Cary Providers

DTIC Science & Technology

2013-10-01

latest (2004) National Health and Nutrition Examination Survey (NHANES) data demonstrated that 42.3% of patients with DM have A1Cs over 7% (22). The...military healthcare system (MHS) - where there is no cost to the patient for care and testing supplies - has similar results with hemoglobin A1C’s... Educators in both military and civilian health care settings (23), the vast majority of patients with DM are managed by primary care providers (PCPs

Creating and synthesizing evidence with decision makers in mind: integrating evidence from clinical trials and other study designs.

PubMed

Atkins, David

2007-10-01

Randomized controlled trials (RCTs) remain the accepted "gold standard" for determining the efficacy of new drugs or medical procedures. Randomized trials alone, however, cannot provide all the relevant information decision makers need to determine the relative risks and benefits when choosing the best treatment of individual patients or weighing the implications of particular policies affecting medical therapies. To demonstrate the limitations of RCTs in providing the information needed by medical decision makers, and to show how information from observational studies can supplement evidence from RCTs. Qualitative description of the limitations of RCTs in providing the information needed by medical decision makers, and demonstration of how evidence from additional sources can aid in decision making, using the examples of deciding whether a 60-year-old woman with mildly elevated blood pressure should take daily low-dose aspirin, and whether a hospital network should implement carotid artery surgery for asymptomatic patients. Even the most rigorously designed RCTs leave many questions central to medical decision making unanswered. Research using cohort and case-control designs, disease and intervention registries, and outcomes studies based on administrative data can all shed light on who is most likely to benefit from the treatment, and what the important tradeoffs are. This suggests the need to revise the traditional evidence hierarchy, whereby evidence progresses linearly from basic research to rigorous RCTs. This revised hierarchy recognizes that other research designs can provide important evidence to strengthen our understanding of how to apply research findings in practice.

Ethical challenges related to elder care. High level decision-makers' experiences

PubMed Central

Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

2007-01-01

Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet. PMID:17419880

Ethical challenges related to elder care. High level decision-makers' experiences.

PubMed

Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

2007-04-10

Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.

Navigating the boundary of science for decision making at the state and local level

NASA Astrophysics Data System (ADS)

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

2015-12-01

Scientific information should play a vital role in many decision making processes, yet issues incorporating geoscience information often arise due to inherent differences between how scientists and decision makers operate. Decision makers and scientists have different priorities, produce work at different rates, and often lack an understanding of each others' institutional constraints. Boundary organizations, entities that facilitate collaboration and information flow across traditional boundaries such as that between scientists and decision makers, are in a unique position to improve the dialogue between disparate groups. The American Geosciences Institute (AGI), a nonprofit federation of 50 geoscience societies and organizations, is linking the geoscience and decision-making communities through its Critical Issues Program. AGI's Critical Issues program has first-hand experience in improving the transfer of information across the science-decision making boundary, particularly in areas pertaining to water resources and hazards. This presentation will focus on how, by collaborating with organizations representing the decision making and geoscience communities to inform our program development, we have created our three main content types - website, webinar series, and research database - to better meet the needs of the decision-making process. The program presents existing geoscience information in a way that makes the interconnected nature of geoscience topics more easily understood, encourages discussion between the scientific and decision-making communities, and has established a trusted source of impartial geoscience information. These efforts have focused on state and local decision makers—groups that increasingly influence climate and risk-related decisions, yet often lack the resources to access and understand geoscience information.

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

PubMed

Kelly, B D

2017-05-01

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

Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia.

PubMed

Hanson, Laura C; Song, Mi-Kyung; Zimmerman, Sheryl; Gilliam, Robin; Rosemond, Cherie; Chisholm, Latarsha; Lin, Feng-Chang

2016-12-01

Ensuring fidelity to a behavioral intervention implemented in nursing homes requires awareness of the unique considerations of this setting for research. The purpose of this article is to describe the goals of care cluster-randomized trial and the methods used to monitor and promote fidelity to a goals of care decision aid intervention delivered in nursing homes. The cluster randomized trial tested whether a decision aid for goals of care in advanced dementia could improve (1) the quality of communication and decision-making, (2) the quality of palliative care, and (3) the quality of dying for nursing home residents with advanced dementia. In 11 intervention nursing homes, family decision-makers for residents with advanced dementia received a two-component intervention: viewing a video decision aid about goals of care choices and then participating in a structured decision-making discussion with the nursing home care plan team, ideally within 3 months after the decision aid was viewed. Following guidelines from the National Institutes of Health Behavior Change Consortium, fidelity was assessed in study design, in nursing home staff training for intervention implementation, and in monitoring and receipt of the intervention. We also monitored the content and timing of goals of care discussions. Investigators enrolled 151 family decision-maker/resident dyads in intervention sites; of those, 136 (90%) received both components of the intervention, and 92%-99% of discussions addressed each of four recommended content areas-health status, goals of care, choice of a goal, and treatment planning. A total of 94 (69%) of the discussions between family decision-makers and the nursing home care team were completed within 3 months. The methods we used for intervention fidelity allowed nursing home staff to implement a goals of care decision aid intervention for advanced dementia. Key supports for implementation included design features that aligned with nursing home practice, efficient staff training, and a structured guide for goals of care discussions between family decision-makers and staff. These approaches may be used to promote fidelity to behavioral interventions in future clinical trials. © The Author(s) 2016.

Diabetes mellitus and tuberculosis: programmatic management issues

PubMed Central

Kumar, A. M. V.; Satyanarayana, S.; Lin, Y.; Zachariah, R.; Lönnroth, K.; Kapur, A.

2015-01-01

SUMMARY In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB. PMID:26162352

A Systematic Design Method for Two-Variable Numeric Function Generators Using Multiple-Valued Decision Diagrams

DTIC Science & Technology

2010-08-01

R.K. Brayton , and A.L. Sangiovanni-Vincentelli, “Multi-valued decision diagrams: Theory and applications,” Multiple-Valued Logic: An International...S.N. Yanushkevich, D.M. Miller, V.P. Shmerko, and R.S. Stankovic, Decision Diagram Techniques for Micro- and Nanoelectronic De- sign, CRC Press, Taylor

A rough set approach for determining weights of decision makers in group decision making

PubMed Central

Yang, Qiang; Du, Ping-an; Wang, Yong; Liang, Bin

2017-01-01

This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs’ decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member’ decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs’ evaluations and selections. PMID:28234974

A technique for determining viable military logistics support alternatives

NASA Astrophysics Data System (ADS)

Hester, Jesse Stuart

A look at today's US military will see them operating much beyond the scope of protecting and defending the United States. These operations now consist of, but are not limited to humanitarian aid, disaster relief, peace keeping, and conflict resolution. This broad spectrum of operational environments has necessitated a transformation of the individual military services to a hybrid force that is attempting to leverage the inherent and emerging capabilities and strengths of all those under the umbrella of the Department of Defense (DOD), this concept has been coined Joint Operations. Supporting Joint Operations requires a new approach to determining a viable military logistics support system. The logistics architecture for these operations has to accommodate scale, time, varied mission objectives, and imperfect information. Compounding the problem is the human in the loop (HITL) decision maker (DM) who is a necessary component for quickly assessing and planning logistics support activities. Past outcomes are not necessarily good indicators of future results, but they can provide a reasonable starting point for planning and prediction of specific needs for future requirements. Adequately forecasting the necessary logistical support structure and commodities needed for any resource intensive environment has progressed well beyond stable demand assumptions to one in which dynamic and nonlinear environments can be captured with some degree of fidelity and accuracy. While these advances are important, a holistic approach that allows exploration of the operational environment or design space does not exist to guide the military logistician in a methodical way to support military forecasting activities. To bridge this capability gap, a method called Adaptive Technique for Logistics Architecture Solutions (ATLAS) has been developed. This method provides a process that facilitates the use of techniques and tools that filter and provide relevant information to the DM. By doing so, a justifiable course of action (COA) can be determined based on a variety of quantitative and qualitative information available. This thesis describes and applies the ATLAS method to a notional military scenario that involves the Navy concept of Seabasing and the Marine Corps concept of Distributed Operations applied to a platoon sized element. The small force is tasked to conduct deterrence and combat operations over a seven day period. This work uses modeling and simulation to incorporate expert opinion and knowledge of military operations, dynamic reasoning methods, and certainty analysis to create a decisions support system (DSS) that can be used to provide the DM an enhanced view of the logistics environment and uses variables that impact specific measures of effectiveness. The results from applying the ATLAS method provide a better understanding and ability for the DM to conduct the logistics planning/execution more efficiently and quickly. This is accomplished by providing relevant data that can be applied to perform dynamic forecasting activities for the platoon and aids in determining the necessary support architecture to fulfill the forecasted need.

Expanding Health Technology Assessments to Include Effects on the Environment.

PubMed

Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

2016-01-01

There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Do Processing Patterns of Strengths and Weaknesses Predict Differential Treatment Response?

PubMed

Miciak, Jeremy; Williams, Jacob L; Taylor, W Pat; Cirino, Paul T; Fletcher, Jack M; Vaughn, Sharon

2016-08-01

No previous empirical study has investigated whether the LD identification decisions of proposed methods to operationalize processing strengths and weaknesses (PSW) approaches for LD identification are associated with differential treatment response. We investigated whether the identification decisions of the concordance/discordance model (C/DM; Hale & Fiorello, 2004) and Cross Battery Assessment approach (XBA method; Flanagan, Ortiz, & Alfonso, 2007) were consistent and whether they predicted intervention response beyond that accounted for by pretest performance on measures of reading. Psychoeducational assessments were administered at pretest to 203 4 th graders with low reading comprehension and individual results were utilized to identify students who met LD criteria according to the C/DM and XBA methods and students who did not. Resulting group status permitted an investigation of agreement for identification methods and whether group status at pretest (LD or not LD) was associated with differential treatment response to an intensive reading intervention. The LD identification decisions of the XBA and C/DM demonstrated poor agreement with one another (κ = -.10). Comparisons of posttest performance for students who met LD criteria and those who did not meet were largely null, with small effect sizes across all measures. LD status, as identified through the C/DM and XBA approaches, was not associated with differential treatment response and did not contribute educationally meaningful information about how students would respond to intensive reading intervention. These results do not support the value of cognitive assessment utilized in this way as part of the LD identification process.

Use of Inverse Reinforcement Learning for Identity Prediction

NASA Technical Reports Server (NTRS)

Hayes, Roy; Bao, Jonathan; Beling, Peter; Horowitz, Barry

2011-01-01

We adopt Markov Decision Processes (MDP) to model sequential decision problems, which have the characteristic that the current decision made by a human decision maker has an uncertain impact on future opportunity. We hypothesize that the individuality of decision makers can be modeled as differences in the reward function under a common MDP model. A machine learning technique, Inverse Reinforcement Learning (IRL), was used to learn an individual's reward function based on limited observation of his or her decision choices. This work serves as an initial investigation for using IRL to analyze decision making, conducted through a human experiment in a cyber shopping environment. Specifically, the ability to determine the demographic identity of users is conducted through prediction analysis and supervised learning. The results show that IRL can be used to correctly identify participants, at a rate of 68% for gender and 66% for one of three college major categories.

Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in Zambia.

PubMed

Tuba, Mary; Sandoy, Ingvild F; Bloch, Paul; Byskov, Jens

2010-11-01

Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya. This paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery. Poor status of the AFR conditions of relevance, publicity, appeals and leadership corresponds well to the differing perceptions of fairness and unfairness among outpatient attendees and decision-makers. This may have been re-enforced by existing disagreements between the two groups regarding who the legitimate stakeholders to involve during service delivery were. Conflicts identified in this study could be resolved by promoting application of approaches such as AFR during priority setting in the district.

Multiple-attribute group decision making with different formats of preference information on attributes.

PubMed

Xu, Zeshui

2007-12-01

Interval utility values, interval fuzzy preference relations, and interval multiplicative preference relations are three common uncertain-preference formats used by decision-makers to provide their preference information in the process of decision making under fuzziness. This paper is devoted in investigating multiple-attribute group-decision-making problems where the attribute values are not precisely known but the value ranges can be obtained, and the decision-makers provide their preference information over attributes by three different uncertain-preference formats i.e., 1) interval utility values; 2) interval fuzzy preference relations; and 3) interval multiplicative preference relations. We first utilize some functions to normalize the uncertain decision matrix and then transform it into an expected decision matrix. We establish a goal-programming model to integrate the expected decision matrix and all three different uncertain-preference formats from which the attribute weights and the overall attribute values of alternatives can be obtained. Then, we use the derived overall attribute values to get the ranking of the given alternatives and to select the best one(s). The model not only can reflect both the subjective considerations of all decision-makers and the objective information but also can avoid losing and distorting the given objective and subjective decision information in the process of information integration. Furthermore, we establish some models to solve the multiple-attribute group-decision-making problems with three different preference formats: 1) utility values; 2) fuzzy preference relations; and 3) multiplicative preference relations. Finally, we illustrate the applicability and effectiveness of the developed models with two practical examples.

How to pose the question matters: Behavioural Economics concepts in decision making on the basis of ensemble forecasts

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo; van Andel, Schalk Jan

2014-05-01

Part of recent research in ensemble and probabilistic hydro-meteorological forecasting analyses which probabilistic information is required by decision makers and how it can be most effectively visualised. This work, in addition, analyses if decision making in flood early warning is also influenced by the way the decision question is posed. For this purpose, the decision-making game "Do probabilistic forecasts lead to better decisions?", which Ramos et al (2012) conducted at the EGU General Assembly 2012 in the city of Vienna, has been repeated with a small group and expanded. In that game decision makers had to decide whether or not to open a flood release gate, on the basis of flood forecasts, with and without uncertainty information. A conclusion of that game was that, in the absence of uncertainty information, decision makers are compelled towards a more risk-averse attitude. In order to explore to what extent the answers were driven by the way the questions were framed, in addition to the original experiment, a second variant was introduced where participants were asked to choose between a sure value (for either loosing or winning with a giving probability) and a gamble. This set-up is based on Kahneman and Tversky (1979). Results indicate that the way how the questions are posed may play an important role in decision making and that Prospect Theory provides promising concepts to further understand how this works.

A Comparison of Computational Cognitive Models: Agent-Based Systems Versus Rule-Based Architectures

DTIC Science & Technology

2003-03-01

Java™ How To Program , Prentice Hall, 1999. Friedman-Hill, E., Jess, The Expert System Shell for the Java Platform, Sandia National Laboratories, 2001...transition from the descriptive NDM theory to a computational model raises several questions: Who is an experienced decision maker? How do you model the...progression from being a novice to an experienced decision maker? How does the model account for previous experiences? Are there situations where

[The influence of the relationship between physicians and pharmaceutical companies on the patient from the point of view of policy-makers in Israel].

PubMed

Nissanholtz-Gannot, Rachel; Shani, Segev; Shvarts, Shifra

2010-11-01

The relationship between doctors and pharmaceutical companies is an integral part of the health system in Israel and the whole world. The mutual need for such a relationship requires us, as a society, to examine its influence on the individual and the system as a whole. This research examines the relationship from the points of view of the relevant parties within the health system and outside the health system (decision-makers). The authors used in-depth interviews and qualitative research methods in order to examine and understand the various positions of decision-makers. The position of the decision-makers, regarding all the aspects of this relationship, expresses their wishes and depends on their point of view. The impact of the relationship between the doctors and the pharmaceutical companies was examined with regard to the prescription behavior of the doctor. All the government representatives, all the physicians' representatives and those of the health funds, believe that the physicians' prescription behavior is impacted by the relationship. There are those who perceive this to be a negative trend and some doctors believe it to be a positive trend. With regard to possible harm to the patient, the parties believe that the relationship does not harm the patient, whereas most of the government representatives identify harm to the patients, both on the economic and health levels. The authors believe that the "influence" which exists or could exist on the part of the pharmaceutical companies is the main stumbling block in this relationship, which is expressed in the decision-makers' perspective.

The marketing activities of hospitals: environmental, organizational, and managerial influences.

PubMed

Myrtle, R C; Martinez, C F

1991-03-01

This article reports the results of a study designed to examine the relationship of environmental, organizational and structural factors, perceptions of key decision makers about competitive conditions, and changes in operational performance with the level of the marketing activities engaged in by 145 California hospitals. Measures assessing the impact of environmental conditions and the perception of the key decision makers were found to be related to the marketing activities of the organization. However, the relationship between measures which examined the structural and performance impacts on the marketing activities did not demonstrate the same predictive ability. The results suggest that marketing activities were affected by the key decision maker's assessment of the competitive nature of the environment, influence of key stakeholders, and tangible changes in the organization's task environment. Performance and other measures were not found to be as influential in determining these activities.

Conceptual framework for nutrition surveillance systems.

PubMed

Mock, N B; Bertrand, W E

1993-01-01

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

The impact of frontal and cerebellar lesions on decision making: evidence from the Iowa Gambling Task

PubMed Central

Cardoso, Caroline de Oliveira; Branco, Laura Damiani; Cotrena, Charles; Kristensen, Christian Haag; Schneider Bakos, Daniela Di Giorge; Fonseca, Rochele Paz

2014-01-01

Although the frontal lobes have traditionally been considered the neural substrates of executive functioning (EF), recent studies have suggested that other structures, such as the cerebellum, may be associated with these abilities. The role of the cerebellum has only been sparsely investigated in connection with decision making (DM), an important component of EF, and the few results obtained on this front have been inconclusive. The current study sought to investigate the role of the cerebellum in DM by comparing the performance of patients with cerebellar strokes, frontal-damaged patients, and a healthy control group on the Iowa Gambling Task (IGT). A total of nine cerebellar-damaged adults participated in the study, as well as nine individuals with frontal strokes and 18 control individuals. Patients were administered a version of the IGT adapted to the population of Southern Brazil. There was a marginal difference in mean IGT net scores between the two clinical groups, although both displayed impaired performance as compared to the control group. Overall, the DM ability of patients with cerebellar damage proved to be more preserved than that of individuals with frontal lobe strokes, but less preserved than that of the control group. These data suggested that, while the frontal lobes may be the most important brain structures for DM, the cerebellum might also play an active role in this cognitive function. Future studies assessing participants with lesions in different cerebellar regions and hemispheres will prove invaluable for the understanding of the neural structures involved in DM, and make significant contributions to the globalist-localizationist debate in DM neuroscience. PMID:24782697

A Chaotic Ordered Hierarchies Consistency Analysis Performance Evaluation Model

NASA Astrophysics Data System (ADS)

Yeh, Wei-Chang

2013-02-01

The Hierarchies Consistency Analysis (HCA) is proposed by Guh in-cooperated along with some case study on a Resort to reinforce the weakness of Analytical Hierarchy Process (AHP). Although the results obtained enabled aid for the Decision Maker to make more reasonable and rational verdicts, the HCA itself is flawed. In this paper, our objective is to indicate the problems of HCA, and then propose a revised method called chaotic ordered HCA (COH in short) which can avoid problems. Since the COH is based upon Guh's method, the Decision Maker establishes decisions in a way similar to that of the original method.

A model of adaptive decision-making from representation of information environment by quantum fields.

PubMed

Bagarello, F; Haven, E; Khrennikov, A

2017-11-13

We present the mathematical model of decision-making (DM) of agents acting in a complex and uncertain environment (combining huge variety of economical, financial, behavioural and geopolitical factors). To describe interaction of agents with it, we apply the formalism of quantum field theory (QTF). Quantum fields are a purely informational nature. The QFT model can be treated as a far relative of the expected utility theory, where the role of utility is played by adaptivity to an environment (bath). However, this sort of utility-adaptivity cannot be represented simply as a numerical function. The operator representation in Hilbert space is used and adaptivity is described as in quantum dynamics. We are especially interested in stabilization of solutions for sufficiently large time. The outputs of this stabilization process, probabilities for possible choices, are treated in the framework of classical DM. To connect classical and quantum DM, we appeal to Quantum Bayesianism. We demonstrate the quantum-like interference effect in DM, which is exhibited as a violation of the formula of total probability, and hence the classical Bayesian inference scheme.This article is part of the themed issue 'Second quantum revolution: foundational questions'. © 2017 The Author(s).

A model of adaptive decision-making from representation of information environment by quantum fields

NASA Astrophysics Data System (ADS)

Bagarello, F.; Haven, E.; Khrennikov, A.

2017-10-01

We present the mathematical model of decision-making (DM) of agents acting in a complex and uncertain environment (combining huge variety of economical, financial, behavioural and geopolitical factors). To describe interaction of agents with it, we apply the formalism of quantum field theory (QTF). Quantum fields are a purely informational nature. The QFT model can be treated as a far relative of the expected utility theory, where the role of utility is played by adaptivity to an environment (bath). However, this sort of utility-adaptivity cannot be represented simply as a numerical function. The operator representation in Hilbert space is used and adaptivity is described as in quantum dynamics. We are especially interested in stabilization of solutions for sufficiently large time. The outputs of this stabilization process, probabilities for possible choices, are treated in the framework of classical DM. To connect classical and quantum DM, we appeal to Quantum Bayesianism. We demonstrate the quantum-like interference effect in DM, which is exhibited as a violation of the formula of total probability, and hence the classical Bayesian inference scheme. This article is part of the themed issue `Second quantum revolution: foundational questions'.

36 CFR 907.14 - Corporation decision making procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major decision making points all relevant environmental concerns are considered by the Decision Maker, the...

Decision Support | Solar Research | NREL

Science.gov Websites

informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

In the communication chain between scientists and decision makers (end users), scientific outputs, as maps, are a fundamental source of information on hazards zoning and the related at risk areas definition. Anyway the relationship between volcanic phenomena, their probability and potential impact can be complex and the geospatial information not easily decoded or understood by not experts even if decision makers. Focusing on volcanic hazard the goal of MED SUV WP6 Task 3 is to improve the communication efficacy of scientific outputs, to contribute in filling the gap between scientists and decision-makers. Campi Flegrei caldera, in Neapolitan area has been chosen as the pilot research area where to apply an evaluation/validation procedure to provide a robust evaluation of the volcanic maps and its validation resulting from end users response. The selected sample involved are decision makers and officials from Campanian Region Civil Protection and municipalities included in Campi Flegrei RED ZONE, the area exposed to risk from to pyroclastic currents hazard. Semi-structured interviews, with a sample of decision makers and civil protection officials have been conducted to acquire both quantitative and qualitative data. The tested maps have been: the official Campi Flegrei Caldera RED ZONE map, three maps produced by overlapping the Red Zone limit on Orthophoto, DTM and Contour map, as well as other maps included a probabilistic one, showing volcanological data used to border the Red Zone. The outcomes' analysis have assessed level of respondents' understanding of content as displayed, and their needs in representing the complex information embedded in volcanic hazard. The final output has been the development of a leaflet as "guidelines" that can support decision makers and officials in understanding volcanic hazard and risk maps, and also in using them as a communication tool in information program for the population at risk. The same evaluation /validation process has been applied also on the scientific output of MED-SUV WP6, as a tool for the short-term probabilistic volcanic hazard assessment. For the Campi Flegrei volcanic system, the expected tool has been implemented to compute hazard curves, hazard maps and probability maps for tephra fallout on a target grid covering the Campania region. This allows the end user to visualize the hazard from tephra fallout and its uncertainty. The response of end-users to such products will help to determine to what extent end-users understand them, find them useful, and match their requirements. In order to involve also Etna area in WP6 TASK 3 activities, a questionnaire developed in the VUELCO project (Volcanic Unrest in Europe and Latin America) has been proposed to Sicily Civil Protection officials having decision-making responsibility in case of volcanic unrest at Etna and Stromboli, to survey their opinions and requirements also in case of volcanic unrest

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

PubMed

Stamarski, Cailin S; Son Hing, Leanne S

2015-01-01

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

Social motives and strategic misrepresentation in social decision making.

PubMed

Steinel, Wolfgang; De Dreu, Carsten K W

2004-03-01

In 4 experiments, the authors studied the influence of social motives on deception and strategic misrepresentation. In a newly developed information provision game, individuals faced a decision maker whose decision would affect both own and other's outcomes. By withholding information or by giving (in)accurate information about payoffs, participants could try to influence other's decision making. Less accurate and more inaccurate information was given when the decision maker was competitive rather than cooperative (Experiment 1), especially when participants had a prosocial rather than selfish value orientation (Experiments 3 and 4). Accurate information was withheld because of fear of exploitation and greed, and inaccurate information was given because of greed (Experiment 2). Finally, participants engaged in strategic misrepresentation that may trick competitive others into damaging their own and increasing the participant's outcomes.

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

PubMed Central

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

2014-01-01

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

Use of the recognition heuristic depends on the domain's recognition validity, not on the recognition validity of selected sets of objects.

PubMed

Pohl, Rüdiger F; Michalkiewicz, Martha; Erdfelder, Edgar; Hilbig, Benjamin E

2017-07-01

According to the recognition-heuristic theory, decision makers solve paired comparisons in which one object is recognized and the other not by recognition alone, inferring that recognized objects have higher criterion values than unrecognized ones. However, success-and thus usefulness-of this heuristic depends on the validity of recognition as a cue, and adaptive decision making, in turn, requires that decision makers are sensitive to it. To this end, decision makers could base their evaluation of the recognition validity either on the selected set of objects (the set's recognition validity), or on the underlying domain from which the objects were drawn (the domain's recognition validity). In two experiments, we manipulated the recognition validity both in the selected set of objects and between domains from which the sets were drawn. The results clearly show that use of the recognition heuristic depends on the domain's recognition validity, not on the set's recognition validity. In other words, participants treat all sets as roughly representative of the underlying domain and adjust their decision strategy adaptively (only) with respect to the more general environment rather than the specific items they are faced with.

Entropy Methods For Univariate Distributions in Decision Analysis

NASA Astrophysics Data System (ADS)

Abbas, Ali E.

2003-03-01

One of the most important steps in decision analysis practice is the elicitation of the decision-maker's belief about an uncertainty of interest in the form of a representative probability distribution. However, the probability elicitation process is a task that involves many cognitive and motivational biases. Alternatively, the decision-maker may provide other information about the distribution of interest, such as its moments, and the maximum entropy method can be used to obtain a full distribution subject to the given moment constraints. In practice however, decision makers cannot readily provide moments for the distribution, and are much more comfortable providing information about the fractiles of the distribution of interest or bounds on its cumulative probabilities. In this paper we present a graphical method to determine the maximum entropy distribution between upper and lower probability bounds and provide an interpretation for the shape of the maximum entropy distribution subject to fractile constraints, (FMED). We also discuss the problems with the FMED in that it is discontinuous and flat over each fractile interval. We present a heuristic approximation to a distribution if in addition to its fractiles, we also know it is continuous and work through full examples to illustrate the approach.

When is diagnostic testing inappropriate or irrational? Acceptable regret approach.

PubMed

Hozo, Iztok; Djulbegovic, Benjamin

2008-01-01

The authors provide a new model within the framework of theories of bounded rationality for the observed physicians' behavior that their ordering of diagnostic tests may not be rational. Contrary to the prevailing thinking, the authors find that physicians do not act irrationally or inappropriately when they order diagnostic tests in usual clinical practice. When acceptable regret (i.e., regret that a decision maker finds tolerable upon making a wrong decision) is taken into account, the authors show that physicians tend to order diagnostic tests at a higher level of pretest probability of disease than predicted by expected utility theory. They also show why physicians tend to overtest when regret about erroneous decisions is extremely small. Finally, they explain variations in the practice of medicine. They demonstrate that in the same clinical situation, different decision makers might have different acceptable regret thresholds for withholding treatment, for ordering a diagnostic test, or for administering treatment. This in turn means that for some decision makers, the most rational strategy is to do nothing, whereas for others, it may be to order a diagnostic test, and still for others, choosing treatment may be the most rational course of action.

Moving the science data quality dialogue forward

NASA Astrophysics Data System (ADS)

Robinson, Erin; Meyer, Carol B.; Lenhardt, W. Christopher

2012-05-01

Federation of Earth Science Information Partners Summer 2011 Meeting; Santa Fe, New Mexico, 12-15 July 2011 Scientific data quality is important to scientists, archivists, decision makers, and the public. Uncertain quality costs valuable research dollars and has impacts beyond the initial science. The Federation of Earth Science Information Partners (ESIP) is a consortium of Earth science data and technology professionals spanning the government (NASA, National Oceanic and Atmospheric Administration, U.S. Environmental Protection Agency, U.S. Geological Survey (USGS), National Science Foundation), academia, and private sectors (both commercial and nonprofit). The organization is dedicated to transforming research data and information into useful and usable data and information products for decision makers, policy makers, and the public.

Improving IT Portfolio Management Decision Confidence Using Multi-Criteria Decision Making and Hypervariate Display Techniques

ERIC Educational Resources Information Center

Landmesser, John Andrew

2014-01-01

Information technology (IT) investment decision makers are required to process large volumes of complex data. An existing body of knowledge relevant to IT portfolio management (PfM), decision analysis, visual comprehension of large volumes of information, and IT investment decision making suggest Multi-Criteria Decision Making (MCDM) and…

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

EPA Science Inventory

NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

Risk manager formula for success: Influencing decision making.

PubMed

Midgley, Mike

2017-10-01

Providing the ultimate decision makers with a quantitative risk analysis based on thoughtful assessment by the organization's experts enables an efficient decision. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

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

NASA Astrophysics Data System (ADS)

Madani, Kaveh

2016-04-01

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

Toward actionable science: Empowering ecologists to engage in the process of translation through decision-maker and stakeholder partnerships

NASA Astrophysics Data System (ADS)

Enquist, C.; Jackson, S. T.; Garfin, G. M.

2017-12-01

Translational ecology is an approach by which ecologists, stakeholders, and decision-makers work collaboratively to develop and deliver ecological research that, ideally, results in actionable science that leads to improved environmental decision-making. We analyzed a diverse array of real-world case studies and distilled six principles that characterize the practice of translational ecology: communication, commitment, collaboration, engagement, process, and decision-framing. In this talk, we highlight a subset of the case studies that illustrate these principles. Notably, we found that translational ecology is distinct from both basic and applied ecological research. As a practice, the approach deliberately extends research beyond theory or opportunistic applications, motivated by a search for outcomes that directly serve the needs of natural resource managers and decision-makers. Translational ecology is also distinct from knowledge co-production in that it does not require deep engagement between collaborators, although incorporating differing modes of co-production relative to the decision context, associated time frame, and available financial resources can greatly enhance the translational approach. Although there is a need for incentives to pursue in this type of work, we found that the creativity and context-specific knowledge of resource managers, practitioners, and decision-makers informs and enriches the scientific process, helping shape actionable science. Moreover, the process of addressing research questions arising from on-the-ground management issues, rather than from the top-down or expert-oriented perspectives of traditional science, can foster the long-term trust and commitment that is critical for long-term, sustained engagement between partners. Now, perhaps more than ever, the climate and environmental issues facing society are complex, often politicized, and value-laden. We argue that ecological science should play a key role in informing these problems and ecologists can engage as important partners committed to finding solutions. More broadly, scientists that embrace translational approaches are poised to make science-informed decision-making a reality in the face of a rapidly changing global environment.

Against all odds -- Probabilistic forecasts and decision making

NASA Astrophysics Data System (ADS)

Liechti, Katharina; Zappa, Massimiliano

2015-04-01

In the city of Zurich (Switzerland) the setting is such that the damage potential due to flooding of the river Sihl is estimated to about 5 billion US dollars. The flood forecasting system that is used by the administration for decision making runs continuously since 2007. It has a time horizon of max. five days and operates at hourly time steps. The flood forecasting system includes three different model chains. Two of those are run by the deterministic NWP models COSMO-2 and COSMO-7 and one is driven by the probabilistic NWP COSMO-Leps. The model chains are consistent since February 2010, so five full years are available for the evaluation for the system. The system was evaluated continuously and is a very nice example to present the added value that lies in probabilistic forecasts. The forecasts are available on an online-platform to the decision makers. Several graphical representations of the forecasts and forecast-history are available to support decision making and to rate the current situation. The communication between forecasters and decision-makers is quite close. To put it short, an ideal situation. However, an event or better put a non-event in summer 2014 showed that the knowledge about the general superiority of probabilistic forecasts doesn't necessarily mean that the decisions taken in a specific situation will be based on that probabilistic forecast. Some years of experience allow gaining confidence in the system, both for the forecasters and for the decision-makers. Even if from the theoretical point of view the handling during crisis situation is well designed, a first event demonstrated that the dialog with the decision-makers still lacks of exercise during such situations. We argue, that a false alarm is a needed experience to consolidate real-time emergency procedures relying on ensemble predictions. A missed event would probably also fit, but, in our case, we are very happy not to report about this option.

Decision Performance Using Spatial Decision Support Systems: A Geospatial Reasoning Ability Perspective

ERIC Educational Resources Information Center

Erskine, Michael A.

2013-01-01

As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…

Decision-Making Phenomena Described by Expert Nurses Working in Urban Community Health Settings.

ERIC Educational Resources Information Center

Watkins, Mary P.

1998-01-01

Expert community health nurses (n=28) described crucial clinical situations. Content analysis revealed that decision making was both rational and intuitive. Eight themes were identified: decision-making focus, type, purpose, decision-maker characteristics, sequencing of events, data collection methods, facilitators/barriers, and decision-making…

49 CFR 1503.655 - Initial decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Rules of Practice in TSA Civil Penalty Actions § 1503.655 Initial decision. (a) Contents. The ALJ may... copies of that initial decision available to all parties and the TSA decision maker. (b) Written decision... ALJ is persuasive authority in any other civil penalty action, unless appealed and reversed by the TSA...

Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

ERIC Educational Resources Information Center

Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

2014-01-01

Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

The game of making decisions under uncertainty: How sure must one be?

NASA Astrophysics Data System (ADS)

Werner, Micha; Verkade, Jan; Wetterhall, Fredrik; van Andel, Schalk-Jan; Ramos, Maria-Helena

2016-04-01

Probabilistic hydrometeorological forecasting is now widely accepted to be more skillful than deterministic forecasts, and is increasingly being integrated into operational practice. Provided they are reliable and unbiased, probabilistic forecasts have the advantage that they give decision maker not only the forecast value, but also the uncertainty associated to that prediction. Though that information provides more insight, it does now leave the forecaster/decision maker with the challenge of deciding at what level of probability of a threshold being exceeded the decision to act should be taken. According to the cost-loss theory, that probability should be related to the impact of the threshold being exceeded. However, it is not entirely clear how easy it is for decision makers to follow that rule, even when the impact of a threshold being exceeded, and the actions to choose from are known. To continue the tradition in the "Ensemble Hydrometeorological Forecast" session, we will address the challenge of making decisions based on probabilistic forecasts through a game to be played with the audience. We will explore how decisions made differ depending on the known impacts of the forecasted events. Participants will be divided into a number of groups with differing levels of impact, and will be faced with a number of forecast situations. They will be asked to make decisions and record the consequence of those decisions. A discussion of the differences in the decisions made will be presented at the end of the game, with a fuller analysis later posted on the HEPEX web site blog (www.hepex.org).

Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure

ERIC Educational Resources Information Center

Khemka, Ishita; Hickson, Linda; Mallory, Sarah B.

2016-01-01

This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from…

At Least I Tried: The Relationship between Regulatory Focus and Regret Following Action vs. Inaction

PubMed Central

Itzkin, Adi; Van Dijk, Dina; Azar, Ofer H.

2016-01-01

Regret is an unpleasant feeling that may arise following decisions that ended poorly, and may affect the decision-maker's well-being and future decision making. Some studies show that a decision to act leads to greater regret than a decision not to act when both resulted in failure, because the latter is usually the norm. In some cases, when the norm is to act, this pattern is reversed. We suggest that the decision maker's regulatory focus, affects regret after action or inaction. Specifically, promotion-focused individuals, who tend to be more proactive, view action as more normal than prevention-focused individuals, and therefore experience regulatory fit when an action decision is made. Hence, we hypothesized that promotion-focused individuals will feel less regret than prevention-focused individuals when a decision to act ended poorly. In addition, we hypothesized that a trigger for change implied in the situation, decreases the level of regret following action. We tested our hypotheses on a sample of 330 participants enrolled in an online survey. The participants received six decision scenarios, in which they were asked to evaluate the level of regret following action and inaction. Individual regulatory focus was measured by two different scales. Promotion-focused individuals attributed less regret than prevention-focused individuals to action decisions. Regret following inaction was not affected by regulatory focus. In addition, a trigger for change decreases regret following action. Orthodox people tend to attribute more regret than non-orthodox to a person who made an action decision. The results contribute to the literature by showing that not only the situation but also the decision maker's orientation affects the regret after action vs. inaction. PMID:27833581

A mobile and web-based clinical decision support and monitoring system for diabetes mellitus patients in primary care: a study protocol for a randomized controlled trial.

PubMed

Kart, Özge; Mevsim, Vildan; Kut, Alp; Yürek, İsmail; Altın, Ayşe Özge; Yılmaz, Oğuz

2017-11-29

Physicians' guideline use rates for diagnosis, treatment and monitoring of diabetes mellitus (DM) is very low. Time constraints, patient overpopulation, and complex guidelines require alternative solutions for real time patient monitoring. Rapidly evolving e-health technology combined with clinical decision support and monitoring systems (CDSMS) provides an effective solution to these problems. The purpose of the study is to develop a user-friendly, comprehensive, fully integrated web and mobile-based Clinical Decision Support and Monitoring System (CDSMS) for the screening, diagnosis, treatment, and monitoring of DM diseases which is used by physicians and patients in primary care and to determine the effectiveness of the system. The CDSMS will be based on evidence-based guidelines for DM disease. A web and mobile-based application will be developed in which the physician will remotely monitor patient data through mobile applications in real time. The developed CDSMS will be tested in two stages. In the first stage, the usability, understandability, and adequacy of the application will be determined. Five primary care physicians will use the developed application for at least 16 DM patients. Necessary improvements will be made according to physician feedback. In the second phase, a parallel, single-blind, randomized controlled trial will be implemented. DM diagnosed patients will be recruited for the CDSMS trial by their primary care physicians. Ten physicians and their 439 patients will be involved in the study. Eligible participants will be assigned to intervention and control groups with simple randomization. The significance level will be accepted as p < 0.05. In the intervention group, the system will make recommendations on patient monitoring, diagnosis, and treatment. These recommendations will be implemented at the physician's discretion. Patients in the control group will be treated by physicians according to current DM treatment standards. Patients in both groups will be monitored for 6 months. Patient data will be compared between 0th and 6th month of the study. . Clinical and laboratory outcomes will be assessed in person while others will be self-assessed online. The developed system will be the first of its kind to utilize evidence based guidelines to provide health services to DM patients. ClinicalTrials.gov NCT02917226 . 28 September 2016.

Extension of a Computer Assisted Decision Support (CADS) Study to Improve Outcomes in Patients with Type 2 DM Treated by Primary Cary Providers (short title, CADS-X)

DTIC Science & Technology

2012-10-01

National Health and Nutrition Examination Survey (NHANES) data demonstrated that 42.3% of patients with DM have A1Cs over 7% (22). The military healthcare...system (MHS) - where there is no cost to the patient for care and testing supplies - has similar results with hemoglobin A1C’s over 7% in 42% of...Endocrinologists and Certified Diabetes Educators in both military and civilian health care settings (23), the vast majority of patients with DM are

Gaining Momentum: How Media Influences Public Opinion To Push Civil-Military Decision Makers Into Formulating Foreign Policy

DTIC Science & Technology

2016-02-09

1 AIR WAR COLLEGE AIR UNIVERSITY GAINING MOMENTUM: HOW MEDIA INFLUENCES PUBLIC OPINION TO PUSH CIVIL-MILITARY DECISION MAKERS INTO...engagements from the past, evidence suggest the media or press does have an influence over public opinion, especially during times of war and humanitarian...changes and that leaders must take into consideration that public opinion and the media may provide a large amount of influence over how the nation

The bare necessities? A realist review of necessity argumentations used in health care coverage decisions.

PubMed

Kleinhout-Vliek, Tineke; de Bont, Antoinette; Boer, Bert

2017-07-01

Policy makers and insurance companies decide on coverage of care by both calculating (cost-) effectiveness and assessing the necessity of coverage. To investigate argumentations pertaining to necessity used in coverage decisions made by policy makers and insurance companies, as well as those argumentations used by patients, authors, the public and the media. This study is designed as a realist review, adhering to the RAMESES quality standards. Embase, Medline and Web of Science were searched and 98 articles were included that detailed necessity-based argumentations. We identified twenty necessity-based argumentation types. Seven are only used to argue in favour of coverage, five solely for arguing against coverage, and eight are used to argue both ways. A positive decision appears to be facilitated when patients or the public set the decision on the agenda. Moreover, half the argumentation types are only used by patients, authors, the public and the media, whereas the other half is also used by policy makers and insurance companies. The latter group is more accepted and used in more different countries. The majority of necessity-based argumentation types is used for either favouring or opposing coverage, and not for both. Patients, authors, the public and the media use a broader repertoire of argumentation types than policy makers and insurance companies. Copyright © 2017 Elsevier B.V. All rights reserved.

Cost-effectiveness of dapagliflozin versus DPP-4 inhibitors as an add-on to Metformin in the Treatment of Type 2 Diabetes Mellitus from a UK Healthcare System Perspective.

PubMed

Charokopou, M; McEwan, P; Lister, S; Callan, L; Bergenheim, K; Tolley, K; Postema, R; Townsend, R; Roudaut, M

2015-11-05

Type 2 diabetes mellitus (T2DM) is a chronic, progressive condition where the primary treatment goal is to maintain control of glycated haemoglobin (HbA1c). In order for healthcare decision makers to ensure patients receive the highest standard of care within the available budget, the clinical benefits of each treatment option must be balanced against the economic consequences. The aim of this study was to assess the cost-effectiveness of dapagliflozin, the first-in-class sodium-glucose co-transporter 2 (SGLT2) inhibitor, compared with a dipeptidyl peptidase-4 inhibitor (DPP-4i), when added to metformin for the treatment of patients with T2DM inadequately controlled on metformin alone. The previously published and validated Cardiff diabetes model was used as the basis for this economic evaluation, with treatment effect parameters sourced from a systematic review and network meta-analysis. Costs, derived from a UK healthcare system perspective, and quality-adjusted life years (QALYs), were used to present the final outcome as an incremental cost-effectiveness ratio (ICER) over a lifetime horizon. Univariate and probabilistic sensitivity analyses (PSA) were carried out to assess uncertainty in the model results. Compared with DPP-4i, dapagliflozin was associated with a mean incremental benefit of 0.032 QALYs (95% confidence interval [CI]: -0.022, 0.140) and with an incremental cost of £216 (95% CI: £-258, £795). This resulted in an ICER point estimate of £6,761 per QALY gained. Sensitivity analysis determined incremental costs to be insensitive to variation in most parameters, with only the treatment effect on weight having a notable impact on the incremental QALYs; however, there were no scenarios which raised the ICER above £15,000 per QALY. The PSA estimated that dapagliflozin had an 85% probability of being cost-effective at a willingness-to-pay threshold of £20,000 per QALY gained. Dapagliflozin in combination with metformin was shown to be a cost-effective treatment option from a UK healthcare system perspective for patients with T2DM who are inadequately controlled on metformin alone.

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

PubMed

Haynes, R Brian; Wilczynski, Nancy L

2010-02-05

Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses. A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.

The Decision-Making Structure and the Dean.

ERIC Educational Resources Information Center

Johnson, Betty M.; George, Shirley A.

1987-01-01

Characteristics in the college academic setting and the external environment that affect the decision-making structure and that the dean should consider before reorganization are examined. Concepts and theories about governance, decision-making, organizational structure, and characteristics of effective decision makers are also briefly reviewed. A…

Spatial planning using probabilistic flood maps

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo; Mukolwe, Micah; Di Baldassarre, Giuliano

2015-04-01

Probabilistic flood maps account for uncertainty in flood inundation modelling and convey a degree of certainty in the outputs. Major sources of uncertainty include input data, topographic data, model structure, observation data and parametric uncertainty. Decision makers prefer less ambiguous information from modellers; this implies that uncertainty is suppressed to yield binary flood maps. Though, suppressing information may potentially lead to either surprise or misleading decisions. Inclusion of uncertain information in the decision making process is therefore desirable and transparent. To this end, we utilise the Prospect theory and information from a probabilistic flood map to evaluate potential decisions. Consequences related to the decisions were evaluated using flood risk analysis. Prospect theory explains how choices are made given options for which probabilities of occurrence are known and accounts for decision makers' characteristics such as loss aversion and risk seeking. Our results show that decision making is pronounced when there are high gains and loss, implying higher payoffs and penalties, therefore a higher gamble. Thus the methodology may be appropriately considered when making decisions based on uncertain information.

Economic Decisions for Others: An Exception to Loss Aversion Law

PubMed Central

Mengarelli, Flavia; Moretti, Laura; Faralla, Valeria; Vindras, Philippe; Sirigu, Angela

2014-01-01

In everyday life, people often make decisions on behalf of others. The current study investigates whether risk preferences of decision-makers differ when the reference point is no longer their own money but somebody else money. Thirty four healthy participants performed three different monetary risky choices tasks by making decisions for oneself and for another unknown person. Results showed that loss aversion bias was significantly reduced when participants were choosing on behalf of another person compared to when choosing for themselves. The influence of emotions like regret on decision-making may explain these results. We discuss the importance of the sense of responsibility embodied in the emotion of regret in modulating economic decisions for self but not for others. Moreover, our findings are consistent with the Risk-as-feelings hypothesis, suggesting that self-other asymmetrical behavior is due to the extent the decision-maker is affected by the real and emotional consequences of his/her decision. PMID:24454788

The Inferential Structure of Actionable Science in Climatological and Hydrological Co-Productions

NASA Astrophysics Data System (ADS)

Brumble, K. C.

2016-12-01

Across the geophysical sciences, and in hydrology in particular, there is a growing emphasis on and desire to produce "actionable science" and "user-inspired" science. Fueled by the need to make research approachable, intelligible, and useful for decision-makers, policy-makers, and across disciplinary boundaries, actionable science endeavors seek to replace the traditional downward flow of information model for knowledge in the sciences. Instead the focus is on more dynamical knowledge flow between the local and contingent and the vast and complex. New methodologies which allow for the co-production of knowledge between modelers, model users, and decision-makers will be surveyed for the structure of knowledge flow present, and for innovations in communicating and handling uncertainties across traditional disciplinary boundaries. Current and possible future methods for handling sources of uncertainty and cascades of uncertainty will be addressed. Examples will be drawn from recent projects involving the interactions between climate modeling groups, hydrological modelers, and decision makers at the local and regional level in water security to try and identify key methodologies for the co-production of actionable knowledge exportable to other applications in the boundary between systems impacted by climate change.

Family medicine in Iran: facing the health system challenges.

PubMed

Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

2014-11-30

In response to the current fragmented context of health systems, it is essential to support the revitalization of primary health care in order to provide a stronger sense of direction and integrity. Around the world, family medicine recognized as a core discipline for strengthening primary health care setting. This study aimed to understand the perspectives of policy makers and decision makers of Iran's health system about the implementation of family medicine in Iran urban areas. This study is a qualitative study with framework analysis. Purposive semi-structured interviews were conducted with Policy and decision makers in the five main organizations of Iran health care system. The codes were extracted using inductive and deductive methods. According to 27 semi-structured interviews were conducted with Policy and decision makers, three main themes and 8 subthemes extracted, including: The development of referral system, better access to health care and the management of chronic diseases. Family medicine is a viable means for a series of crucial reforms in the face of the current challenges of health system. Implementation of family medicine can strengthen the PHC model in Iran urban areas. Attempting to create a general consensus among various stakeholders is essential for effective implementation of the project.

The determinants of efficiency in the Canadian health care system.

PubMed

Allin, Sara; Grignon, Michel; Wang, Li

2016-01-01

In spite of the vast number of studies measuring economic efficiency in health care, there has been little take-up of this evidence by policy-makers to date. This study provides an illustration of how a system-level study drawing on best practice in empirical measurement of efficiency may be of practical use to health system decision makers and managers. We make use of the rich data available in Canada to undertake a robust two-stage data envelopment analysis to calculate efficiency at the regional (sub-provincial) level. Decisions about what the health system produces (the outcome to measure efficiency against) and what are the resources it has to produce that outcome were based on interviews and consultation with health system decision makers. Overall, we find large inefficiencies in the Canadian health care system, which could improve outcomes (here, measured as a reduction in treatable causes of death) by between 18 and 35% across our analyses. Also, we find that inefficiencies are the result of three main sets of factors that policy makers could pay attention to: management factors, such as hospital re-admissions; public health factors, such as obesity and smoking rates; and environmental factors such as the population's average income.

Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion

PubMed Central

Shamshiri-Milani, Hourieh; Pourreza, Abolghasem; Akbari, Feizollah

2010-01-01

Introduction Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. Materials and Methods A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. Results There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. Conclusion It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights. PMID:23926489

Ethics and public health emergencies: rationing vaccines.

PubMed

Wynia, Matthew K

2006-01-01

There are three broad ethical issues related to handling public health emergencies. They are the three R's-rationing, restrictions and responsibilities. Recently, a severe shortage of annual influenza vaccine in the US, combined with the threat of pandemic flu, has provided an opportunity for policy makers to think about rationing in very concrete terms. Some lessons from annual flu vaccination likely will apply to pandemic vaccine distribution, but many preparatory decisions must be based on very rough estimates. What ethical principles should guide rationing decisions, what data should inform these decisions, how to revise decisions as new data emerge, and how to implement rationing decisions on the ground are all important considerations. In addition, ethicists might be able to help policy makers think through the importance of international cooperation in surmounting global rationing dilemmas and to accept the inevitable responsibilities of government in making and implementing rationing decisions.

A multicriteria decision making approach based on fuzzy theory and credibility mechanism for logistics center location selection.

PubMed

Wang, Bowen; Xiong, Haitao; Jiang, Chengrui

2014-01-01

As a hot topic in supply chain management, fuzzy method has been widely used in logistics center location selection to improve the reliability and suitability of the logistics center location selection with respect to the impacts of both qualitative and quantitative factors. However, it does not consider the consistency and the historical assessments accuracy of experts in predecisions. So this paper proposes a multicriteria decision making model based on credibility of decision makers by introducing priority of consistency and historical assessments accuracy mechanism into fuzzy multicriteria decision making approach. In this way, only decision makers who pass the credibility check are qualified to perform the further assessment. Finally, a practical example is analyzed to illustrate how to use the model. The result shows that the fuzzy multicriteria decision making model based on credibility mechanism can improve the reliability and suitability of site selection for the logistics center.

Escalation research: Providing new frontiers for applying behavior analysis to organizational behavior

PubMed Central

Goltz, Sonia M.

2000-01-01

Decision fiascoes such as escalation of commitment, the tendency of decision makers to “throw good money after bad,” can have serious consequences for organizations and are therefore of great interest in applied research. This paper discusses the use of behavior analysis in organizational behavior research on escalation. Among the most significant aspects of behavior-analytic research on escalation is that it has indicated that both the patterns of outcomes that decision makers have experienced for past decisions and the patterns of responses that they make are critical for understanding escalation. This research has also stimulated the refinement of methods by researchers to better assess decision making and the role reinforcement plays in it. Finally, behavior-analytic escalation research has not only indicated the utility of reinforcement principles for predicting more complex human behavior but has also suggested some additional areas for future exploration of decision making using behavior analysis. PMID:22478347

A Multicriteria Decision Making Approach Based on Fuzzy Theory and Credibility Mechanism for Logistics Center Location Selection

PubMed Central

Wang, Bowen; Jiang, Chengrui

2014-01-01

As a hot topic in supply chain management, fuzzy method has been widely used in logistics center location selection to improve the reliability and suitability of the logistics center location selection with respect to the impacts of both qualitative and quantitative factors. However, it does not consider the consistency and the historical assessments accuracy of experts in predecisions. So this paper proposes a multicriteria decision making model based on credibility of decision makers by introducing priority of consistency and historical assessments accuracy mechanism into fuzzy multicriteria decision making approach. In this way, only decision makers who pass the credibility check are qualified to perform the further assessment. Finally, a practical example is analyzed to illustrate how to use the model. The result shows that the fuzzy multicriteria decision making model based on credibility mechanism can improve the reliability and suitability of site selection for the logistics center. PMID:25215319

CHEMFLO: ONE-DIMENSIONAL WATER AND CHEMICAL MOVEMENT IN UNSATURATED SOILS

EPA Science Inventory

An interactive software system was developed to enable decision-makers, regulators, policy-makers, scientists, consultants, and students to simulate the movement of waterand chemicals in unsaturated soils. Water movement is modeled using Richards (1931) - equation. Chemical trans...

An Overview of NASA's IM&S Verification and Validation Process Plan and Specification for Space Exploration

NASA Technical Reports Server (NTRS)

Gravitz, Robert M.; Hale, Joseph

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. This information will allow the decision-maker to understand the risks involved in using a model's results in the decision-making process. This presentation will discuss NASA's approach for verification and validation (V&V) of its models or simulations supporting space exploration. This presentation will describe NASA's V&V process and the associated M&S verification and validation (V&V) activities required to support the decision-making process. The M&S V&V Plan and V&V Report templates for ESMD will also be illustrated.

Eco-informatics for decision makers advancing a research agenda

USGS Publications Warehouse

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

2005-01-01

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

The prefabricated building risk decision research of DM technology on the basis of Rough Set

NASA Astrophysics Data System (ADS)

Guo, Z. L.; Zhang, W. B.; Ma, L. H.

2017-08-01

With the resources crises and more serious pollution, the green building has been strongly advocated by most countries and become a new building style in the construction field. Compared with traditional building, the prefabricated building has its own irreplaceable advantages but is influenced by many uncertainties. So far, a majority of scholars have been studying based on qualitative researches from all of the word. This paper profoundly expounds its significance about the prefabricated building. On the premise of the existing research methods, combined with rough set theory, this paper redefines the factors which affect the prefabricated building risk. Moreover, it quantifies risk factors and establish an expert knowledge base through assessing. And then reduced risk factors about the redundant attributes and attribute values, finally form the simplest decision rule. This simplest decision rule, which is based on the DM technology of rough set theory, provides prefabricated building with a controllable new decision-making method.

Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries.

PubMed

Baji, Petra; García-Goñi, Manuel; Gulácsi, László; Mentzakis, Emmanouil; Paolucci, Francesco

2016-09-01

In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.

Distributive justice and infertility treatment in Canada.

PubMed

Nisker, Jeff

2008-05-01

An exploration of distributive justice in Canadian infertility treatment requires the integration of ethical, clinical, and economic principles. In 1971, American philosopher John Rawls proposed a theoretical model for fair decision-making in which "rational" and "self-interested" citizens are behind a "veil of ignorance" with respect to both their own position and the position of other decision-makers. Rawls proposed that these self-interested decision-makers, fearing that they are among the least advantaged persons who could be affected by the decision, will agree only upon rules that encode equality of opportunity and that bestow the greatest benefit on the least advantaged citizens. Regarding health policy decision-making, Rawls' model is best illustrated by Canadian philosopher Warren Bourgeois in his panel of "volunteers." These rational and self-interested volunteers receive an amnestic drug that renders them unaware of their health, social, and financial position, but they know that they are representative of diverse spheres of citizens whose well-being will be affected by their decision. After describing fair decision-making, Bourgeois considers the lack of a distributive justice imperative in Canada's Assisted Human Reproduction Act, in contrast to legislation in European nations and Australia, summarizes the economic and clinical considerations that must be provided to the decision-makers behind the "veil of ignorance" for fair decisions to occur, and considers altruism in relation to equality of access. He concludes by noting that among countries with legislation governing assisted reproduction Canada is alone in having legislation that is void of distributive justice in providing access to clinically appropriate infertility care.

Engaging the US Military and Local Communities in Planning for Coastal Flooding Risks

NASA Astrophysics Data System (ADS)

Caldas, A.; Dahl, K. A.; Spanger-Siegfried, E.; Udvardy, S.

2016-12-01

Given their central role in U.S. national security, military installations have historically been well protected. But sea level rise, increased tidal flooding, and heightened storm surges have already been observed in several installations. Understanding and preparing for these risks falls to at least three sets of decision-makers: 1) Military leadership responsible for long-term assessment of installation viability; 2) Planners at each military installation who are responsible for day-to-day decision-making; and 3) Local policy-makers and their constituents, who have vested interests in protecting their assets and communities. To enable decision makers in each of these groups to better understand these risks, and how they may unfold this century, the Union of Concerned Scientists (UCS) designed and executed an analysis of coastal flooding risk as sea level rises. At the outset, we engaged experts from the Department of Defense for input on key questions such as which installations to focus on and which sea level rise projections they found most compelling and most credible. With this input, we analyzed the changing risk of coastal flooding at 18 installations along the US East and Gulf Coasts. When we had preliminary results, we engaged planners at as many installations as possible in reviews of the results. Engaging policy-makers and their constituents is ongoing: As part of the report release, we sent press releases to news outlets both large and small, and report authors were available for interviews, press releases, and Congressional staff briefings. Furthermore, we made all results available in publicly accessible online repositories. By engaging subject matter experts in both the planning and initial review of results, then maximizing transparency and availability upon the publication of our analyses, we have produced an analysis that is relevant to all three sets of decision-makers.

Boundary Organizations: Creating a Unique Model for Sustained Dialog Among Scientists and Decison Makers About Long-term Change

NASA Astrophysics Data System (ADS)

Duncan, B.; Carter, H.; Knight, E.; Meyer, R.

2015-12-01

California Ocean Science Trust is a boundary organization formed by the state of California. We work across traditional boundaries between government, science, and communities to build trust and understanding in ocean and coastal science. We work closely with decision makers to understand their priority needs and identify opportunities for science to have a meaningful impact, and we engage scientists and other experts to compile and translate information into innovative products that help to meet those needs. This often sparks new collaborations that live well beyond the products themselves. Through this unique model, we are deepening relationships and facilitating an ongoing dialogue between scientists, decision-makers, and communities. The West Coast of the United States is already experiencing climate-driven changes in marine conditions at both large and small spatial scales. Decision makers are increasingly concerned with the potential threats that these changes pose to coastal communities, industries, ecosystems, and species. Detecting and understanding these multi-stressor changes requires consideration across scientific disciplines and management jurisdictions. Research and monitoring programs must reflect this new reality: they should be designed to connect with the decision makers who may use their results. In this presentation, I will share how we are drawing from the West Coast Ocean Acidification and Hypoxia Science Panel - an interdisciplinary team of scientists convened by Ocean Science Trust from California, Oregon, Washington, and British Columbia - to develop actionable guidance for long-term monitoring for long-term change. Building on our experiences working with the Panel, I will discuss the unique model that boundary organizations provide for sustained dialog across traditionally siloed disciplines and management regimes, and share best practices and lessons learned in working across those boundaries.

Present-value analysis: A systems approach to public decisionmaking for cost effectiveness

NASA Technical Reports Server (NTRS)

Herbert, T. T.

1971-01-01

Decision makers within Governmental agencies and Congress must evaluate competing (and sometimes conflicting) proposals which seek funding and implementation. Present value analysis can be an effective decision making tool by enabling the formal evaluation of the effects of competing proposals on efficient national resource utilization. A project's costs are not only its direct disbursements, but its social costs as well. How much does it cost to have those funds diverted from their use and economic benefit by the private sector to the public project? Comparisons of competing projects' social costs allow decision makers to expand their decision bases by quantifying the projects' impacts upon the economy and the efficient utilization of the country's limited national resources. A conceptual model is established for the choosing of the appropriate discount rate to be used in evaluation decisions through the technique.

Changing Times, Complex Decisions: Presidential Values and Decision Making

ERIC Educational Resources Information Center

Hornak, Anne M.; Garza Mitchell, Regina L.

2016-01-01

Objective: The objective of this article is to delve more deeply into the thought processes of the key decision makers at community colleges and understand how they make decisions. Specifically, this article focuses on the role of the community college president's personal values in decision making. Method: We conducted interviews with 13…

Moogle, Google, and Garbage Cans: The Impact of Technology on Decision Making

ERIC Educational Resources Information Center

Sellers, Martin P.

2005-01-01

Decision makers are faced daily with making important and pervasive decisions. This is especially significant in higher education, where decisions about academics will have considerable impact on the next generation of leaders. In place of rational decisions about the substance of learning and instruction, academic administrators make incremental…

Ecological Rationality: A Framework for Understanding and Aiding the Aging Decision Maker

PubMed Central

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

2012-01-01

The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker. PMID:22347843

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

PubMed

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

2012-01-01

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

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS

EPA Science Inventory

Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...

A Method for Decision Making using Sustainability Indicators

EPA Science Inventory

Calculations aimed at representing the thought process of decision makers are common within multi-objective decision support tools. These calculations that mathematically describe preferences most often combine various utility scores (i.e., abilities to satisfy desires) with weig...

NASA E-DECIDER Rapid Disaster Decision Support Products

NASA Image and Video Library

2014-09-03

A NASA-funded disaster decision support system, provided a number of rapid response map data products to decision makers at the California Earthquake Clearinghouse following its activation for the Aug. 24, 2014 magnitude 6.0 earthquake in Napa, California

Habits: bridging the gap between personhood and personal identity

PubMed Central

Wagner, Nils-Frederic; Northoff, Georg

2014-01-01

In philosophy, the criteria for personhood (PH) at a specific point in time (synchronic), and the necessary and sufficient conditions of personal identity (PI) over time (diachronic) are traditionally separated. Hence, the transition between both timescales of a person's life remains largely unclear. Personal habits reflect a decision-making (DM) process that binds together synchronic and diachronic timescales. Despite the fact that the actualization of habits takes place synchronically, they presuppose, for the possibility of their generation, time in a diachronic sense. The acquisition of habits therefore rests upon PI over time; that is, the temporal extension of personal decisions is the necessary condition for the possible development of habits. Conceptually, habits can thus be seen as a bridge between synchronic and diachronic timescales of a person's life. In order to investigate the empirical mediation of this temporal linkage, we draw upon the neuronal mechanisms underlying DM; in particular on the distinction between internally and externally guided DM. Externally guided DM relies on external criteria at a specific point in time (synchronic); on a neural level, this has been associated with lateral frontal and parietal brain regions. In contrast, internally guided DM is based on the person's own preferences that involve a more longitudinal and thus diachronic timescale, which has been associated with the brain's intrinsic activity. Habits can be considered to reflect a balance between internally and externally guided DM, which implicates a particular temporal balance between diachronic and synchronic elements, thus linking two different timescales. Based on such evidence, we suggest a habit-based neurophilosophical approach of PH and PI by focusing on the empirically-based linkage between the synchronic and diachronic elements of habits. By doing so, we propose to link together what philosophically has been described and analyzed separately as PH and PI. PMID:24904370

Transition to drug co-use among adolescent cannabis users: The role of decision-making and mental health.

PubMed

Lopez-Quintero, Catalina; Granja, Karen; Hawes, Samuel; Duperrouzel, Jacqueline C; Pacheco-Colón, Ileana; Gonzalez, Raul

2018-05-15

Co-use of cannabis and drugs other than cannabis (DOTC) influences the risk of experiencing cannabis disorders. Accordingly, we explored whether speed of transition to drug co-use, the number of DOTC used, and/or being an experimental cannabis-only user, a regular cannabis-only user, or a regular cannabis user who co-uses DOTC (i.e., cannabis-plus user) were associated with decision-making (DM), mental health disorder symptoms, or cannabis use-related characteristics. We analyzed baseline data from a sub-sample of 266 adolescent (ages 14 to 16) cannabis users (CU) participating in an ongoing longitudinal study. Assessments included semi-structured interviews, self-report questionnaires, and measures of drug use, DM (measured via the Iowa Gambling Task), mental health disorders, and cannabis use-related problems. Endorsing a larger number of mood disorders symptoms was associated with being a regular cannabis-plus user rather than a regular cannabis-only user (AOR = 1.08, C.I.95% 1.01, 1.15). Poorer DM was associated with a faster transition to co-use, such that for each one unit increase in DM performance, the years to onset of drug co-use increased by 1% (p = 0.032). Endorsing a larger number of cannabis use-related problems was positively associated with endorsing a larger number of DOTC used (p = 0.001). This study provides new evidence on the process of drug co-use among CU. Specifically, mood disorder symptoms were associated with use of DOTC among regular CU. Furthermore, poorer DM was associated with a faster transition to drug co-use. Poorer DM and mood disorder symptoms may aggravate or accelerate the onset of adverse consequences among adolescent CU. Copyright © 2018 Elsevier Ltd. All rights reserved.

Expressing collective voices on children's health: photovoice exploration with mothers of young children from the Indian Sundarbans.

PubMed

Ghosh, Upasona; Bose, Shibaji; Bramhachari, Rittika; Mandal, Sabyasachi

2016-11-15

The Indian Sundarbans is marked by inhospitable terrain and frequent climatic shocks which jointly hinder access to health care. Community members, and women in particular, have few means to communicate their concerns to local decision makers. Photovoice is one way in which communities can raise their local health challenges with decision makers. This study unlocks mothers' voices on the determinants of their children's health to inform local level decision-making on child health issues in the Indian Sundarbans. Photovoice action research was conducted in three blocks in the Sundarbans region of West Bengal, India. The project involved eight groups of eight to ten mothers who had at least one child below 6 years of age across four villages. The mothers received training on photo documentation and ethical concerns before taking two rounds of photographs within 6 months, interspersed by fortnightly group meetings facilitated by researchers. Photographs and key messages were communicated to local decision makers during block and village level interface sessions with the mothers and researchers. Mothers' photos focused on specific determinants of health, such as water and sanitation; health status, such as malnutrition and non-communicable diseases; service accessibility; climate conditions; and social issues such as early marriage and recurrent pregnancy. Some issues were not captured by photos but were discussed in group meetings, including domestic violence and the non-availability of medical practitioners. We found differences by mother's educational status, livelihood and caste identity in the extent and nature of photographs taken. As a result of the mother's interface with community decision makers, which included showcasing a selection of their photos, efforts to improve road infrastructure and human resource availability in the primary health centres and local government were realized. Photovoice has the potential to express the voices of vulnerable communities regarding their health needs and can help them dialogue with local decision makers to inform community health policy and planning. More needs to be done to understand how social differences among photovoice participants influences how they engage with the methodology.

Communicating about bioenergy sustainability.

PubMed

Dale, Virginia H; Kline, Keith L; Perla, Donna; Lucier, Al

2013-02-01

Defining and measuring sustainability of bioenergy systems are difficult because the systems are complex, the science is in early stages of development, and there is a need to generalize what are inherently context-specific enterprises. These challenges, and the fact that decisions are being made now, create a need for improved communications among scientists as well as between scientists and decision makers. In order for scientists to provide information that is useful to decision makers, they need to come to an agreement on how to measure and report potential risks and benefits of diverse energy alternatives in a way that allows decision makers to compare options. Scientists also need to develop approaches that contribute information about problems and opportunities relevant to policy and decision making. The need for clear communication is especially important at this time when there is a plethora of scientific papers and reports and it is difficult for the public or decision makers to assess the merits of each analysis. We propose three communication guidelines for scientists whose work can contribute to decision making: (1) relationships between the question and the analytical approach should be clearly defined and make common sense; (2) the information should be presented in a manner that non-scientists can understand; and (3) the implications of methods, assumptions, and limitations should be clear. The scientists' job is to analyze information to build a better understanding of environmental, cultural, and socioeconomic aspects of the sustainability of energy alternatives. The scientific process requires transparency, debate, review, and collaboration across disciplines and time. This paper serves as an introduction to the papers in the special issue on "Sustainability of Bioenergy Systems: Cradle to Grave" because scientific communication is essential to developing more sustainable energy systems. Together these four papers provide a framework under which the effects of bioenergy can be assessed and compared to other energy alternatives to foster sustainability.

Advance directives lessen the decisional burden of surrogate decision-making for the chronically critically ill.

PubMed

Hickman, Ronald L; Pinto, Melissa D

2014-03-01

To identify the relationships between advance directive status, demographic characteristics and decisional burden (role stress and depressive symptoms) of surrogate decision-makers (SDMs) of patients with chronic critical illness. Although the prevalence of advance directives among Americans has increased, SDMs are ultimately responsible for complex medical decisions of the chronically critically ill patient. Decisional burden has lasting psychological effects on SDMs. There is insufficient evidence on the influence of advance directives on the decisional burden of surrogate decision-makers of patients with chronic critical illness. The study was a secondary data analysis of cross-sectional data. Data were obtained from 489 surrogate decision-makers of chronically critically ill patients at two academic medical centres in Northeast Ohio, United States, between September 2005-May 2008. Data were collected using demographic forms and questionnaires. A single-item measure of role stress and the Center for Epidemiological Studies Depression (CESD) scale were used to capture the SDM's decisional burden. Descriptive statistics, t-tests, chi-square and path analyses were performed. Surrogate decision-makers who were nonwhite, with low socioeconomic status and low education level were less likely to have advance directive documentation for their chronically critically ill patient. The presence of an advance directive mitigates the decisional burden by directly reducing the SDM's role stress and indirectly lessening the severity of depressive symptoms. Most SDMs of chronically critically ill patients will not have the benefit of knowing the patient's preferences for life-sustaining therapies and consequently be at risk of increased decisional burden. Study results are clinically useful for patient education on the influence of advance directives. Patients may be informed that SDMs without advance directives are at risk of increased decisional burden and will require decisional support to facilitate patient-centred decision-making. © 2013 John Wiley & Sons Ltd.

Some aspects of diabetes care in Chengdu.

PubMed

Xiu, L J; Shang, D P

1995-10-01

The great impact of diabetes mellitus (DM) on the development of China economically and sociomedically was firstly recognized by knowing the overall prevalence of the disease being 0.67% in the whole country from a nationwide cooperative survey in 1980. Shortly after the cooperative survey an epidemiological study carried out in Chengdu yielded a prevalence in DM of 1.12%, which was almost double the overall prevalence and slightly higher than that of Beijing (1.10%)--the highest one among the 14 places in the cooperative study. Increasing prevalence of DM is a general trend. Over the past decade the incidence of diabetes in hospitalized patients at the First University Hospital, WCUMS, increased from 5.7 to 13.54 per thousand. Factors that fluence the increment of prevalence of DM include increase of total calorie intake (2680 kcal/day in 1990--close to the average world level), inappropriate high carbohydrate diet habit, change of life style, e.g. urbanization, mental stress, and ageing of the population. Primary and secondary care conducted in recent decades involve nutritional intervention, education via news media and workshop, foundation of prevention networks and providing better clinical and laboratory services, etc. Future improvement of diabetes care in this region is determined by activation of the public, motivation of the policy makers, more effective education and propagation by an influenced organization, fund support, man power and resources development, and domestic and international communications and collaborations.

Forgone but not forgotten: the effects of partial and full feedback in "harsh" and "kind" environments.

PubMed

Rakow, Tim; Newell, Ben R; Wright, Louise

2015-12-01

In a perfect world, the choice of any course of action would lead to a satisfactory outcome, and we would obtain feedback about both our chosen course and those we have chosen to forgo. In reality, however, we often face harsh environments in which we can only minimize losses, and we receive impoverished feedback. In these studies, we examined how decision makers dealt with these challenges in a simple task in which we manipulated three features of the decision: The outcomes from the available options were either mostly positive or mostly negative (kind or harsh environment); feedback was either full or partial (outcomes revealed for all options or only for the chosen option); and for the final 20 trials in a sequence, participants either chose on each trial or set an "advance-directive" policy. The propensity to choose the better option was explained by several factors: Full feedback was more beneficial in harsh than in kind environments; policy decisions encouraged better decisions and ameliorated the adverse impact of a harsh environment; and beliefs about the value of strategy diversification predicted switch rates and choice quality. The results suggest a subtle interplay between bottom-up and top-down processes: Although harsh environments encourage poor choices, and some decision makers choose less well than others, this need not imply that the decision maker has failed to identify the better option.

Evidence-based Sensor Tasking for Space Domain Awareness

NASA Astrophysics Data System (ADS)

Jaunzemis, A.; Holzinger, M.; Jah, M.

2016-09-01

Space Domain Awareness (SDA) is the actionable knowledge required to predict, avoid, deter, operate through, recover from, and/or attribute cause to the loss and/or degradation of space capabilities and services. A main purpose for SDA is to provide decision-making processes with a quantifiable and timely body of evidence of behavior(s) attributable to specific space threats and/or hazards. To fulfill the promise of SDA, it is necessary for decision makers and analysts to pose specific hypotheses that may be supported or refuted by evidence, some of which may only be collected using sensor networks. While Bayesian inference may support some of these decision making needs, it does not adequately capture ambiguity in supporting evidence; i.e., it struggles to rigorously quantify 'known unknowns' for decision makers. Over the past 40 years, evidential reasoning approaches such as Dempster Shafer theory have been developed to address problems with ambiguous bodies of evidence. This paper applies mathematical theories of evidence using Dempster Shafer expert systems to address the following critical issues: 1) How decision makers can pose critical decision criteria as rigorous, testable hypotheses, 2) How to interrogate these hypotheses to reduce ambiguity, and 3) How to task a network of sensors to gather evidence for multiple competing hypotheses. This theory is tested using a simulated sensor tasking scenario balancing search versus track responsibilities.

Importance of perspective in economic analyses of cancer screening decisions.

PubMed

Mansley, E C; McKenna, M T

2001-10-06

As the fifth, and final, report in this Lancet series on health economics, we discuss how economic analyses in public health, with cancer screening as the example, differ depending on the perspective taken. We identify nine different, but related, decision makers at various levels, from the individual patient to society as a whole, and discuss how their different viewpoints affect their ultimate decisions. Central to our discussion is the identification of seven distinct components of perspective, each potentially important in the screening decision. In many fields of healthcare, decisions about the use of resources, such as time, wealth, or energy, are made by weighing up the positive and negative consequences of the alternatives under consideration and are thus based on an economic analysis of the situation (although sometimes this process is subconscious). For simplicity, we restrict our report to the effect of perspective on cancer screening decisions and show how the costs (negative consequences) and benefits (positive consequences) vary depending on the decision maker.

Do the right thing: the assumption of optimality in lay decision theory and causal judgment.

PubMed

Johnson, Samuel G B; Rips, Lance J

2015-03-01

Human decision-making is often characterized as irrational and suboptimal. Here we ask whether people nonetheless assume optimal choices from other decision-makers: Are people intuitive classical economists? In seven experiments, we show that an agent's perceived optimality in choice affects attributions of responsibility and causation for the outcomes of their actions. We use this paradigm to examine several issues in lay decision theory, including how responsibility judgments depend on the efficacy of the agent's actual and counterfactual choices (Experiments 1-3), individual differences in responsibility assignment strategies (Experiment 4), and how people conceptualize decisions involving trade-offs among multiple goals (Experiments 5-6). We also find similar results using everyday decision problems (Experiment 7). Taken together, these experiments show that attributions of responsibility depend not only on what decision-makers do, but also on the quality of the options they choose not to take. Copyright © 2015 Elsevier Inc. All rights reserved.

Research on efficiency evaluation model of integrated energy system based on hybrid multi-attribute decision-making.

PubMed

Li, Yan

2017-05-25

The efficiency evaluation model of integrated energy system, involving many influencing factors, and the attribute values are heterogeneous and non-deterministic, usually cannot give specific numerical or accurate probability distribution characteristics, making the final evaluation result deviation. According to the characteristics of the integrated energy system, a hybrid multi-attribute decision-making model is constructed. The evaluation model considers the decision maker's risk preference. In the evaluation of the efficiency of the integrated energy system, the evaluation value of some evaluation indexes is linguistic value, or the evaluation value of the evaluation experts is not consistent. These reasons lead to ambiguity in the decision information, usually in the form of uncertain linguistic values and numerical interval values. In this paper, the risk preference of decision maker is considered when constructing the evaluation model. Interval-valued multiple-attribute decision-making method and fuzzy linguistic multiple-attribute decision-making model are proposed. Finally, the mathematical model of efficiency evaluation of integrated energy system is constructed.

People learn other people's preferences through inverse decision-making.

PubMed

Jern, Alan; Lucas, Christopher G; Kemp, Charles

2017-11-01

People are capable of learning other people's preferences by observing the choices they make. We propose that this learning relies on inverse decision-making-inverting a decision-making model to infer the preferences that led to an observed choice. In Experiment 1, participants observed 47 choices made by others and ranked them by how strongly each choice suggested that the decision maker had a preference for a specific item. An inverse decision-making model generated predictions that were in accordance with participants' inferences. Experiment 2 replicated and extended a previous study by Newtson (1974) in which participants observed pairs of choices and made judgments about which choice provided stronger evidence for a preference. Inverse decision-making again predicted the results, including a result that previous accounts could not explain. Experiment 3 used the same method as Experiment 2 and found that participants did not expect decision makers to be perfect utility-maximizers. Copyright © 2017 Elsevier B.V. All rights reserved.

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…

Variability in school closure decisions in response to 2009 H1N1: a qualitative systems improvement analysis

PubMed Central

2011-01-01

Background School closure was employed as a non-pharmaceutical intervention against pandemic 2009 H1N1, particularly during the first wave. More than 700 schools in the United States were closed. However, closure decisions reflected significant variation in rationales, decision triggers, and authority for closure. This variability presents the opportunity for improved efficiency and decision-making. Methods We identified media reports relating to school closure as a response to 2009 H1N1 by monitoring high-profile sources and searching Lexis-Nexis and Google news alerts, and reviewed reports for key themes. News stories were supplemented by observing conference calls and meetings with health department and school officials, and by discussions with decision-makers and community members. Results There was significant variation in the stated goal of closure decision, including limiting community spread of the virus, protecting particularly vulnerable students, and responding to staff shortages or student absenteeism. Because the goal of closure is relevant to its timing, nature, and duration, unclear rationales for closure can challenge its effectiveness. There was also significant variation in the decision-making authority to close schools in different jurisdictions, which, in some instances, was reflected in open disagreement between school and public health officials. Finally, decision-makers did not appear to expect the level of scientific uncertainty encountered early in the pandemic, and they often expressed significant frustration over changing CDC guidance. Conclusions The use of school closure as a public health response to epidemic disease can be improved by ensuring that officials clarify the goals of closure and tailor closure decisions to those goals. Additionally, authority to close schools should be clarified in advance, and decision-makers should expect to encounter uncertainty disease emergencies unfold and plan accordingly. PMID:21284865

The once and future application of cost-effectiveness analysis.

PubMed

Berger, M L

1999-09-01

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

Choosing and using climate change scenarios for ecological-impact assessments and conservation decisions

USGS Publications Warehouse

Amy K. Snover,; Nathan J. Mantua,; Littell, Jeremy; Michael A. Alexander,; Michelle M. McClure,; Janet Nye,

2013-01-01

Increased concern over climate change is demonstrated by the many efforts to assess climate effects and develop adaptation strategies. Scientists, resource managers, and decision makers are increasingly expected to use climate information, but they struggle with its uncertainty. With the current proliferation of climate simulations and downscaling methods, scientifically credible strategies for selecting a subset for analysis and decision making are needed. Drawing on a rich literature in climate science and impact assessment and on experience working with natural resource scientists and decision makers, we devised guidelines for choosing climate-change scenarios for ecological impact assessment that recognize irreducible uncertainty in climate projections and address common misconceptions about this uncertainty. This approach involves identifying primary local climate drivers by climate sensitivity of the biological system of interest; determining appropriate sources of information for future changes in those drivers; considering how well processes controlling local climate are spatially resolved; and selecting scenarios based on considering observed emission trends, relative importance of natural climate variability, and risk tolerance and time horizon of the associated decision. The most appropriate scenarios for a particular analysis will not necessarily be the most appropriate for another due to differences in local climate drivers, biophysical linkages to climate, decision characteristics, and how well a model simulates the climate parameters and processes of interest. Given these complexities, we recommend interaction among climate scientists, natural and physical scientists, and decision makers throughout the process of choosing and using climate-change scenarios for ecological impact assessment.

The Lenfest Ocean Program's experience in building institutional support for connecting science and decision-making in marine systems

NASA Astrophysics Data System (ADS)

Bednarek, A.; Close, S.; Curran, K.; Hudson, C.

2017-12-01

Addressing contemporary sustainability challenges requires attention to the integration of scientific knowledge into decision-making and deliberation. However, this remains a challenge in practice. We contend that careful stewardship of this process of integration can result in positive, durable outcomes by reconciling the production and use of scientific knowledge, and improve its relevance and utility to decision-makers. We will share lessons learned from a grantmaking program that has addressed this challenge through programmatic innovations, including by supporting staff devoted to an intermediary role. Over the past 13 years, the Lenfest Ocean Program served in a boundary spanning role by integrating decision-makers into the scoping and outreach of program supported scientific research grants. Program staff engage with decision-makers and influencers to identify policy-relevant research questions and approaches, ensuring that the research direction addresses users' needs. As research progresses, the staff monitor the grant's progress to improve the match between the research and user needs. The process is resource-intensive, however, and raises interesting questions about the role and development of this kind of specialist within different kinds of institutions, including funding agencies. We suggest that nurturing this role as a practice and profession could ultimately help the scientific community more efficiently respond to sustainability challenges.

Vulnerability assessment of urban ecosystems driven by water resources, human health and atmospheric environment

NASA Astrophysics Data System (ADS)

Shen, Jing; Lu, Hongwei; Zhang, Yang; Song, Xinshuang; He, Li

2016-05-01

As ecosystem management is a hotspot and urgent topic with increasing population growth and resource depletion. This paper develops an urban ecosystem vulnerability assessment method representing a new vulnerability paradigm for decision makers and environmental managers, as it's an early warning system to identify and prioritize the undesirable environmental changes in terms of natural, human, economic and social elements. The whole idea is to decompose a complex problem into sub-problem, and analyze each sub-problem, and then aggregate all sub-problems to solve this problem. This method integrates spatial context of Geographic Information System (GIS) tool, multi-criteria decision analysis (MCDA) method, ordered weighted averaging (OWA) operators, and socio-economic elements. Decision makers can find out relevant urban ecosystem vulnerability assessment results with different vulnerable attitude. To test the potential of the vulnerability methodology, it has been applied to a case study area in Beijing, China, where it proved to be reliable and consistent with the Beijing City Master Plan. The results of urban ecosystem vulnerability assessment can support decision makers in evaluating the necessary of taking specific measures to preserve the quality of human health and environmental stressors for a city or multiple cities, with identifying the implications and consequences of their decisions.

Volume sharing of reservoir water

NASA Astrophysics Data System (ADS)

Dudley, Norman J.

1988-05-01

Previous models optimize short-, intermediate-, and long-run irrigation decision making in a simplified river valley system characterized by highly variable water supplies and demands for a single decision maker controlling both reservoir releases and farm water use. A major problem in relaxing the assumption of one decision maker is communicating the stochastic nature of supplies and demands between reservoir and farm managers. In this paper, an optimizing model is used to develop release rules for reservoir management when all users share equally in releases, and computer simulation is used to generate an historical time sequence of announced releases. These announced releases become a state variable in a farm management model which optimizes farm area-to-irrigate decisions through time. Such modeling envisages the use of growing area climatic data by the reservoir authority to gauge water demand and the transfer of water supply data from reservoir to farm managers via computer data files. Alternative model forms, including allocating water on a priority basis, are discussed briefly. Results show lower mean aggregate farm income and lower variance of aggregate farm income than in the single decision-maker case. This short-run economic efficiency loss coupled with likely long-run economic efficiency losses due to the attenuated nature of property rights indicates the need for quite different ways of integrating reservoir and farm management.

Interval-valued distributed preference relation and its application to group decision making

PubMed Central

Liu, Yin; Xue, Min; Chang, Wenjun; Yang, Shanlin

2018-01-01

As an important way to help express the preference relation between alternatives, distributed preference relation (DPR) can represent the preferred, non-preferred, indifferent, and uncertain degrees of one alternative over another simultaneously. DPR, however, is unavailable in some situations where a decision maker cannot provide the precise degrees of one alternative over another due to lack of knowledge, experience, and data. In this paper, to address this issue, we propose interval-valued DPR (IDPR) and present its properties of validity and normalization. Through constructing two optimization models, an IDPR matrix is transformed into a score matrix to facilitate the comparison between any two alternatives. The properties of the score matrix are analyzed. To guarantee the rationality of the comparisons between alternatives derived from the score matrix, the additive consistency of the score matrix is developed. In terms of these, IDPR is applied to model and solve multiple criteria group decision making (MCGDM) problem. Particularly, the relationship between the parameters for the consistency of the score matrix associated with each decision maker and those for the consistency of the score matrix associated with the group of decision makers is analyzed. A manager selection problem is investigated to demonstrate the application of IDPRs to MCGDM problems. PMID:29889871

Hesitant Fuzzy Linguistic Preference Utility Set and Its Application in Selection of Fire Rescue Plans.

PubMed

Liao, Huchang; Si, Guangsen; Xu, Zeshui; Fujita, Hamido

2018-04-03

Hesitant fuzzy linguistic term set provides an effective tool to represent uncertain decision information. However, the semantics corresponding to the linguistic terms in it cannot accurately reflect the decision-makers' subjective cognition. In general, different decision-makers' sensitivities towards the semantics are different. Such sensitivities can be represented by the cumulative prospect theory value function. Inspired by this, we propose a linguistic scale function to transform the semantics corresponding to linguistic terms into the linguistic preference values. Furthermore, we propose the hesitant fuzzy linguistic preference utility set, based on which, the decision-makers can flexibly express their distinct semantics and obtain the decision results that are consistent with their cognition. For calculations and comparisons over the hesitant fuzzy linguistic preference utility sets, we introduce some distance measures and comparison laws. Afterwards, to apply the hesitant fuzzy linguistic preference utility sets in emergency management, we develop a method to obtain objective weights of attributes and then propose a hesitant fuzzy linguistic preference utility-TOPSIS method to select the best fire rescue plan. Finally, the validity of the proposed method is verified by some comparisons of the method with other two representative methods including the hesitant fuzzy linguistic-TOPSIS method and the hesitant fuzzy linguistic-VIKOR method.

Decision Analysis for a Sustainable Environment, Economy & Society

EPA Science Inventory

Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts. ...

Decision Analysis For A Sustainable Environment, Economy, & Society

EPA Science Inventory

Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts....

Teachers as Decision-Makers.

ERIC Educational Resources Information Center

Shedd, Joseph B.; And Others

Scholars working from various perspectives are beginning to define teaching as a decision-making process. Research shows that teachers are reflective and connect knowledge to situations through observation, understanding, analysis, interpretation, and decision-making. This paper provides empirical evidence to show the relationship of…

Hypothetical decision making in schizophrenia: The role of expected value computation and “irrational” biases

PubMed Central

Brown, Jaime K.; Waltz, James A.; Strauss, Gregory P.; McMahon, Robert P.; Frank, Michael J.; Gold, James M.

2013-01-01

The aim of the present study was to examine the contributions to decision making (DM) deficits in schizophrenia (SZ) patients, of expected value (EV) estimation and loss aversion. Patients diagnosed with SZ (n=46) and healthy controls (n=34) completed two gambling tasks. In one task, participants chose between two options with the same EV across two conditions: Loss frames and Keep frames. A second task involved accepting or rejecting gambles, in which gain and loss amounts varied, determining the EV of each trial. SZ patients showed a reduced “framing effect” relative to controls, as they did not show an increased tendency to gamble when faced with a certain loss. SZ patients also showed a reduced tendency to modify behavior as a function of EV. The degree to which choices tracked EV correlated significantly with several cognitive measures in both patients and controls. SZ patients show distinct deviations from normal behavior under risk when their decisions are based on prospective outcomes. These deviations are two-fold: cognitive deficits prevent value-based DM in more-impaired patients, and in less-impaired patients there is a lack of influence from well-established subjective biases found in healthy people. These abnormalities likely affect every-day DM strategies in schizophrenia patients. PMID:23664664

Hypothetical decision making in schizophrenia: the role of expected value computation and "irrational" biases.

PubMed

Brown, Jaime K; Waltz, James A; Strauss, Gregory P; McMahon, Robert P; Frank, Michael J; Gold, James M

2013-09-30

The aim of the present study was to examine the contributions to decision making (DM) deficits in schizophrenia (SZ) patients of expected value (EV) estimation and loss aversion. Patients diagnosed with SZ (n=46) and healthy controls (n=34) completed two gambling tasks. In one task, participants chose between two options with the same EV across two conditions: Loss frames and Keep frames. A second task involved accepting or rejecting gambles, in which gain and loss amounts varied, determining the EV of each trial. SZ patients showed a reduced "framing effect" relative to controls, as they did not show an increased tendency to gamble when faced with a certain loss. SZ patients also showed a reduced tendency to modify behavior as a function of EV. The degree to which choices tracked EV correlated significantly with several cognitive measures in both patients and controls. SZ patients show distinct deviations from normal behavior under risk when their decisions are based on prospective outcomes. These deviations are two-fold: cognitive deficits prevent value-based DM in more-impaired patients, and in less-impaired patients there is a lack of influence from well-established subjective biases found in healthy people. These abnormalities likely affect everyday DM strategies in schizophrenia patients. © 2013 Elsevier Ireland Ltd. All rights reserved.

Decision Making Under Uncertainty

DTIC Science & Technology

2010-11-01

A sound approach to rational decision making requires a decision maker to establish decision objectives, identify alternatives, and evaluate those...often violate the axioms of rationality when making decisions under uncertainty. The systematic description of such observations may lead to the...which leads to “anchoring” on the initial value. The fact that individuals have been shown to deviate from rationality when making decisions

An Overview of Evidence-Based Program Registers (EBPRs) for Behavioral Health

PubMed Central

Burkhardt, Jason T.; Schröter, Daniela C.; Magura, Stephen; Means, Stephanie N.; Coryn, Chris L.S.

2015-01-01

Evaluations of behavioral health interventions have identified many that are potentially effective. However, clinicians and other decision makers typically lack the time and ability to effectively search and synthesize the relevant research literature. In response to this opportunity, and to increasing policy and funding pressures for the use of evidence-based practices, a number of “what works” websites have emerged to assist decision makers in selecting interventions with the highest probability of benefit. However, these registers as a whole are not well understood. This article, which represents phase one of a concurrent mixed methods study, presents a review of the scopes, structures, dissemination strategies, uses, and challenges faced by evidence-based registers in the behavioral health disciplines. The major findings of this study show that in general, registers of evidence-based practices are able, to a degree, to identify the most effective practices and meet the needs of decision makers. However, much needs to be done to improve the ability of the registers to fully realize their purpose. PMID:25450777

Near-Term Actions to Address Long-Term Climate Risk

NASA Astrophysics Data System (ADS)

Lempert, R. J.

2014-12-01

Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

Word-of-mouth communications in health care marketing.

PubMed

MacStravic, R S

1985-10-01

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

The Role of Cooperation and Information Exchange in Transnational River Basins: the Zambezi River case

NASA Astrophysics Data System (ADS)

Castelletti, A.; Giuliani, M.; Soncini-Sessa, R.

2012-12-01

The presence of multiple, institutionally independent but physically interconnected decision-makers is a distinctive features of many water resources systems, especially of transnational river basins. The adoption of a centralized approach to study the optimal operation of these systems, as mostly done in the water resources literature, is conceptually interesting to quantify the best achievable performance, but of little practical impact given the real political and institutional setting. Centralized management indeed assumes a cooperative attitude and full information exchange by the involved parties. However, when decision-makers belong to different countries or institutions, it is very likely that they act considering only their local objectives, producing global externalities that negatively impact on other objectives. In this work we adopt a Multi-Agent Systems framework, which naturally allows to represent a set of self-interested agents (decision-makers and/or stakeholders) acting in a distributed decision-making process. According to this agent-based approach, each agent represents a decision-maker, whose decisions are defined by an explicit optimization problem considering only the agent's local interests. In particular, this work assesses the role of information exchange and increasing level of cooperation among originally non-cooperative agents. The Zambezi River basin is used to illustrate the methodology: the four largest reservoirs in the basin (Ithezhithezhi, Kafue-Gorge, Kariba and Cahora Bassa) are mainly operated for maximizing the economic revenue from hydropower energy production with considerably negative effects on the aquatic ecosystem in the Zambezi delta due to the alteration of the natural flow regime. We comparatively analyse the ideal centralized solution and the current situation where all the decision-makers act independently and non-cooperatively. Indeed, although a new basin-level institution called Zambezi Watercourse Commission (ZAMCON) should be established in the next future, Zambia recently refused to sign and ratify the ZAMCON Protocol and the road toward a fully cooperative framework is still long. Results show that increasing levels of information exchange can help in mitigating the conflict generated by a non-cooperative setting as it allows the downstream agents, i.e. Mozambique country, to better adapt to the upstream management strategies. Furthermore, the role of information exchange depends on the considered objectives and it is particularly relevant for environmental interests.

Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in zambia

PubMed Central

2010-01-01

Background Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya. Methods This paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Results Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery. Conclusion Poor status of the AFR conditions of relevance, publicity, appeals and leadership corresponds well to the differing perceptions of fairness and unfairness among outpatient attendees and decision-makers. This may have been re-enforced by existing disagreements between the two groups regarding who the legitimate stakeholders to involve during service delivery were. Conflicts identified in this study could be resolved by promoting application of approaches such as AFR during priority setting in the district. PMID:21040552

Learning consensus in adversarial environments

NASA Astrophysics Data System (ADS)

Vamvoudakis, Kyriakos G.; García Carrillo, Luis R.; Hespanha, João. P.

2013-05-01

This work presents a game theory-based consensus problem for leaderless multi-agent systems in the presence of adversarial inputs that are introducing disturbance to the dynamics. Given the presence of enemy components and the possibility of malicious cyber attacks compromising the security of networked teams, a position agreement must be reached by the networked mobile team based on environmental changes. The problem is addressed under a distributed decision making framework that is robust to possible cyber attacks, which has an advantage over centralized decision making in the sense that a decision maker is not required to access information from all the other decision makers. The proposed framework derives three tuning laws for every agent; one associated with the cost, one associated with the controller, and one with the adversarial input.

Living with a Crucial Decision: A Qualitative Study of Parental Narratives Three Years after the Loss of Their Newborn in the NICU

PubMed Central

Caeymaex, Laurence; Speranza, Mario; Vasilescu, Caroline; Danan, Claude; Bourrat, Marie-Michèle

2011-01-01

Background The importance of involving parents in the end-of-life decision-making-process (EOL DMP) for their child in the neonatal intensive care unit (NICU) is recognised by ethical guidelines in numerous countries. However, studies exploring parents' opinions on the type of involvement report conflicting results. This study sought to explore parents' experience of the EOL DMP for their child in the NICU. Methods The study used a retrospective longitudinal design with a qualitative analysis of parental experience 3 years after the death of their child in four NICUs in France. 53 face-to-face interviews and 80 telephone interviews were conducted with 164 individuals. Semi-structured interviews were conducted to explore how parents perceived their role in the decision process, what they valued about physicians' attitudes in this situation and whether their long-term emotional well being varied according to their perceived role in the EOL DMP. Findings Qualitative analysis identified four types of perceived role in the DMP: shared, medical, informed parental decision, and no decision. Shared DM was the most appreciated by parents. Medical DM was experienced as positive only when it was associated with communication. Informed parental DM was associated with feelings of anxiousness and abandonment. The physicians' attitudes that were perceived as helpful in the long term were explicit sharing of responsibility, clear expression of staff preferences, and respectful care and language toward the child. Interpretation Parents find it valuable to express their opinion in the EOL DMP of their child. Nonetheless, they do need continuous emotional support and an explicit share of the responsibility for the decision. As involvement preferences and associated feelings can vary, parents should be able to decide what role they want to play. However, our study suggests that fully autonomous decisions should be misadvised in these types of tragic choices. PMID:22194873

Adaptive Flexibility and Maladaptive Routines in Selecting Fast and Frugal Decision Strategies

ERIC Educational Resources Information Center

Broder, Arndt; Schiffer, Stefanie

2006-01-01

Decision routines unburden the cognitive capacity of the decision maker. In changing environments, however, routines may become maladaptive. In 2 experiments with a hypothetical stock market game (n = 241), the authors tested whether decision routines tend to persist at the level of decision strategies rather than at the level of options in…

Why, When, and How to Take into Account the Uncertainty Involved in Career Decisions.

ERIC Educational Resources Information Center

Gati, Itamar

1990-01-01

Theoretically analyzes career decisions under uncertainty, when career decision maker ranks options rather than choosing best one. Found that how decisions were framed affected ranking of options and quality of decisions. Analysis showed that the rank order of options in optimal ranking always coincided with the rank order of the options by their…

Robustness Metrics: How Are They Calculated, When Should They Be Used and Why Do They Give Different Results?

NASA Astrophysics Data System (ADS)

McPhail, C.; Maier, H. R.; Kwakkel, J. H.; Giuliani, M.; Castelletti, A.; Westra, S.

2018-02-01

Robustness is being used increasingly for decision analysis in relation to deep uncertainty and many metrics have been proposed for its quantification. Recent studies have shown that the application of different robustness metrics can result in different rankings of decision alternatives, but there has been little discussion of what potential causes for this might be. To shed some light on this issue, we present a unifying framework for the calculation of robustness metrics, which assists with understanding how robustness metrics work, when they should be used, and why they sometimes disagree. The framework categorizes the suitability of metrics to a decision-maker based on (1) the decision-context (i.e., the suitability of using absolute performance or regret), (2) the decision-maker's preferred level of risk aversion, and (3) the decision-maker's preference toward maximizing performance, minimizing variance, or some higher-order moment. This article also introduces a conceptual framework describing when relative robustness values of decision alternatives obtained using different metrics are likely to agree and disagree. This is used as a measure of how "stable" the ranking of decision alternatives is when determined using different robustness metrics. The framework is tested on three case studies, including water supply augmentation in Adelaide, Australia, the operation of a multipurpose regulated lake in Italy, and flood protection for a hypothetical river based on a reach of the river Rhine in the Netherlands. The proposed conceptual framework is confirmed by the case study results, providing insight into the reasons for disagreements between rankings obtained using different robustness metrics.

Possibilities and hindrances for prevention of intimate partner violence: perceptions among professionals and decision makers in a Swedish medium-sized town.

PubMed

Jakobsson, A; von Borgstede, C; Krantz, G; Spak, F; Hensing, G

2013-09-01

Intimate partner violence (IPV) is a major public health problem, but few evidence-based prevention programs have yet been implemented. This study explored the perceptions and beliefs of local-level decision makers, social and health-care professionals, and representatives from the police force regarding the possibilities and hindrances for prevention of IPV. An explorative qualitative approach was used, and participants were strategically selected for focus group discussions. The participants, 19 men and 23 women, were professionals or decision makers within health-care services, social welfare, municipal administration, the police force, local industry, and local politicians in a Swedish town of 54,000 inhabitants. The focus group discussions were audio recorded, transcribed verbatim, and thematically analyzed. A manifest content analysis was performed on the text. Preschools, schools, sports associations, workplaces, and the mass media were suggested as possible arenas for prevention measures. The proposed activities included norm building and improved social support structures. Hindrances were conceptualized as societal beliefs and attitudes, shame, silence, gender inequality, the counteracting influence of the media, and lack of resources. The participants demonstrated closeness and distance to IPV, expressed as acceptance or referral of responsibility to others regarding where and by whom prevention measures should be executed. This study gave new insights in the prevailing perceptions of professionals and decision makers of a medium-sized Swedish town, which can be a useful knowledge in future preventive work and contribute to bridge the gap between research and practice.

Nature of Science and Decision-Making

ERIC Educational Resources Information Center

Khishfe, Rola

2012-01-01

The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…

Decision Making In A High-Tech World: Automation Bias and Countermeasures

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.; Skitka, Linda J.; Burdick, Mark R.; Heers, Susan T.; Rosekind, Mark R. (Technical Monitor)

1996-01-01

Automated decision aids and decision support systems have become essential tools in many high-tech environments. In aviation, for example, flight management systems computers not only fly the aircraft, but also calculate fuel efficient paths, detect and diagnose system malfunctions and abnormalities, and recommend or carry out decisions. Air Traffic Controllers will soon be utilizing decision support tools to help them predict and detect potential conflicts and to generate clearances. Other fields as disparate as nuclear power plants and medical diagnostics are similarly becoming more and more automated. Ideally, the combination of human decision maker and automated decision aid should result in a high-performing team, maximizing the advantages of additional cognitive and observational power in the decision-making process. In reality, however, the presence of these aids often short-circuits the way that even very experienced decision makers have traditionally handled tasks and made decisions, and introduces opportunities for new decision heuristics and biases. Results of recent research investigating the use of automated aids have indicated the presence of automation bias, that is, errors made when decision makers rely on automated cues as a heuristic replacement for vigilant information seeking and processing. Automation commission errors, i.e., errors made when decision makers inappropriately follow an automated directive, or automation omission errors, i.e., errors made when humans fail to take action or notice a problem because an automated aid fails to inform them, can result from this tendency. Evidence of the tendency to make automation-related omission and commission errors has been found in pilot self reports, in studies using pilots in flight simulations, and in non-flight decision making contexts with student samples. Considerable research has found that increasing social accountability can successfully ameliorate a broad array of cognitive biases and resultant errors. To what extent these effects generalize to performance situations is not yet empirically established. The two studies to be presented represent concurrent efforts, with student and professional pilot samples, to determine the effects of accountability pressures on automation bias and on the verification of the accurate functioning of automated aids. Students (Experiment 1) and commercial pilots (Experiment 2) performed simulated flight tasks using automated aids. In both studies, participants who perceived themselves as accountable for their strategies of interaction with the automation were significantly more likely to verify its correctness, and committed significantly fewer automation-related errors than those who did not report this perception.

Mathematical solution of multilevel fractional programming problem with fuzzy goal programming approach

NASA Astrophysics Data System (ADS)

Lachhwani, Kailash; Poonia, Mahaveer Prasad

2012-08-01

In this paper, we show a procedure for solving multilevel fractional programming problems in a large hierarchical decentralized organization using fuzzy goal programming approach. In the proposed method, the tolerance membership functions for the fuzzily described numerator and denominator part of the objective functions of all levels as well as the control vectors of the higher level decision makers are respectively defined by determining individual optimal solutions of each of the level decision makers. A possible relaxation of the higher level decision is considered for avoiding decision deadlock due to the conflicting nature of objective functions. Then, fuzzy goal programming approach is used for achieving the highest degree of each of the membership goal by minimizing negative deviational variables. We also provide sensitivity analysis with variation of tolerance values on decision vectors to show how the solution is sensitive to the change of tolerance values with the help of a numerical example.

Quantum decision-maker theory and simulation

NASA Astrophysics Data System (ADS)

Zak, Michail; Meyers, Ronald E.; Deacon, Keith S.

2000-07-01

A quantum device simulating the human decision making process is introduced. It consists of quantum recurrent nets generating stochastic processes which represent the motor dynamics, and of classical neural nets describing the evolution of probabilities of these processes which represent the mental dynamics. The autonomy of the decision making process is achieved by a feedback from the mental to motor dynamics which changes the stochastic matrix based upon the probability distribution. This feedback replaces unavailable external information by an internal knowledge- base stored in the mental model in the form of probability distributions. As a result, the coupled motor-mental dynamics is described by a nonlinear version of Markov chains which can decrease entropy without an external source of information. Applications to common sense based decisions as well as to evolutionary games are discussed. An example exhibiting self-organization is computed using quantum computer simulation. Force on force and mutual aircraft engagements using the quantum decision maker dynamics are considered.

The neural basis of belief updating and rational decision making

PubMed Central

Achtziger, Anja; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes’ rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision. PMID:22956673

The neural basis of belief updating and rational decision making.

PubMed

Achtziger, Anja; Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes' rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision.

Accelerated bridge construction (ABC) decision making and economic modeling tool.

DOT National Transportation Integrated Search

2011-12-01

In this FHWA-sponsored pool funded study, a set of decision making tools, based on the Analytic Hierarchy Process (AHP) was developed. This tool set is prepared for transportation specialists and decision-makers to determine if ABC is more effective ...

Decision Support Framework (DSF) Team Research Implementation Plan

EPA Science Inventory

The mission of ORD's Ecosystem Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

Decision-making tool for applying adaptive traffic control systems : final report.

DOT National Transportation Integrated Search

2016-03-01

Adaptive traffic signal control technologies have been increasingly deployed in real world situations. The objective of this project was to develop a decision-making tool to guide traffic engineers and decision-makers who must decide whether or not a...

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.

PubMed

Smith, Neale; Mitton, Craig; Bryan, Stirling; Davidson, Alan; Urquhart, Bonnie; Gibson, Jennifer L; Peacock, Stuart; Donaldson, Cam

2013-07-02

Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as 'good' or 'very good'. This paper explores these findings in greater detail and assesses them in context of the larger literature. Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada's health system leadership teams.

Health care priority setting in Norway a multicriteria decision analysis

PubMed Central

2012-01-01

Background Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles. Methods In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. Results The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Conclusions Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions. PMID:22335815

Health care priority setting in Norway a multicriteria decision analysis.

PubMed

Defechereux, Thierry; Paolucci, Francesco; Mirelman, Andrew; Youngkong, Sitaporn; Botten, Grete; Hagen, Terje P; Niessen, Louis W

2012-02-15

Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles. In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.

Knowledge transfer and exchange processes for environmental health issues in Canadian Aboriginal communities.

PubMed

Jack, Susan M; Brooks, Sandy; Furgal, Chris M; Dobbins, Maureen

2010-02-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information.

Knowledge Transfer and Exchange Processes for Environmental Health Issues in Canadian Aboriginal Communities

PubMed Central

Jack, Susan M.; Brooks, Sandy; Furgal, Chris M.; Dobbins, Maureen

2010-01-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information. PMID:20616996

Anxiety Evokes Hypofrontality and Disrupts Rule-Relevant Encoding by Dorsomedial Prefrontal Cortex Neurons.

PubMed

Park, Junchol; Wood, Jesse; Bondi, Corina; Del Arco, Alberto; Moghaddam, Bita

2016-03-16

Anxiety is a debilitating symptom of most psychiatric disorders, including major depression, post-traumatic stress disorder, schizophrenia, and addiction. A detrimental aspect of anxiety is disruption of prefrontal cortex (PFC)-mediated executive functions, such as flexible decision making. Here we sought to understand how anxiety modulates PFC neuronal encoding of flexible shifting between behavioral strategies. We used a clinically substantiated anxiogenic treatment to induce sustained anxiety in rats and recorded from dorsomedial PFC (dmPFC) and orbitofrontal cortex (OFC) neurons while they were freely moving in a home cage and while they performed a PFC-dependent task that required flexible switches between rules in two distinct perceptual dimensions. Anxiety elicited a sustained background "hypofrontality" in dmPFC and OFC by reducing the firing rate of spontaneously active neuronal subpopulations. During task performance, the impact of anxiety was subtle, but, consistent with human data, behavior was selectively impaired when previously correct conditions were presented as conflicting choices. This impairment was associated with reduced recruitment of dmPFC neurons that selectively represented task rules at the time of action. OFC rule representation was not affected by anxiety. These data indicate that a neural substrate of the decision-making deficits in anxiety is diminished dmPFC neuronal encoding of task rules during conflict-related actions. Given the translational relevance of the model used here, the data provide a neuronal encoding mechanism for how anxiety biases decision making when the choice involves overcoming a conflict. They also demonstrate that PFC encoding of actions, as opposed to cues or outcome, is especially vulnerable to anxiety. A debilitating aspect of anxiety is its impact on decision making and flexible control of behavior. These cognitive constructs depend on proper functioning of the prefrontal cortex (PFC). Understanding how anxiety affects PFC encoding of cognitive events is of great clinical and evolutionary significance. Using a clinically valid experimental model, we find that, under anxiety, decision making may be skewed by salient and conflicting environmental stimuli at the expense of flexible top-down guided choices. We also find that anxiety suppresses spontaneous activity of PFC neurons, and weakens encoding of task rules by dorsomedial PFC neurons. These data provide a neuronal encoding scheme for how anxiety disengages PFC during decision making. Copyright © 2016 the authors 0270-6474/16/363322-14$15.00/0.

Economic Evaluation of Environmental Health Interventions to Support Decision Making

PubMed Central

Hutton, Guy

2008-01-01

Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840