Computer-Assisted Career Guidance Systems: A Part of NCDA History

ERIC Educational Resources Information Center

Harris-Bowlsbey, JoAnn

2013-01-01

The first computer-assisted career planning systems were developed in the late 1960s and were based soundly on the best of career development and decision-making theory. Over the years, this tradition has continued as the technology that delivers these systems' content has improved dramatically and as they have been universally accepted as…

A new decision sciences for complex systems.

PubMed

Lempert, Robert J

2002-05-14

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

Development and evaluation of learning module on clinical decision-making in Prosthodontics.

PubMed

Deshpande, Saee; Lambade, Dipti; Chahande, Jayashree

2015-01-01

Best practice strategies for helping students learn the reasoning skills of problem solving and critical thinking (CT) remain a source of conjecture, particularly with regard to CT. The dental education literature is fundamentally devoid of research on the cognitive components of clinical decision-making. This study was aimed to develop and evaluate the impact of blended learning module on clinical decision-making skills of dental graduates for planning prosthodontics rehabilitation. An interactive teaching module consisting of didactic lectures on clinical decision-making and a computer-assisted case-based treatment planning software was developed Its impact on cognitive knowledge gain in clinical decision-making was evaluated using an assessment involving problem-based multiple choice questions and paper-based case scenarios. Mean test scores were: Pretest (17 ± 1), posttest 1 (21 ± 2) and posttest 2 (43 ± 3). Comparison of mean scores was done with one-way ANOVA test. There was overall significant difference in between mean scores at all the three points (P < 0.001). A pair-wise comparison of mean scores was done with Bonferroni test. The mean difference is significant at the 0.05 level. The pair-wise comparison shows that posttest 2 score is significantly higher than posttest 1 and posttest 1 is significantly higher than pretest that is, pretest 2 > posttest 1 > pretest. Blended teaching methods employing didactic lectures on the clinical decision-making as well as computer assisted case-based learning can be used to improve quality of clinical decision-making in prosthodontic rehabilitation for dental graduates.

Computer-assisted navigation in orthopedic surgery.

PubMed

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

2013-08-01

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

The Development, Implementation, and Evaluation of a Computer-Assisted Branched Test for a Program of Individually Prescribed Instruction.

ERIC Educational Resources Information Center

Ferguson, Richard L.

The focus of this study was upon the development and evaluation of a computer-assisted branched test to be used in making instructional decisions for individuals in the program of Individually Prescribed Instruction. A Branched Test is one in which the presentation of test items is contingent upon the previous responses of the examinee. The…

The Use of Microcomputers in the Treatment of Cognitive-Communicative Impairments.

ERIC Educational Resources Information Center

Story, Tamara B.; Sbordone, Robert J.

1988-01-01

The use of microcomputer-assisted therapy as part of the total rehabilitation plan for brain-injured individuals with cognitive-communicative impairments is addressed. Design of effective computer-assisted remediation requires a careful decision-making process. Specific types of software are suggested for dealing with deficits in organization,…

The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

PubMed

Kelly, B D

2015-03-01

Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.

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

PubMed

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

2014-07-06

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

Use of handheld computers in clinical practice: a systematic review

PubMed Central

2014-01-01

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

From vagueness in medical thought to the foundations of fuzzy reasoning in medical diagnosis.

PubMed

Seising, Rudolf

2006-11-01

This article delineates a relatively unknown path in the history of medical philosophy and medical diagnosis. It is concerned with the phenomenon of vagueness in the physician's "style of thinking" and with the use of fuzzy sets, systems, and relations with a view to create a model of such reasoning when physicians make a diagnosis. It represents specific features of medical ways of thinking that were mentioned by the Polish physician and philosopher Ludwik Fleck in 1926. The paper links Lotfi Zadeh's work on system theory before the age of fuzzy sets with system-theory concepts in medical philosophy that were introduced by the philosopher Mario Bunge, and with the fuzzy-theoretical analysis of the notions of health, illness, and disease by the Iranian-German physician and philosopher Kazem Sadegh-Zadeh. Some proposals to apply fuzzy sets in medicine were based on a suggestion made by Zadeh: symptoms and diseases are fuzzy in nature and fuzzy sets are feasible to represent these entity classes of medical knowledge. Yet other attempts to use fuzzy sets in medicine were self-contained. The use of this approach contributed to medical decision-making and the development of computer-assisted diagnosis in medicine. With regard to medical philosophy, decision-making, and diagnosis; the framework of fuzzy sets, systems, and relations is very useful to deal with the absence of sharp boundaries of the sets of symptoms, diagnoses, and phenomena of diseases. The foundations of reasoning and computer assistance in medicine were the result of a rapid accumulation of data from medical research. This explosion of knowledge in medicine gave rise to the speculation that computers could be used for the medical diagnosis. Medicine became, to a certain extent, a quantitative science. In the second half of the 20th century medical knowledge started to be stored in computer systems. To assist physicians in medical decision-making and patient care, medical expert systems using the theory of fuzzy sets and relations (such as the Viennese "fuzzy version" of the Computer-Assisted Diagnostic System, CADIAG, which was developed at the end of the 1970s) were constructed. The development of fuzzy relations in medicine and their application in computer-assisted diagnosis show that this fuzzy approach is a framework to deal with the "fuzzy mode of thinking" in medicine.

The River Basin Model: Computer Output. Water Pollution Control Research Series.

ERIC Educational Resources Information Center

Envirometrics, Inc., Washington, DC.

This research report is part of the Water Pollution Control Research Series which describes the results and progress in the control and abatement of pollution in our nation's waters. The River Basin Model described is a computer-assisted decision-making tool in which a number of computer programs simulate major processes related to water use that…

Undergraduate Student Task Group Approach to Complex Problem Solving Employing Computer Programming.

ERIC Educational Resources Information Center

Brooks, LeRoy D.

A project formulated a computer simulation game for use as an instructional device to improve financial decision making. The author constructed a hypothetical firm, specifying its environment, variables, and a maximization problem. Students, assisted by a professor and computer consultants and having access to B5500 and B6700 facilities, held 16…

Computer Network Operations Methodology

DTIC Science & Technology

2004-03-01

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

Plant Closings and Capital Flight: A Computer-Assisted Simulation.

ERIC Educational Resources Information Center

Warner, Stanley; Breitbart, Myrna M.

1989-01-01

A course at Hampshire College was designed to simulate the decision-making environment in which constituencies in a medium-sized city would respond to the closing and relocation of a major corporate plant. The project, constructed as a role simulation with a computer component, is described. (MLW)

Real time simulation of computer-assisted sequencing of terminal area operations

NASA Technical Reports Server (NTRS)

Dear, R. G.

1981-01-01

A simulation was developed to investigate the utilization of computer assisted decision making for the task of sequencing and scheduling aircraft in a high density terminal area. The simulation incorporates a decision methodology termed Constrained Position Shifting. This methodology accounts for aircraft velocity profiles, routes, and weight classes in dynamically sequencing and scheduling arriving aircraft. A sample demonstration of Constrained Position Shifting is presented where six aircraft types (including both light and heavy aircraft) are sequenced to land at Denver's Stapleton International Airport. A graphical display is utilized and Constrained Position Shifting with a maximum shift of four positions (rearward or forward) is compared to first come, first serve with respect to arrival at the runway. The implementation of computer assisted sequencing and scheduling methodologies is investigated. A time based control concept will be required and design considerations for such a system are discussed.

Apply creative thinking of decision support in electrical nursing record.

PubMed

Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung

2006-01-01

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.

Predictive analytics and child protection: constraints and opportunities.

PubMed

Russell, Jesse

2015-08-01

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

Liability for Personal Injury Caused by Defective Medical Computer Programs

PubMed Central

Brannigan, Vincent M.

1980-01-01

Defective medical computer programs can cause personal injury. Financial responsibility for the injury under tort law will turn on several factors: whether the program is a product or a service, what types of defect exist in the product, and who produced the program. The factors involved in making these decisions are complex, but knowledge of the relevant issues can assist computer personnel in avoiding liability.

77 FR 10744 - Agency Information Collection Activities; Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

... establish disclosure requirements that assist consumers in making informed purchasing decisions, and... establish disclosure requirements that assist consumers in making informed purchasing decisions and... disclosure requirements that assist consumers in making informed purchasing decisions, and recordkeeping...

76 FR 77230 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

... consumers in making informed purchasing decisions, and recordkeeping requirements that assist the Commission... Rules establish disclosure requirements that assist consumers in making informed purchasing decisions... consumers in making informed purchasing decisions, and recordkeeping requirements that assist the Commission...

Medical imaging and registration in computer assisted surgery.

PubMed

Simon, D A; Lavallée, S

1998-09-01

Imaging, sensing, and computing technologies that are being introduced to aid in the planning and execution of surgical procedures are providing orthopaedic surgeons with a powerful new set of tools for improving clinical accuracy, reliability, and patient outcomes while reducing costs and operating times. Current computer assisted surgery systems typically include a measurement process for collecting patient specific medical data, a decision making process for generating a surgical plan, a registration process for aligning the surgical plan to the patient, and an action process for accurately achieving the goals specified in the plan. Some of the key concepts in computer assisted surgery applied to orthopaedics with a focus on the basic framework and underlying technologies is outlined. In addition, technical challenges and future trends in the field are discussed.

INDIVIDUALIZING UNIVERSITY INSTRUCTION, EXPLORING COMPUTER POTENTIAL TO AID COLLEGE TEACHERS BY DIRECTING THE LEARNING PROCESS. INTER-UNIVERSITY PROJECT ONE, PUBLICATIONS SERIES.

ERIC Educational Resources Information Center

FALL, CHARLES R.

THIS DOCUMENT CONCLUDES THAT INSTRUCTION BY COMPUTER-BASED RESOURCE UNITS CAN FACILITATE LEARNING AND PROVIDE THE INSTRUCTOR WITH VALUABLE ASSISTANCE. BY PRE-PLANNING THE TEACHING-LEARNING SITUATION, RESOURCE UNITS CAN FREE THE INSTRUCTOR FOR DECISION-MAKING TASKS. RESOURCE UNITS CAN ALSO PROVIDE APPROPRIATE LEARNING GOALS AND STUDY GUIDES TO EACH…

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

PubMed

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

2012-07-01

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

Multi-criteria decision making development of ion chromatographic method for determination of inorganic anions in oilfield waters based on artificial neural networks retention model.

PubMed

Stefanović, Stefica Cerjan; Bolanča, Tomislav; Luša, Melita; Ukić, Sime; Rogošić, Marko

2012-02-24

This paper describes the development of ad hoc methodology for determination of inorganic anions in oilfield water, since their composition often significantly differs from the average (concentration of components and/or matrix). Therefore, fast and reliable method development has to be performed in order to ensure the monitoring of desired properties under new conditions. The method development was based on computer assisted multi-criteria decision making strategy. The used criteria were: maximal value of objective functions used, maximal robustness of the separation method, minimal analysis time, and maximal retention distance between two nearest components. Artificial neural networks were used for modeling of anion retention. The reliability of developed method was extensively tested by the validation of performance characteristics. Based on validation results, the developed method shows satisfactory performance characteristics, proving the successful application of computer assisted methodology in the described case study. Copyright © 2011 Elsevier B.V. All rights reserved.

Strategic Imagination: The Lost Dimension of Strategic Studies.

DTIC Science & Technology

1984-09-01

the advent of computer technology brought about not only an increased usage of gaming techniques, but also broadened the spectrum of prob- lems and...direct relevance for the use of experts as advisors in decision-making, especially in areas of broad or long-range policy formulation. It is useful for...and the Anti Submarine Warfare trainer in Norfolk. 5. Computer Assisted Games The advent of computers opened many new possibili- ties for scenario

Three-dimensional-printed cardiac prototypes aid surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases: Early experience and proof of concept in a resource-limited environment.

PubMed

Kappanayil, Mahesh; Koneti, Nageshwara Rao; Kannan, Rajesh R; Kottayil, Brijesh P; Kumar, Krishna

2017-01-01

Three-dimensional. (3D) printing is an innovative manufacturing process that allows computer-assisted conversion of 3D imaging data into physical "printouts" Healthcare applications are currently in evolution. The objective of this study was to explore the feasibility and impact of using patient-specific 3D-printed cardiac prototypes derived from high-resolution medical imaging data (cardiac magnetic resonance imaging/computed tomography [MRI/CT]) on surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases (CHDs). Five patients with complex CHD with previously unresolved management decisions were chosen. These included two patients with complex double-outlet right ventricle, two patients with criss-cross atrioventricular connections, and one patient with congenitally corrected transposition of great arteries with pulmonary atresia. Cardiac MRI was done for all patients, cardiac CT for one; specific surgical challenges were identified. Volumetric data were used to generate patient-specific 3D models. All cases were reviewed along with their 3D models, and the impact on surgical decision-making and preoperative planning was assessed. Accurate life-sized 3D cardiac prototypes were successfully created for all patients. The models enabled radically improved 3D understanding of anatomy, identification of specific technical challenges, and precise surgical planning. Augmentation of existing clinical and imaging data by 3D prototypes allowed successful execution of complex surgeries for all five patients, in accordance with the preoperative planning. 3D-printed cardiac prototypes can radically assist decision-making, planning, and safe execution of complex congenital heart surgery by improving understanding of 3D anatomy and allowing anticipation of technical challenges.

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

ERIC Educational Resources Information Center

Marble, James E.; And Others

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

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

ERIC Educational Resources Information Center

May, Donald M.; And Others

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

The NASA/Baltimore Applications Project (BAP). Computer aided dispatch and communications system for the Baltimore Fire Department: A case study of urban technology application

NASA Technical Reports Server (NTRS)

Levine, A. L.

1981-01-01

An engineer and a computer expert from Goddard Space Flight Center were assigned to provide technical assistance in the design and installation of a computer assisted system for dispatching and communicating with fire department personnel and equipment in Baltimore City. Primary contributions were in decision making and management processes. The project is analyzed from four perspectives: (1) fire service; (2) technology transfer; (3) public administration; and (5) innovation. The city benefitted substantially from the approach and competence of the NASA personnel. Given the proper conditions, there are distinct advantages in having a nearby Federal laboratory provide assistance to a city on a continuing basis, as is done in the Baltimore Applications Project.

Individual Differences in Learner Controlled CAI.

ERIC Educational Resources Information Center

Judd, Wilson A.; And Others

Two assumptions in support of learner-controlled computer-assisted instruction (CAI) are that (1) instruction administered under learner control will be less aversive than if administered under program control, and (2) the student is sufficiently aware of his learning state to make, in most instances, his own instructional decisions. Some 130…

Guidelines for the Development of Computerized Student Information Systems.

ERIC Educational Resources Information Center

Armes, Nancy, Ed.; And Others

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

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

ERIC Educational Resources Information Center

Miller, Randolph A.

2009-01-01

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

An Investigation Into the Navy Public Works Centers Specific Work Service Processing Problems.

DTIC Science & Technology

1980-12-01

demonstrated. These computations are from Navy Area Audit Service reports or PWC and NAVFACENGCOM reports. Number One-time Annual Personnel 3,553...study, all of the endorsements, and a Navy Audit Service audit of the cost analysis, the CNO makes the final consolidation decision. With a decision to...organizations to which local activities turn for environmental issue assistance such as noise, water and air polution , airfield encroachment, local

Systematic Analysis of the Decision Rules of Traditional Chinese Medicine

PubMed Central

Bin-Rong, Ma; Xi-Yuan, Jiang; Su-Ming, Liso; Huai-ning, Zhu; Xiu-ru, Lin

1981-01-01

Chinese traditional medicine has evolved over many centuries, and has accumulated a body of observed relationships between symptoms, signs and prognoses, and the efficacy of alternative treatments and prescriptions. With the assistance of a computer-based clinical data base for recording the diagnostic and therapeutic practice of skilled practitioners of Chinese traditional medicine, a systematic program is being conducted to identify and define the clinical decision-making rules that underlie current practice.

A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation.

PubMed

van der Krieke, Lian; Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

2013-10-07

Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical decision making (COMRADE satisfaction with communication: F1,68=0.422, P=.52; COMRADE confidence in decision: F1,67=0.086, P=.77). In addition, results of the process evaluation suggest that the intervention did not optimally fit in with routine practice of the participating teams. The development of electronic decision aids to facilitate shared medical decision making is encouraged and many people with a psychotic disorder can work with them. This holds for both first-episode patients and long-term care patients, although the latter group might need more assistance. However, results of this paper could not support the assumption that the use of electronic decision aids increases patient involvement in medical decision making. This may be because of weak implementation of the study protocol and a low response rate.

[End-of-life decisions and practices in critically ill patients in the cardiac intensive care unit. A nationwide survey].

PubMed

Schimmer, C; Hamouda, K; Oezkur, M; Sommer, S-P; Leistner, M; Leyh, R

2016-03-01

Ethical and medical criteria in the decision-making process of withholding or withdrawal of life support therapy in critically ill patients present a great challenge in intensive care medicine. The purpose of this work was to assess medical and ethical criteria that influence the decision-making process for changing the aim of therapy in critically ill cardiac surgery patients. A questionnaire was distributed to all German cardiac surgery centers (n = 79). All clinical directors, intensive care unit (ICU) consultants and ICU head nurses were asked to complete questionnaires (n = 237). In all, 86 of 237 (36.3 %) questionnaires were returned. Medical reasons which influence the decision-making process for changing the aim of therapy were cranial computed tomography (cCT) with poor prognosis (91.9 %), multi-organ failure (70.9 %), and failure of assist device therapy (69.8 %). Concerning ethical reasons, poor expected quality of life (48.8 %) and the presumed patient's wishes (40.7 %) were reported. There was a significant difference regarding the perception of the three different professional groups concerning medical and ethical criteria as well as the involvement in the decision-making process. In critically ill cardiac surgery patients, medical reasons which influence the decision-making process for changing the aim of therapy included cCT with poor prognosis, multi-organ failure, and failure of assist device therapy. Further studies are mandatory in order to be able to provide adequate answers to this difficult topic.

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

PubMed

Miller, Randolph A

2009-09-01

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

Dopamine Beta Hydroxylase Genotype Identifies Individuals Less Susceptible to Bias in Computer-Assisted Decision Making

PubMed Central

Parasuraman, Raja; de Visser, Ewart; Lin, Ming-Kuan; Greenwood, Pamela M.

2012-01-01

Computerized aiding systems can assist human decision makers in complex tasks but can impair performance when they provide incorrect advice that humans erroneously follow, a phenomenon known as “automation bias.” The extent to which people exhibit automation bias varies significantly and may reflect inter-individual variation in the capacity of working memory and the efficiency of executive function, both of which are highly heritable and under dopaminergic and noradrenergic control in prefrontal cortex. The dopamine beta hydroxylase (DBH) gene is thought to regulate the differential availability of dopamine and norepinephrine in prefrontal cortex. We therefore examined decision-making performance under imperfect computer aiding in 100 participants performing a simulated command and control task. Based on two single nucleotide polymorphism (SNPs) of the DBH gene, −1041 C/T (rs1611115) and 444 G/A (rs1108580), participants were divided into groups of low and high DBH enzyme activity, where low enzyme activity is associated with greater dopamine relative to norepinephrine levels in cortex. Compared to those in the high DBH enzyme activity group, individuals in the low DBH enzyme activity group were more accurate and speedier in their decisions when incorrect advice was given and verified automation recommendations more frequently. These results indicate that a gene that regulates relative prefrontal cortex dopamine availability, DBH, can identify those individuals who are less susceptible to bias in using computerized decision-aiding systems. PMID:22761865

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

PubMed Central

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

2012-01-01

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

Computer-assisted learning and simulation systems in dentistry--a challenge to society.

PubMed

Welk, A; Splieth, Ch; Wierinck, E; Gilpatrick, R O; Meyer, G

2006-07-01

Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted learning (CAL) and computer-assisted simulation (CAS) systems still appear to be underutilized in dental education. Advantages, challenges, problems, and solutions of computer-assisted learning and simulation in dentistry are discussed by means of MEDLINE, open Internet platform searches, and key results of a study among German dental schools. The advantages of computer-assisted learning are seen for example in self-paced and self-directed learning and increased motivation. It is useful for both objective theoretical and practical tests and for training students to handle complex cases. CAL can lead to more structured learning and can support training in evidence-based decision-making. The reasons for the still relatively rare implementation of CAL/CAS systems in dental education include an inability to finance, lack of studies of CAL/CAS, and too much effort required to integrate CAL/CAS systems into the curriculum. To overcome the reasons for the relative low degree of computer technology use, we should strive for multicenter research and development projects monitored by the appropriate national and international scientific societies, so that the potential of computer technology can be fully realized in graduate, postgraduate, and continuing dental education.

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

NASA Astrophysics Data System (ADS)

Rimland, Jeffrey; McNeese, Michael; Hall, David

2013-05-01

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

Recruiter Perceptions of Information that Employment References Should Provide to Assist in Making Selection Decisions

ERIC Educational Resources Information Center

Evuleocha, Stevina U.; Ugbah, Steve D.; Law, Sweety

2009-01-01

Authors investigated perceptions of campus recruiters (N = 168) in the San Francisco Bay Area regarding the importance of 15 types of information they solicit from job applicants' references in making selection decisions. Results suggest campus recruiters should consider 10 types of information to assist them in making selection decisions. Results…

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Automated dredging and disposal alternatives management system (ADDAMS). Environmental effects of dredging. Technical note

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

NONE

This technical note describes the current capabilities and availability of the Automated Dredging and Disposal Alternatives Management System (ADDAMS). The technical note replaces the earlier Technical Note EEDP-06-12, which should be discarded. Planning, design, and management of dredging and dredged material disposal projects often require complex or tedious calculations or involve complex decision-making criteria. In addition, the evaluations often must be done for several disposal alternatives or disposal sites. ADDAMS is a personal computer (PC)-based system developed to assist in making such evaluations in a timely manner. ADDAMS contains a collection of computer programs (applications) designed to assist in managingmore » dredging projects. This technical note describes the system, currently available applications, mechanisms for acquiring and running the system, and provisions for revision and expansion.« less

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

PubMed Central

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

2006-01-01

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

A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

PubMed Central

Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

2013-01-01

Background Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. Objective This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. Methods The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical decision making (COMRADE satisfaction with communication: F1,68=0.422, P=.52; COMRADE confidence in decision: F1,67=0.086, P=.77). In addition, results of the process evaluation suggest that the intervention did not optimally fit in with routine practice of the participating teams. Conclusions The development of electronic decision aids to facilitate shared medical decision making is encouraged and many people with a psychotic disorder can work with them. This holds for both first-episode patients and long-term care patients, although the latter group might need more assistance. However, results of this paper could not support the assumption that the use of electronic decision aids increases patient involvement in medical decision making. This may be because of weak implementation of the study protocol and a low response rate. Trial Registration Dutch Trial Register (NTR) trial number: 10340; http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=10340 (Archived by WebCite at http://www.webcitation.org/6Jj5umAeS). PMID:24100091

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.

75 FR 36102 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... will discuss, make recommendations, and vote on premarket approval application for MelaFind, sponsored by MELA Sciences, Inc. MelaFind is a non-invasive computer vision system intended to assist in the... characteristics of melanoma, before a final decision to biopsy has been rendered. MelaFind acquires and displays...

Ubiquitous Performance-Support System as Mindtool: A Case Study of Instructional Decision Making and Learning Assistant

ERIC Educational Resources Information Center

Peng, Hsinyi; Chuang, Po-Ya; Hwang, Gwo-Jen; Chu, Hui-Chun; Wu, Ting-Ting; Huang, Shu-Xian

2009-01-01

Researchers have conducted various studies on applying wireless communication and ubiquitous computing technologies to education, so that the technologies can provide learners and educators with more active and adaptive support. This study proposes a Ubiquitous Performance-support System (UPSS) that can facilitate the seamless use of powerful new…

29 CFR 2509.96-1 - Interpretive bulletin relating to participant investment education.

Code of Federal Regulations, 2010 CFR

2010-07-01

...., regarding general investment principles and strategies, to assist them in making investment decisions. 29..., whose investment decisions will directly affect their income at retirement, with information designed to assist them in making investment and retirement-related decisions appropriate to their particular...

Computer-assisted image analysis to quantify daily growth rates of broiler chickens.

PubMed

De Wet, L; Vranken, E; Chedad, A; Aerts, J M; Ceunen, J; Berckmans, D

2003-09-01

1. The objective was to investigate the possibility of detecting daily body weight changes of broiler chickens with computer-assisted image analysis. 2. The experiment included 50 broiler chickens reared under commercial conditions. Ten out of 50 chickens were randomly selected and video recorded (upper view) 18 times during the 42-d growing period. The number of surface and periphery pixels from the images was used to derive a relationship between body dimension and live weight. 3. The relative error in weight estimation, expressed in terms of the standard deviation of the residuals from image surface data was 10%, while it was found to be 15% for the image periphery data. 4. Image-processing systems could be developed to assist the farmer in making important management and marketing decisions.

Graphic Representations as Tools for Decision Making.

ERIC Educational Resources Information Center

Howard, Judith

2001-01-01

Focuses on the use of graphic representations to enable students to improve their decision making skills in the social studies. Explores three visual aids used in assisting students with decision making: (1) the force field; (2) the decision tree; and (3) the decision making grid. (CMK)

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.

AQUATOOL, a generalized decision-support system for water-resources planning and operational management

NASA Astrophysics Data System (ADS)

Andreu, J.; Capilla, J.; Sanchís, E.

1996-04-01

This paper describes a generic decision-support system (DSS) which was originally designed for the planning stage of dicision-making associated with complex river basins. Subsequently, it was expanded to incorporate modules relating to the operational stage of decision-making. Computer-assisted design modules allow any complex water-resource system to be represented in graphical form, giving access to geographically referenced databases and knowledge bases. The modelling capability includes basin simulation and optimization modules, an aquifer flow modelling module and two modules for risk assessment. The Segura and Tagus river basins have been used as case studies in the development and validation phases. The value of this DSS is demonstrated by the fact that both River Basin Agencies currently use a version for the efficient management of their water resources.

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

PubMed

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

2012-10-01

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

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

PubMed Central

Weaver, Robert R.

1987-01-01

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

PSYCHE: An Object-Oriented Approach to Simulating Medical Education

PubMed Central

Mullen, Jamie A.

1990-01-01

Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

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

ERIC Educational Resources Information Center

Murillo, Leo

2017-01-01

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

Attributes Affecting Computer-Aided Decision Making--A Literature Survey.

ERIC Educational Resources Information Center

Moldafsky, Neil I; Kwon, Ik-Whan

1994-01-01

Reviews current literature about personal, demographic, situational, and cognitive attributes that affect computer-aided decision making. The effectiveness of computer-aided decision making is explored in relation to decision quality, effectiveness, and confidence. Studies of the effects of age, anxiety, cognitive type, attitude, gender, and prior…

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

Robust Decision Making: The Cognitive and Computational Modeling of Team Problem Solving for Decision Making under Complex and Dynamic Conditions

DTIC Science & Technology

2015-07-14

AFRL-OSR-VA-TR-2015-0202 Robust Decision Making: The Cognitive and Computational Modeling of Team Problem Solving for Decision Making under Complex...Computational Modeling of Team Problem Solving for Decision Making Under Complex and Dynamic Conditions 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA9550-12-1...functioning as they solve complex problems, and propose the means to improve the performance of teams, under changing or adversarial conditions. By

44 CFR 9.6 - Decision-making process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making process. 9.6... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process... protection decision-making process to be followed by the Agency in applying the Orders to its actions. While...

DoD Research and Engineering Enterprise

DTIC Science & Technology

2014-05-01

Secretary of Defense Hagel, Pentagon Press Briefing Room, February 24, 2014 Technological superiority has been central to the strategy of the...understand the environment, to software algorithms that can make a decision or seek human assistance. Through autonomy, we should be able to greatly reduce...computers are a commercial product 1 , and quantum key distribution for data encryption is nearly a commercial product. These two applications are

Exploring Effective Decision Making through Human-Centered and Computational Intelligence Methods

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

Han, Kyungsik; Cook, Kristin A.; Shih, Patrick C.

Decision-making has long been studied to understand a psychological, cognitive, and social process of selecting an effective choice from alternative options. Its studies have been extended from a personal level to a group and collaborative level, and many computer-aided decision-making systems have been developed to help people make right decisions. There has been significant research growth in computational aspects of decision-making systems, yet comparatively little effort has existed in identifying and articulating user needs and requirements in assessing system outputs and the extent to which human judgments could be utilized for making accurate and reliable decisions. Our research focus ismore » decision-making through human-centered and computational intelligence methods in a collaborative environment, and the objectives of this position paper are to bring our research ideas to the workshop, and share and discuss ideas.« less

Amyotrophic lateral sclerosis and assisted ventilation: how patients decide.

PubMed

Lemoignan, Josée; Ells, Carolyn

2010-06-01

Throughout the course of their illness, people with amyotrophic lateral sclerosis (ALS) must make many treatment decisions; however, none has such a significant impact on quality of life and survival as decisions about assisted ventilation. The purpose of this study was to better understand the experience of decision-making about assisted ventilation for ALS patients. Using qualitative phenomenology methodology, 10 semi-structured interviews were conducted with persons with ALS and their caregivers to elicit factors that are pertinent to their decision-making process about assisted ventilation. Six main themes emerged from the interviews. (1) the meaning of the intervention - participants made a sharp distinction between non-invasive ventilation, which they viewed as a means to relieve symptoms of respiratory failure, and invasive ventilation, which they viewed as taking over their breathing and thereby saving their life when they otherwise would die, (2) the importance of context - including functional status, available supports, and financial implications, (3) the importance of values - with respect to communication, relationships, autonomy, life, and quality of life, (4) the effect of fears - particularly respiratory distress, chocking, running out of air, and the process of death itself, (5) the need for information - how use of assisted ventilation would impact daily life, how death from respiratory failure would occur, how caregivers and persons with ALS differ in their information needs and common misconceptions, and (6) adaptation to or acceptance of the intervention - a lengthy process that involved gradual familiarization with the equipment and its benefits. People with ALS and caregivers value autonomy in decision-making about assisted ventilation. Their decision-making process is neither wholly rational nor self-interested, and includes factors that health professionals should anticipate and address. Discussions about assisted ventilation and timing should be tailored to each individual and undertaken periodically.

Application Of The CSRL Language To The Design Of Diagnostic Expert Systems: The Moodis Experience, A Preliminary Report

NASA Astrophysics Data System (ADS)

Bravos, Angelo; Hill, Howard; Choca, James; Bresolin, Linda B.; Bresolin, Michael J.

1986-03-01

Computer technology is rapidly becoming an inseparable part of many health science specialties. Recently, a new area of computer technology, namely Artificial Intelligence, has been applied toward assisting the medical experts in their diagnostic and therapeutic decision making process. MOODIS is an experimental diagnostic expert system which assists Psychiatry specialists in diagnosing human Mood Disorders, better known as Affective Disorders. Its diagnostic methodology is patterned after MDX, a diagnostic expert system developed at LAIR (Laboratory for Artificial Intelligence Research) of Ohio State University. MOODIS is implemented in CSRL (Conceptual Structures Representation Language) also developed at LAIR. This paper describes MOODIS in terms of conceptualization and requirements, and discusses why the MDX approach and CSRL were chosen.

Biomedical wellness challenges and opportunities

NASA Astrophysics Data System (ADS)

Tangney, John F.

2012-06-01

The mission of ONR's Human and Bioengineered Systems Division is to direct, plan, foster, and encourage Science and Technology in cognitive science, computational neuroscience, bioscience and bio-mimetic technology, social/organizational science, training, human factors, and decision making as related to future Naval needs. This paper highlights current programs that contribute to future biomedical wellness needs in context of humanitarian assistance and disaster relief. ONR supports fundamental research and related technology demonstrations in several related areas, including biometrics and human activity recognition; cognitive sciences; computational neurosciences and bio-robotics; human factors, organizational design and decision research; social, cultural and behavioral modeling; and training, education and human performance. In context of a possible future with automated casualty evacuation, elements of current science and technology programs are illustrated.

Evolutionary and Neural Computing Based Decision Support System for Disease Diagnosis from Clinical Data Sets in Medical Practice.

PubMed

Sudha, M

2017-09-27

As a recent trend, various computational intelligence and machine learning approaches have been used for mining inferences hidden in the large clinical databases to assist the clinician in strategic decision making. In any target data the irrelevant information may be detrimental, causing confusion for the mining algorithm and degrades the prediction outcome. To address this issue, this study attempts to identify an intelligent approach to assist disease diagnostic procedure using an optimal set of attributes instead of all attributes present in the clinical data set. In this proposed Application Specific Intelligent Computing (ASIC) decision support system, a rough set based genetic algorithm is employed in pre-processing phase and a back propagation neural network is applied in training and testing phase. ASIC has two phases, the first phase handles outliers, noisy data, and missing values to obtain a qualitative target data to generate appropriate attribute reduct sets from the input data using rough computing based genetic algorithm centred on a relative fitness function measure. The succeeding phase of this system involves both training and testing of back propagation neural network classifier on the selected reducts. The model performance is evaluated with widely adopted existing classifiers. The proposed ASIC system for clinical decision support has been tested with breast cancer, fertility diagnosis and heart disease data set from the University of California at Irvine (UCI) machine learning repository. The proposed system outperformed the existing approaches attaining the accuracy rate of 95.33%, 97.61%, and 93.04% for breast cancer, fertility issue and heart disease diagnosis.

Nordic couples' decision-making processes during assisted reproduction treatments.

PubMed

Sol Olafsdottir, Helga; Wikland, Matts; Möller, Anders

2013-06-01

To study couples' perceptions of their decision-making process during the first three years of infertility treatments. This study is a part of a larger project studying the decision-making processes of 22 infertile heterosexual couples, recruited from fertility clinics in all five Nordic countries, over a three year period. A descriptive qualitative method was used. Process of decision-making during assisted reproduction treatments. Seventeen couples had succeeded in becoming parents after approximately three years. Our study suggests that the decision-making process during fertility treatments has three phases: (i) recognizing the decisions to be made, with subcategories; the driving force, mutual project, (ii) gathering knowledge and experience about the options, with subcategories; trust, patient competence, personalized support, and (iii) adapting decisions to possible options, with subcategories; strategic planning, adaption. The core category was "maintaining control in a situation of uncertainty." Two parallel processes affect couples' decision-making process, one within themselves and their relationship, and the other in their contact with the fertility clinic. Couples struggle to make decisions, trusting clinic personnel for guidance, knowledge, and understanding. Nevertheless, couples expressed disappointment with the clinics' reactions to their requests for shared decision-making. Copyright © 2013 Elsevier B.V. All rights reserved.

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

Multi-objective decision-making under uncertainty: Fuzzy logic methods

NASA Technical Reports Server (NTRS)

Hardy, Terry L.

1995-01-01

Fuzzy logic allows for quantitative representation of vague or fuzzy objectives, and therefore is well-suited for multi-objective decision-making. This paper presents methods employing fuzzy logic concepts to assist in the decision-making process. In addition, this paper describes software developed at NASA Lewis Research Center for assisting in the decision-making process. Two diverse examples are used to illustrate the use of fuzzy logic in choosing an alternative among many options and objectives. One example is the selection of a lunar lander ascent propulsion system, and the other example is the selection of an aeration system for improving the water quality of the Cuyahoga River in Cleveland, Ohio. The fuzzy logic techniques provided here are powerful tools which complement existing approaches, and therefore should be considered in future decision-making activities.

The use of wireless laptop computers for computer-assisted learning in pharmacokinetics.

PubMed

Munar, Myrna Y; Singh, Harleen; Belle, Donna; Brackett, Carolyn C; Earle, Sandra B

2006-02-15

To implement computer-assisted learning workshops into pharmacokinetics courses in a doctor of pharmacy (PharmD) program. Workshops were designed for students to utilize computer software programs on laptop computers to build pharmacokinetic models to predict drug concentrations resulting from various dosage regimens. In addition, students were able to visualize through graphing programs how altering different parameters changed drug concentration-time curves. Surveys were conducted to measure students' attitudes toward computer technology before and after implementation. Finally, traditional examinations were used to evaluate student learning. Doctor of pharmacy students responded favorably to the use of wireless laptop computers in problem-based pharmacokinetic workshops. Eighty-eight percent (n = 61/69) and 82% (n = 55/67) of PharmD students completed surveys before and after computer implementation, respectively. Prior to implementation, 95% of students agreed that computers would enhance learning in pharmacokinetics. After implementation, 98% of students strongly agreed (p < 0.05) that computers enhanced learning. Examination results were significantly higher after computer implementation (89% with computers vs. 84% without computers; p = 0.01). Implementation of wireless laptop computers in a pharmacokinetic course enabled students to construct their own pharmacokinetic models that could respond to changing parameters. Students had greater comprehension and were better able to interpret results and provide appropriate recommendations. Computer-assisted pharmacokinetic techniques can be powerful tools when making decisions about drug therapy.

The Use of Wireless Laptop Computers for Computer-Assisted Learning in Pharmacokinetics

PubMed Central

Munar, Myrna Y.; Singh, Harleen; Belle, Donna; Brackett, Carolyn C.; Earle, Sandra B.

2006-01-01

Objective To implement computer-assisted learning workshops into pharmacokinetics courses in a doctor of pharmacy (PharmD) program. Design Workshops were designed for students to utilize computer software programs on laptop computers to build pharmacokinetic models to predict drug concentrations resulting from various dosage regimens. In addition, students were able to visualize through graphing programs how altering different parameters changed drug concentration-time curves. Surveys were conducted to measure students’ attitudes toward computer technology before and after implementation. Finally, traditional examinations were used to evaluate student learning. Assessment Doctor of pharmacy students responded favorably to the use of wireless laptop computers in problem-based pharmacokinetic workshops. Eighty-eight percent (n = 61/69) and 82% (n = 55/67) of PharmD students completed surveys before and after computer implementation, respectively. Prior to implementation, 95% of students agreed that computers would enhance learning in pharmacokinetics. After implementation, 98% of students strongly agreed (p < 0.05) that computers enhanced learning. Examination results were significantly higher after computer implementation (89% with computers vs. 84% without computers; p = 0.01). Conclusion Implementation of wireless laptop computers in a pharmacokinetic course enabled students to construct their own pharmacokinetic models that could respond to changing parameters. Students had greater comprehension and were better able to interpret results and provide appropriate recommendations. Computer-assisted pharmacokinetic techniques can be powerful tools when making decisions about drug therapy. PMID:17136147

A Knowledge-Based System for the Computer Assisted Diagnosis of Endoscopic Images

NASA Astrophysics Data System (ADS)

Kage, Andreas; Münzenmayer, Christian; Wittenberg, Thomas

Due to the actual demographic development the use of Computer-Assisted Diagnosis (CAD) systems becomes a more important part of clinical workflows and clinical decision making. Because changes on the mucosa of the esophagus can indicate the first stage of cancerous developments, there is a large interest to detect and correctly diagnose any such lesion. We present a knowledge-based system which is able to support a physician with the interpretation and diagnosis of endoscopic images of the esophagus. Our system is designed to support the physician directly during the examination of the patient, thus prodving diagnostic assistence at the point of care (POC). Based on an interactively marked region in an endoscopic image of interest, the system provides a diagnostic suggestion, based on an annotated reference image database. Furthermore, using relevant feedback mechanisms, the results can be enhanced interactively.

COMMUNITY CAPACITY BUILDING FOR REVITALIZATION AND SUSTAINABLE REDEVELOPMENT

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

Downing, Melinda; Rosenthall, John; Hudson, Michelle

2003-02-27

Capacity building programs help poor and disadvantaged communities to improve their ability to participate in the environmental decision-making processes. They encourage citizen involvement, and provide the tools that enable them to do so. Capacity building enables communities that would otherwise be excluded to participate in the process, leading to better, and more just decisions. The Department of Energy (DOE) continues to be committed to promoting environmental justice and involving its stakeholders more directly in the planning and decision-making process for environmental cleanup. DOE's Environmental Management Program (EM) is in full support of this commitment. Through its environmental justice project, EMmore » provides communities with the capacity to effectively contribute to a complex technical decision-making process by furnishing access to computers, the Internet, training and technical assistance. DOE's Dr. Samuel P. Massie Chairs of Excellence Program (Massie Chairs) function as technical advisors to many of these community projects. The Massie Chairs consist of nationally and internationally recognized engineers and scientists from nine Historically Black Colleges and Universities (HBCUs) and one Hispanic Serving Institution (HIS). This paper will discuss capacity building initiatives in various jurisdictions.« less

77 FR 40634 - Solicitation for a Cooperative Agreement: Pretrial Technical Assistance for Evidence-Based...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

...: Pretrial Technical Assistance for Evidence-Based Decision Making in Local Criminal Justice Systems AGENCY... NIC initiative, Evidence-Based Decision Making (EBDM) in Local Criminal Justice Systems. Work under... individual system planning activities. These change strategies are critical to meeting their system's harm...

75 FR 31285 - Decision-Making Authority Regarding the Denial, Suspension, or Revocation of a Federal Firearms...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... No. ATF 17F; AG Order No. 3160-2010 (2008R-10P)] Decision-Making Authority Regarding the Denial... decision-making and to address any case backlogs that may occur. DATES: This rule is effective August 2... Assistant Director (Enforcement Programs and Services). These changes to the decision-making and related...

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

PubMed

Parker, Lisa

2017-07-01

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

The impact of cancer diagnosis and treatment on employment, income, treatment decisions and financial assistance and their relationship to socioeconomic and disease factors.

PubMed

Paul, Christine; Boyes, Allison; Hall, Alix; Bisquera, Alessandra; Miller, Annie; O'Brien, Lorna

2016-11-01

The financial impact of cancer diagnosis and treatment can be considerable to individuals and their households, leading to changes in treatment decision making. This study aimed to quantify effects on income and employment; describe how cost-related factors influence treatment decision making and need for financial assistance; and to identify patient sociodemographic factors associated with treatment decision making, use of financial assistance and financial effects. A cross-sectional self-report questionnaire was administered to oncology outpatients from two hospitals in Australia: one regional and one metropolitan. Of 255 participants, 67 % indicated a change in employment and 63 % of those reported reduced household income since their diagnosis. Travel (15 %), loss of income (14 %) and cost of treatments (11 %) were commonly cited factors influencing treatment decision making. Seventy-four percent of participants reported that they did not access financial assistance, with more than a third (37 %) of those being unaware that financial assistance was available. Being currently not employed and more recent diagnosis were associated with a reduced income since diagnosis. After adjusting for employment status and age, patients with private health insurance had higher odds of reporting that financial factors had influenced treatment decision making (OR = 2.5). Unemployment is a major driver of the financial impact of cancer. The costs of treatment may be particularly challenging for those with private health insurance who are more likely to be treated in the private health system where out-of-pocket costs are greater. Improved access to financial assistance is required to better avoid potential inequities.

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

PubMed

Posa, Andreas

2016-06-01

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

Big data, smart homes and ambient assisted living.

PubMed

Vimarlund, V; Wass, S

2014-08-15

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

Temporal lobe epilepsy surgery: what do patients want to know?

PubMed

Choi, Hyunmi; Pargeon, Kim; Bausell, Rebecca; Wong, John B; Mendiratta, Anil; Bakken, Suzanne

2011-11-01

Patients with pharmacoresistant temporal lobe epilepsy (TLE) contemplating brain surgery must make a complex treatment decision involving trade-offs. Patient decision aids, containing information on the risks and benefits of treatment interventions, increase patient knowledge and facilitate shared decision making between patients and physicians. We conducted five focus groups to describe the information patients need to make informed decisions about TLE surgery. Twenty patients who had undergone TLE surgery described the information used in their decision-making process, and evaluated the potential for a patient decision aid to assist other patients who are considering surgery. Thematic analysis revealed information needs that were both experiential (i.e., learning about other patients' experiences through testimonials) and factual (i.e., individualized statistical information). Patients also made suggestions on how this information should be delivered to patients. These data will accelerate the development of a patient decision aid designed to assist TLE patients in their decision making about epilepsy surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

Adaptive Allocation of Decision Making Responsibility Between Human and Computer in Multi-Task Situations. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Chu, Y. Y.

1978-01-01

A unified formulation of computer-aided, multi-task, decision making is presented. Strategy for the allocation of decision making responsibility between human and computer is developed. The plans of a flight management systems are studied. A model based on the queueing theory was implemented.

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

PubMed Central

Olin, Emma; von Schreeb, Johan

2014-01-01

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

An approach to quality and performance control in a computer-assisted clinical chemistry laboratory.

PubMed Central

Undrill, P E; Frazer, S C

1979-01-01

A locally developed, computer-based clinical chemistry laboratory system has been in operation since 1970. This utilises a Digital Equipment Co Ltd PDP 12 and an interconnected PDP 8/F computer. Details are presented of the performance and quality control techniques incorporated into the system. Laboratory performance is assessed through analysis of results from fixed-level control sera as well as from cumulative sum methods. At a simple level the presentation may be considered purely indicative, while at a more sophisticated level statistical concepts have been introduced to aid the laboratory controller in decision-making processes. PMID:438340

The multimedia computer for office-based patient education: a systematic review.

PubMed

Wofford, James L; Smith, Edward D; Miller, David P

2005-11-01

Use of the multimedia computer for education is widespread in schools and businesses, and yet computer-assisted patient education is rare. In order to explore the potential use of computer-assisted patient education in the office setting, we performed a systematic review of randomized controlled trials (search date April 2004 using MEDLINE and Cochrane databases). Of the 26 trials identified, outcome measures included clinical indicators (12/26, 46.1%), knowledge retention (12/26, 46.1%), health attitudes (15/26, 57.7%), level of shared decision-making (5/26, 19.2%), health services utilization (4/26, 17.6%), and costs (5/26, 19.2%), respectively. Four trials targeted patients with breast cancer, but the clinical issues were otherwise diverse. Reporting of the testing of randomization (76.9%) and appropriate analysis of main effect variables (70.6%) were more common than reporting of a reliable randomization process (35.3%), blinding of outcomes assessment (17.6%), or sample size definition (29.4%). We concluded that the potential for improving the efficiency of the office through computer-assisted patient education has been demonstrated, but better proof of the impact on clinical outcomes is warranted before this strategy is accepted in the office setting.

Big data and high-performance analytics in structural health monitoring for bridge management

NASA Astrophysics Data System (ADS)

Alampalli, Sharada; Alampalli, Sandeep; Ettouney, Mohammed

2016-04-01

Structural Health Monitoring (SHM) can be a vital tool for effective bridge management. Combining large data sets from multiple sources to create a data-driven decision-making framework is crucial for the success of SHM. This paper presents a big data analytics framework that combines multiple data sets correlated with functional relatedness to convert data into actionable information that empowers risk-based decision-making. The integrated data environment incorporates near real-time streams of semi-structured data from remote sensors, historical visual inspection data, and observations from structural analysis models to monitor, assess, and manage risks associated with the aging bridge inventories. Accelerated processing of dataset is made possible by four technologies: cloud computing, relational database processing, support from NOSQL database, and in-memory analytics. The framework is being validated on a railroad corridor that can be subjected to multiple hazards. The framework enables to compute reliability indices for critical bridge components and individual bridge spans. In addition, framework includes a risk-based decision-making process that enumerate costs and consequences of poor bridge performance at span- and network-levels when rail networks are exposed to natural hazard events such as floods and earthquakes. Big data and high-performance analytics enable insights to assist bridge owners to address problems faster.

Computers in medicine: liability issues for physicians.

PubMed

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

1989-07-01

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

Prostate cancer screening and shared decision-making preferences among African-American members of the Prince Hall Masons.

PubMed

Williams, Randi M; Zincke, Nicole L; Turner, Ralph O; Davis, Jackson L; Davis, Kimberly M; Schwartz, Marc D; Johnson, Lenora; Kerner, Jon F; Taylor, Kathryn L

2008-10-01

Shared decision making (SDM) is recommended as one method to assist men in making an informed decision about prostate cancer screening (PCS). SDM preferences for PCS have not been evaluated among African-American (AA) men. Given AA men's increased risk and the uncertainty surrounding screening, it is critical to determine how to assist AA men in making an informed decision. We assessed the extent to which a sample of AA men wished to engage in SDM regarding PCS and the demographic and psychological characteristics associated with SDM preferences. Participants completed a telephone interview that covered demographic and medical information, SDM preferences, PCS knowledge, decisional conflict, and satisfaction with previous screening decisions. Subjects included 286 AA men aged 40-70, who were members of a Masonic organization. Fifty-seven percent preferred SDM, 36% preferred to make their own decision, and 7% wanted their doctor to decide. A higher level of education and older age were associated with preferring SDM (p<0.05), while men with greater PCS knowledge were more likely to prefer to make the decision independently (p<0.05). Results suggest that physicians need to be prepared to discuss PCS with their patients. Further, more attention may be needed to engage younger, less educated, and less knowledgeable men as they may be less likely to discuss PCS. This understanding of AA men's preferences for PCS decisions helps to clarify the issues that health professionals need to consider when attempting to assist AA men in making a PCS decision. Copyright (c) 2008 John Wiley & Sons, Ltd.

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

NASA Technical Reports Server (NTRS)

Scholtz, Jean C.

1991-01-01

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

Effectiveness of an Electronic Performance Support System on Computer Ethics and Ethical Decision-Making Education

ERIC Educational Resources Information Center

Kert, Serhat Bahadir; Uz, Cigdem; Gecu, Zeynep

2014-01-01

This study examined the effectiveness of an electronic performance support system (EPSS) on computer ethics education and the ethical decision-making processes. There were five different phases to this ten month study: (1) Writing computer ethics scenarios, (2) Designing a decision-making framework (3) Developing EPSS software (4) Using EPSS in a…

Computer-assisted abdominal surgery: new technologies.

PubMed

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

2015-04-01

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

Creation of an Open Framework for Point-of-Care Computer-Assisted Reporting and Decision Support Tools for Radiologists.

PubMed

Alkasab, Tarik K; Bizzo, Bernardo C; Berland, Lincoln L; Nair, Sujith; Pandharipande, Pari V; Harvey, H Benjamin

2017-09-01

Decreasing unnecessary variation in radiology reporting and producing guideline-concordant reports is fundamental to radiology's success in value-based payment models and good for patient care. In this article, we present an open authoring system for point-of-care clinical decision support tools integrated into the radiologist reporting environment referred to as the computer-assisted reporting and decision support (CAR/DS) framework. The CAR/DS authoring system, described herein, includes: (1) a definition format for representing radiology clinical guidelines as structured, machine-readable Extensible Markup Language documents and (2) a user-friendly reference implementation to test the fidelity of the created definition files with the clinical guideline. The proposed definition format and reference implementation will enable content creators to develop CAR/DS tools that voice recognition software (VRS) vendors can use to extend the commercial tools currently in use. In making the definition format and reference implementation software freely available, we hope to empower individual radiologists, expert groups such as the ACR, and VRS vendors to develop a robust ecosystem of CAR/DS tools that can further improve the quality and efficiency of the patient care that our field provides. We hope that this initial effort can serve as the basis for a community-owned open standard for guideline definition that the imaging informatics and VRS vendor communities will embrace and strengthen. To this end, the ACR Assist™ initiative is intended to make the College's clinical content, including the Incidental Findings Committee White Papers, available for decision support tool creation based upon the herein described CAR/DS framework. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Artificial intelligence - New tools for aerospace project managers

NASA Technical Reports Server (NTRS)

Moja, D. C.

1985-01-01

Artificial Intelligence (AI) is currently being used for business-oriented, money-making applications, such as medical diagnosis, computer system configuration, and geological exploration. The present paper has the objective to assess new AI tools and techniques which will be available to assist aerospace managers in the accomplishment of their tasks. A study conducted by Brown and Cheeseman (1983) indicates that AI will be employed in all traditional management areas, taking into account goal setting, decision making, policy formulation, evaluation, planning, budgeting, auditing, personnel management, training, legal affairs, and procurement. Artificial intelligence/expert systems are discussed, giving attention to the three primary areas concerned with intelligent robots, natural language interfaces, and expert systems. Aspects of information retrieval are also considered along with the decision support system, and expert systems for project planning and scheduling.

Earth observations and global change decision making: A special bibliography, 1991

NASA Technical Reports Server (NTRS)

1991-01-01

The first section of the bibliography contains 294 bibliographic citations and abstracts of relevant reports, articles, and documents announced in 'Scientific and Technical Aerospace Reports (STAR)' and 'International Aerospace Abstracts (IAA)'. These abstracts are categorized by the following major subject divisions: aeronautics, astronautics, chemistry and materials, engineering, geosciences, life sciences, mathematical and computer sciences, physics, social sciences, space sciences and general. Following the abstract section, seven indexes are provided for further assistance.

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

NASA Technical Reports Server (NTRS)

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

1977-01-01

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

The Allied Health Care Professional's Role in Assisting Medical Decision Making at the End of Life

ERIC Educational Resources Information Center

Lambert, Heather

2012-01-01

As a patient approaches the end of life, he or she faces a number of very difficult medical decisions. Allied health care professionals, including speech-language pathologists (SLPs) and occupational therapists (OTs), can be instrumental in assisting their patients to make advance care plans, although their traditional job descriptions do not…

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

PubMed

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

2011-05-01

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

Role of Computer Assisted Instruction (CAI) in an Introductory Computer Concepts Course.

ERIC Educational Resources Information Center

Skudrna, Vincent J.

1997-01-01

Discusses the role of computer assisted instruction (CAI) in undergraduate education via a survey of related literature and specific applications. Describes an undergraduate computer concepts course and includes appendices of instructions, flowcharts, programs, sample student work in accounting, COBOL instructional model, decision logic in a…

Preaching What We Practice: Teaching Ethical Decision-Making to Computer Security Professionals

NASA Astrophysics Data System (ADS)

Fleischmann, Kenneth R.

The biggest challenge facing computer security researchers and professionals is not learning how to make ethical decisions; rather it is learning how to recognize ethical decisions. All too often, technology development suffers from what Langdon Winner terms technological somnambulism - we sleepwalk through our technology design, following past precedents without a second thought, and fail to consider the perspectives of other stakeholders [1]. Computer security research and practice involves a number of opportunities for ethical decisions. For example, decisions about whether or not to automatically provide security updates involve tradeoffs related to caring versus user autonomy. Decisions about online voting include tradeoffs between convenience and security. Finally, decisions about routinely screening e-mails for spam involve tradeoffs of efficiency and privacy. It is critical that these and other decisions facing computer security researchers and professionals are confronted head on as value-laden design decisions, and that computer security researchers and professionals consider the perspectives of various stakeholders in making these decisions.

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

PubMed Central

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

2011-01-01

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

Big Data, Smart Homes and Ambient Assisted Living

PubMed Central

Wass, S.

2014-01-01

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

Decision Making about Computer Acquisition and Use in American Schools.

ERIC Educational Resources Information Center

Becker, Henry Jay

1993-01-01

Discusses the centralization and decentralization of decision making about computer use in elementary and secondary schools based on results of a 1989 national survey. Results unexpectedly indicate that more successful programs are the result of districtwide planning than individual teacher or school-level decision making. (LRW)

Adaptive neural coding: from biological to behavioral decision-making

PubMed Central

Louie, Kenway; Glimcher, Paul W.; Webb, Ryan

2015-01-01

Empirical decision-making in diverse species deviates from the predictions of normative choice theory, but why such suboptimal behavior occurs is unknown. Here, we propose that deviations from optimality arise from biological decision mechanisms that have evolved to maximize choice performance within intrinsic biophysical constraints. Sensory processing utilizes specific computations such as divisive normalization to maximize information coding in constrained neural circuits, and recent evidence suggests that analogous computations operate in decision-related brain areas. These adaptive computations implement a relative value code that may explain the characteristic context-dependent nature of behavioral violations of classical normative theory. Examining decision-making at the computational level thus provides a crucial link between the architecture of biological decision circuits and the form of empirical choice behavior. PMID:26722666

Technical Assistance for States | State, Local, and Tribal Governments |

Science.gov Websites

on energy efficiency and renewable energy policies and issues for state and local government decision issues for state and local government decision makers. The expert assistance is intended to support legislators, regulators, state agencies, and their staff members in making informed decisions about solar

The emergent relevance of care staff decision-making and situation awareness to mobility care in nursing homes: an ethnographic study.

PubMed

Taylor, Janice; Sims, Jane; Haines, Terry P

2014-12-01

To explore mobility care as provided by care staff in nursing homes. Care staff regularly assist residents with their mobility. Nurses are increasingly reliant on such staff to provide safe and quality mobility care. However, the nature of care staff decision-making when providing assistance has not been fully addressed in the literature. A focused ethnography. The study was conducted in four nursing homes in Melbourne, Australia. Non-participant observations of residents and staff in 2011. Focus groups with 18 nurses, care and lifestyle staff were conducted at three facilities in 2012. Thematic analysis was employed for focus groups and content analysis for observation data. Cognitive Continuum Theory and the notion of 'situation awareness' assisted data interpretation. Decision-making during mobility care emerged as a major theme. Using Cognitive Continuum Theory as a guide, nursing home staff's decision-making was described as ranging from system-aided, through resident- and peer-aided, to reflective and intuitive. Staff seemed aware of the need for resident-aided decision-making consistent with person-centred care. Habitual mobility care based on shared mental models occurred. It was noted that levels of situation awareness may vary among staff. Care staff may benefit from support via collaborative and reflective practice to develop decision-making skills, situation awareness and person-centred mobility care. Further research is required to explore the connection between staff's skills in mobility care and their decision-making competence as well as how these factors link to quality mobility care. © 2014 John Wiley & Sons Ltd.

An intelligent multi-media human-computer dialogue system

NASA Technical Reports Server (NTRS)

Neal, J. G.; Bettinger, K. E.; Byoun, J. S.; Dobes, Z.; Thielman, C. Y.

1988-01-01

Sophisticated computer systems are being developed to assist in the human decision-making process for very complex tasks performed under stressful conditions. The human-computer interface is a critical factor in these systems. The human-computer interface should be simple and natural to use, require a minimal learning period, assist the user in accomplishing his task(s) with a minimum of distraction, present output in a form that best conveys information to the user, and reduce cognitive load for the user. In pursuit of this ideal, the Intelligent Multi-Media Interfaces project is devoted to the development of interface technology that integrates speech, natural language text, graphics, and pointing gestures for human-computer dialogues. The objective of the project is to develop interface technology that uses the media/modalities intelligently in a flexible, context-sensitive, and highly integrated manner modelled after the manner in which humans converse in simultaneous coordinated multiple modalities. As part of the project, a knowledge-based interface system, called CUBRICON (CUBRC Intelligent CONversationalist) is being developed as a research prototype. The application domain being used to drive the research is that of military tactical air control.

Quantitative imaging biomarkers: the application of advanced image processing and analysis to clinical and preclinical decision making.

PubMed

Prescott, Jeffrey William

2013-02-01

The importance of medical imaging for clinical decision making has been steadily increasing over the last four decades. Recently, there has also been an emphasis on medical imaging for preclinical decision making, i.e., for use in pharamaceutical and medical device development. There is also a drive towards quantification of imaging findings by using quantitative imaging biomarkers, which can improve sensitivity, specificity, accuracy and reproducibility of imaged characteristics used for diagnostic and therapeutic decisions. An important component of the discovery, characterization, validation and application of quantitative imaging biomarkers is the extraction of information and meaning from images through image processing and subsequent analysis. However, many advanced image processing and analysis methods are not applied directly to questions of clinical interest, i.e., for diagnostic and therapeutic decision making, which is a consideration that should be closely linked to the development of such algorithms. This article is meant to address these concerns. First, quantitative imaging biomarkers are introduced by providing definitions and concepts. Then, potential applications of advanced image processing and analysis to areas of quantitative imaging biomarker research are described; specifically, research into osteoarthritis (OA), Alzheimer's disease (AD) and cancer is presented. Then, challenges in quantitative imaging biomarker research are discussed. Finally, a conceptual framework for integrating clinical and preclinical considerations into the development of quantitative imaging biomarkers and their computer-assisted methods of extraction is presented.

Analysis And Assistant Planning System Ofregional Agricultural Economic Inform

NASA Astrophysics Data System (ADS)

Han, Jie; Zhang, Junfeng

For the common problems existed in regional development and planning, we try to design a decision support system for assisting regional agricultural development and alignment as a decision-making tool for local government and decision maker. The analysis methods of forecast, comparative advantage, liner programming and statistical analysis are adopted. According to comparative advantage theory, the regional advantage can be determined by calculating and comparing yield advantage index (YAI), Scale advantage index (SAI), Complicated advantage index (CAI). Combining with GIS, agricultural data are presented as a form of graph such as area, bar and pie to uncover the principle and trend for decision-making which can't be found in data table. This system provides assistant decisions for agricultural structure adjustment, agro-forestry development and planning, and can be integrated to information technologies such as RS, AI and so on.

Shared decision-making in epilepsy management.

PubMed

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

2015-06-01

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

Iowa pavement asset management decision-making framework : [tech transfer summary].

DOT National Transportation Integrated Search

2015-10-01

A structured framework and tool that can reflect local requirements, : practices, and operational conditions would greatly assist local : agencies in making consistent and defensible pavement treatment : selection decisions.

Multi-objective decision-making under uncertainty: Fuzzy logic methods

NASA Technical Reports Server (NTRS)

Hardy, Terry L.

1994-01-01

Selecting the best option among alternatives is often a difficult process. This process becomes even more difficult when the evaluation criteria are vague or qualitative, and when the objectives vary in importance and scope. Fuzzy logic allows for quantitative representation of vague or fuzzy objectives, and therefore is well-suited for multi-objective decision-making. This paper presents methods employing fuzzy logic concepts to assist in the decision-making process. In addition, this paper describes software developed at NASA Lewis Research Center for assisting in the decision-making process. Two diverse examples are used to illustrate the use of fuzzy logic in choosing an alternative among many options and objectives. One example is the selection of a lunar lander ascent propulsion system, and the other example is the selection of an aeration system for improving the water quality of the Cuyahoga River in Cleveland, Ohio. The fuzzy logic techniques provided here are powerful tools which complement existing approaches, and therefore should be considered in future decision-making activities.

A Middle School Principal's and Teachers' Perceptions of Leadership Practices in Data-Driven Decision Making

ERIC Educational Resources Information Center

Godreau Cimma, Kelly L.

2011-01-01

The purpose of this qualitative case study was to describe one Connecticut middle school's voluntary implementation of a data-driven decision making process in order to improve student academic performance. Data-driven decision making is a component of Connecticut's accountability system to assist schools in meeting the requirements of the No…

77 FR 40911 - Solicitation for a Cooperative Agreement-Technical Assistance Site Management in NIC's Evidence...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-11

... policymaking bodies to collectively improve the effectiveness and capacity of their decision making related to...-based decision making in local criminal justice systems. The goal of Phase I of the initiative was to... principle product of Phase I of this initiative was the Evidence-Based Decision Making Framework in Local...

Data Decision-Making and Program-Wide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #7

ERIC Educational Resources Information Center

Fox, Lise; Veguilla, Myrna; Perez Binder, Denise

2014-01-01

The Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) Roadmap on "Data Decision-Making and Program-Wide Implementation of the Pyramid Model" provides programs with guidance on how to collect and use data to ensure the implementation of the Pyramid Model with fidelity and decision-making that…

Vocational Decision-Making Interview. Administration Manual.

ERIC Educational Resources Information Center

Czerlinsky, Thomas; McCray, Paul M.

This guide is intended to assist rehabilitation counselors, school guidance personnel, and others involved in administering and interpreting the results of the Vocational Decision-Making Interview (VDMI). (The VDMI is a structured interview instrument that was developed to facilitate the assessment of an individual's vocational decision-making…

Expert Systems: Tutors, Tools, and Tutees.

ERIC Educational Resources Information Center

Lippert, Renate C.

1989-01-01

Discusses the current status, research, and practical implications of artificial intelligence and expert systems in education. Topics discussed include computer-assisted instruction; intelligent computer-assisted instruction; intelligent tutoring systems; instructional strategies involving the creation of knowledge bases; decision aids;…

Computer-assisted instruction in curricula of physical therapist assistants.

PubMed

Thompson, E C

1987-08-01

This article compares the effectiveness of computer-assisted instruction (CAI) with written, programmed instruction between two groups of physical therapist assistant students. No significant difference in the amount of material learned or retained after completion of testing using either CAI or a written, programmed text was found in this group of 16 subjects. Learning style or attitude about computers did not correlate strongly with performance after the CAI. Findings suggest that more research is needed to support decisions related to fiscal allotments for computer use in college curricula.

Decision Making and Reward in Frontal Cortex

PubMed Central

Kennerley, Steven W.; Walton, Mark E.

2011-01-01

Patients with damage to the prefrontal cortex (PFC)—especially the ventral and medial parts of PFC—often show a marked inability to make choices that meet their needs and goals. These decision-making impairments often reflect both a deficit in learning concerning the consequences of a choice, as well as deficits in the ability to adapt future choices based on experienced value of the current choice. Thus, areas of PFC must support some value computations that are necessary for optimal choice. However, recent frameworks of decision making have highlighted that optimal and adaptive decision making does not simply rest on a single computation, but a number of different value computations may be necessary. Using this framework as a guide, we summarize evidence from both lesion studies and single-neuron physiology for the representation of different value computations across PFC areas. PMID:21534649

Making Informed Decisions: Management Issues Influencing Computers in the Classroom.

ERIC Educational Resources Information Center

Strickland, James

A number of noninstructional factors appear to determine the extent to which computers make a difference in writing instruction. Once computers have been purchased and installed, it is generally school administrators who make management decisions, often from an uninformed pedagogical orientation. Issues such as what hardware and software to buy,…

Enhancing the informed consent process in psychiatric outpatients with a brief computer-based method.

PubMed

Morán-Sánchez, Inés; Luna, Aurelio; Pérez-Cárceles, Maria D

2016-11-30

Informed consent is a key element of ethical clinical research. Those with mental disorders may be at risk for impaired consent capacity. Problems with procedures may also contribute to patient's ´difficulties in understanding consent forms. The present investigation explores if a brief technologically based information presentation of the informed consent process may enhance psychiatric patients understanding and satisfaction. In this longitudinal, within-participants comparison study, patients who initially were judged to lack capacity to make research decisions (n=41) and a control group (n=47) were followed up. Decisional capacity, willingness to participate and cognitive and clinical scores were assessed at baseline and after receiving the computer-assisted enhanced consent. With sufficient cueing, patients with impaired research-related decision-making capacity at baseline were able to display enough understanding of the consent form. Patient satisfaction and willingness to participate also increased at follow up. Implications of these results for clinical practice and medical research involving people with mental disorders are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Networks and games for precision medicine.

PubMed

Biane, Célia; Delaplace, Franck; Klaudel, Hanna

2016-12-01

Recent advances in omics technologies provide the leverage for the emergence of precision medicine that aims at personalizing therapy to patient. In this undertaking, computational methods play a central role for assisting physicians in their clinical decision-making by combining data analysis and systems biology modelling. Complex diseases such as cancer or diabetes arise from the intricate interplay of various biological molecules. Therefore, assessing drug efficiency requires to study the effects of elementary perturbations caused by diseases on relevant biological networks. In this paper, we propose a computational framework called Network-Action Game applied to best drug selection problem combining Game Theory and discrete models of dynamics (Boolean networks). Decision-making is modelled using Game Theory that defines the process of drug selection among alternative possibilities, while Boolean networks are used to model the effects of the interplay between disease and drugs actions on the patient's molecular system. The actions/strategies of disease and drugs are focused on arc alterations of the interactome. The efficiency of this framework has been evaluated for drug prediction on a model of breast cancer signalling. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A validated methodology for determination of laboratory instrument computer interface efficacy

NASA Astrophysics Data System (ADS)

1984-12-01

This report is intended to provide a methodology for determining when, and for which instruments, direct interfacing of laboratory instrument and laboratory computers is beneficial. This methodology has been developed to assist the Tri-Service Medical Information Systems Program Office in making future decisions regarding laboratory instrument interfaces. We have calculated the time savings required to reach a break-even point for a range of instrument interface prices and corresponding average annual costs. The break-even analyses used empirical data to estimate the number of data points run per day that are required to meet the break-even point. The results indicate, for example, that at a purchase price of $3,000, an instrument interface will be cost-effective if the instrument is utilized for at least 154 data points per day if operated in the continuous mode, or 216 points per day if operated in the discrete mode. Although this model can help to ensure that instrument interfaces are cost effective, additional information should be considered in making the interface decisions. A reduction in results transcription errors may be a major benefit of instrument interfacing.

Parental perspectives on inpatient versus outpatient management of pediatric febrile neutropenia.

PubMed

Diorio, Caroline; Martino, Julia; Boydell, Katherine Mary; Ethier, Marie-Chantal; Mayo, Chris; Wing, Richard; Teuffel, Oliver; Sung, Lillian; Tomlinson, Deborah

2011-01-01

To describe parent preference for treatment of febrile neutropenia and the key drivers of parental decision making, structured face-to-face interviews were used to elicit parent preferences for inpatient versus outpatient management of pediatric febrile neutropenia. Parents were presented with 4 different scenarios and asked to indicate which treatment option they preferred and to describe reasons for this preference during the face-to-face interview. Comments were recorded in writing by research assistants. A consensus approach to thematic analysis was used to identify themes from the written comments of the research assistants. A total of 155 parents participated in the study. Of these, 80 (51.6%) parents identified hospital-based intravenous treatment as the most preferred treatment scenario for febrile neutropenia. The major themes identified included convenience/disruptiveness, physical health, emotional well-being, and modifiers of parental decision making. Most parents preferred hospital-based treatment for febrile neutropenia. An understanding of issues that influence parental decision making may assist health care workers in planning program implementation and further support families in their decision-making process.

Type-2 fuzzy set extension of DEMATEL method combined with perceptual computing for decision making

NASA Astrophysics Data System (ADS)

Hosseini, Mitra Bokaei; Tarokh, Mohammad Jafar

2013-05-01

Most decision making methods used to evaluate a system or demonstrate the weak and strength points are based on fuzzy sets and evaluate the criteria with words that are modeled with fuzzy sets. The ambiguity and vagueness of the words and different perceptions of a word are not considered in these methods. For this reason, the decision making methods that consider the perceptions of decision makers are desirable. Perceptual computing is a subjective judgment method that considers that words mean different things to different people. This method models words with interval type-2 fuzzy sets that consider the uncertainty of the words. Also, there are interrelations and dependency between the decision making criteria in the real world; therefore, using decision making methods that cannot consider these relations is not feasible in some situations. The Decision-Making Trail and Evaluation Laboratory (DEMATEL) method considers the interrelations between decision making criteria. The current study used the combination of DEMATEL and perceptual computing in order to improve the decision making methods. For this reason, the fuzzy DEMATEL method was extended into type-2 fuzzy sets in order to obtain the weights of dependent criteria based on the words. The application of the proposed method is presented for knowledge management evaluation criteria.

On-line confidence monitoring during decision making.

PubMed

Dotan, Dror; Meyniel, Florent; Dehaene, Stanislas

2018-02-01

Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence. Furthermore, end-of-trial finger speed predicted the post-decisional subjective confidence rating. These data indicate that confidence is computed on-line, throughout the decision process. Speed-confidence correlations were previously interpreted as a post-decision heuristics, whereby slow decisions decrease subjective confidence, but our results suggest an adaptive mechanism that involves the opposite causality: by slowing down when unconfident, participants gain time to improve their decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2011-04-01

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

Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses.

PubMed

Syrowatka, Ania; Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

2016-01-26

Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than others. Integration of content control improved quality of decision making (SMD 0.59 vs 0.23 for knowledge; SMD 0.39 vs 0.29 for decisional conflict). In contrast, tailoring reduced quality of decision making (SMD 0.40 vs 0.71 for knowledge; SMD 0.25 vs 0.52 for decisional conflict). Similarly, patient narratives also reduced quality of decision making (SMD 0.43 vs 0.65 for knowledge; SMD 0.17 vs 0.46 for decisional conflict). Results were varied for different types of explicit values clarification, feedback, and social support. Integration of media rich or interactive features into computer-based decision aids can improve quality of preference-sensitive decision making. However, this is an emerging field with limited evidence to guide use. The systematic review and thematic synthesis identified features that have been integrated into available computer-based decision aids, in an effort to facilitate reporting of these features and to promote integration of such features into decision aids. The meta-analyses and associated subgroup analyses provide preliminary evidence to support integration of specific features into future decision aids. Further research can focus on clarifying independent contributions of specific features through experimental designs and refining the designs of features to improve effectiveness.

A review of fuzzy cognitive maps in medicine: Taxonomy, methods, and applications.

PubMed

Amirkhani, Abdollah; Papageorgiou, Elpiniki I; Mohseni, Akram; Mosavi, Mohammad R

2017-04-01

A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems. This review study is conducted to identify different FCM structures used in MDSS designs. The best structure for each medical application can be introduced by studying the properties of FCM structures. This paper surveys the most important decision- making methods and applications of FCMs in the medical field in recent years. To investigate the efficiency and capability of different FCM models in designing MDSSs, medical applications are categorized into four key areas: decision-making, diagnosis, prediction, and classification. Also, various diagnosis and decision support problems addressed by FCMs in recent years are reviewed with the goal of introducing different types of FCMs and determining their contribution to the improvements made in the fields of medical diagnosis and treatment. In this survey, a general trend for future studies in this field is provided by analyzing various FCM structures used for medical purposes, and the results from each category. Due to the unique specifications of FCMs in integrating human knowledge and experience with computer-aided techniques, they are among practical instruments for MDSS design. In the not too distant future, they will have a significant role in medical sciences. Copyright © 2017 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

2015-01-01

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

Conflicts of interest improve collective computation of adaptive social structures

PubMed Central

Brush, Eleanor R.; Krakauer, David C.; Flack, Jessica C.

2018-01-01

In many biological systems, the functional behavior of a group is collectively computed by the system’s individual components. An example is the brain’s ability to make decisions via the activity of billions of neurons. A long-standing puzzle is how the components’ decisions combine to produce beneficial group-level outputs, despite conflicts of interest and imperfect information. We derive a theoretical model of collective computation from mechanistic first principles, using results from previous work on the computation of power structure in a primate model system. Collective computation has two phases: an information accumulation phase, in which (in this study) pairs of individuals gather information about their fighting abilities and make decisions about their dominance relationships, and an information aggregation phase, in which these decisions are combined to produce a collective computation. To model information accumulation, we extend a stochastic decision-making model—the leaky integrator model used to study neural decision-making—to a multiagent game-theoretic framework. We then test alternative algorithms for aggregating information—in this study, decisions about dominance resulting from the stochastic model—and measure the mutual information between the resultant power structure and the “true” fighting abilities. We find that conflicts of interest can improve accuracy to the benefit of all agents. We also find that the computation can be tuned to produce different power structures by changing the cost of waiting for a decision. The successful application of a similar stochastic decision-making model in neural and social contexts suggests general principles of collective computation across substrates and scales. PMID:29376116

[Basic concept in computer assisted surgery].

PubMed

Merloz, Philippe; Wu, Hao

2006-03-01

To investigate application of medical digital imaging systems and computer technologies in orthopedics. The main computer-assisted surgery systems comprise the four following subcategories. (1) A collection and recording process for digital data on each patient, including preoperative images (CT scans, MRI, standard X-rays), intraoperative visualization (fluoroscopy, ultrasound), and intraoperative position and orientation of surgical instruments or bone sections (using 3D localises). Data merging based on the matching of preoperative imaging (CT scans, MRI, standard X-rays) and intraoperative visualization (anatomical landmarks, or bone surfaces digitized intraoperatively via 3D localiser; intraoperative ultrasound images processed for delineation of bone contours). (2) In cases where only intraoperative images are used for computer-assisted surgical navigation, the calibration of the intraoperative imaging system replaces the merged data system, which is then no longer necessary. (3) A system that provides aid in decision-making, so that the surgical approach is planned on basis of multimodal information: the interactive positioning of surgical instruments or bone sections transmitted via pre- or intraoperative images, display of elements to guide surgical navigation (direction, axis, orientation, length and diameter of a surgical instrument, impingement, etc. ). And (4) A system that monitors the surgical procedure, thereby ensuring that the optimal strategy defined at the preoperative stage is taken into account. It is possible that computer-assisted orthopedic surgery systems will enable surgeons to better assess the accuracy and reliability of the various operative techniques, an indispensable stage in the optimization of surgery.

Impact of model-based risk analysis for liver surgery planning.

PubMed

Hansen, C; Zidowitz, S; Preim, B; Stavrou, G; Oldhafer, K J; Hahn, H K

2014-05-01

A model-based risk analysis for oncologic liver surgery was described in previous work (Preim et al. in Proceedings of international symposium on computer assisted radiology and surgery (CARS), Elsevier, Amsterdam, pp. 353–358, 2002; Hansen et al. Int I Comput Assist Radiol Surg 4(5):469–474, 2009). In this paper, we present an evaluation of this method. To prove whether and how the risk analysis facilitates the process of liver surgery planning, an explorative user study with 10 liver experts was conducted. The purpose was to compare and analyze their decision-making. The results of the study show that model-based risk analysis enhances the awareness of surgical risk in the planning stage. Participants preferred smaller resection volumes and agreed more on the safety margins’ width in case the risk analysis was available. In addition, time to complete the planning task and confidence of participants were not increased when using the risk analysis. This work shows that the applied model-based risk analysis may influence important planning decisions in liver surgery. It lays a basis for further clinical evaluations and points out important fields for future research.

Detection of Hard Exudates in Colour Fundus Images Using Fuzzy Support Vector Machine-Based Expert System.

PubMed

Jaya, T; Dheeba, J; Singh, N Albert

2015-12-01

Diabetic retinopathy is a major cause of vision loss in diabetic patients. Currently, there is a need for making decisions using intelligent computer algorithms when screening a large volume of data. This paper presents an expert decision-making system designed using a fuzzy support vector machine (FSVM) classifier to detect hard exudates in fundus images. The optic discs in the colour fundus images are segmented to avoid false alarms using morphological operations and based on circular Hough transform. To discriminate between the exudates and the non-exudates pixels, colour and texture features are extracted from the images. These features are given as input to the FSVM classifier. The classifier analysed 200 retinal images collected from diabetic retinopathy screening programmes. The tests made on the retinal images show that the proposed detection system has better discriminating power than the conventional support vector machine. With the best combination of FSVM and features sets, the area under the receiver operating characteristic curve reached 0.9606, which corresponds to a sensitivity of 94.1% with a specificity of 90.0%. The results suggest that detecting hard exudates using FSVM contribute to computer-assisted detection of diabetic retinopathy and as a decision support system for ophthalmologists.

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

DTIC Science & Technology

1981-12-01

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

Clarification process: Resolution of decision-problem conditions

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

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

Personal digital assistant use by nurse practitioners: a descriptive study.

PubMed

Stroud, Sally D; Smith, Carol A; Erkel, Elizabeth A

2009-01-01

We sought to describe the prevalence and patterns of use of personal digital assistants (PDAs) among active nurse practitioners (NPs). A descriptive correlational survey was conducted among NPs in the United States (N = 126). Participants were randomly selected from members of the American Academy of Nurse Practitioners who had listed a practice site on their application. Sixty-four percent of participants used PDAs. A drug reference was reported to be the most useful and frequently installed application. A large majority of PDA users believed that PDA use supported clinical decision making (91%), promoted patient safety (89%), and increased productivity (75%). Sixty-two percent predicted that PDA use would change their practice within the next 5 years. As innovative PDA applications with potential to improve patient outcomes become increasingly available, handheld computer skills will be a fundamental practice competency. To prevent errors in clinical decision making with quick access to PDA reference materials, NPs must critically evaluate the legitimacy and worth of PDA software programs. There is a critical need to evaluate the effectiveness of PDA use in clinical settings and develop an evidence base to guide use of the PDA in solving clinical problems.

Offside Decisions by Expert Assistant Referees in Association Football: Perception and Recall of Spatial Positions in Complex Dynamic Events

ERIC Educational Resources Information Center

Gilis, Bart; Helsen, Werner; Catteeuw, Peter; Wagemans, Johan

2008-01-01

This study investigated the offside decision-making process in association football. The first aim was to capture the specific offside decision-making skills in complex dynamic events. Second, we analyzed the type of errors to investigate the factors leading to incorrect decisions. Federation Internationale de Football Association (FIFA; n = 29)…

Computational Support for Technology- Investment Decisions

NASA Technical Reports Server (NTRS)

Adumitroaie, Virgil; Hua, Hook; Lincoln, William; Block, Gary; Mrozinski, Joseph; Shelton, Kacie; Weisbin, Charles; Elfes, Alberto; Smith, Jeffrey

2007-01-01

Strategic Assessment of Risk and Technology (START) is a user-friendly computer program that assists human managers in making decisions regarding research-and-development investment portfolios in the presence of uncertainties and of non-technological constraints that include budgetary and time limits, restrictions related to infrastructure, and programmatic and institutional priorities. START facilitates quantitative analysis of technologies, capabilities, missions, scenarios and programs, and thereby enables the selection and scheduling of value-optimal development efforts. START incorporates features that, variously, perform or support a unique combination of functions, most of which are not systematically performed or supported by prior decision- support software. These functions include the following: Optimal portfolio selection using an expected-utility-based assessment of capabilities and technologies; Temporal investment recommendations; Distinctions between enhancing and enabling capabilities; Analysis of partial funding for enhancing capabilities; and Sensitivity and uncertainty analysis. START can run on almost any computing hardware, within Linux and related operating systems that include Mac OS X versions 10.3 and later, and can run in Windows under the Cygwin environment. START can be distributed in binary code form. START calls, as external libraries, several open-source software packages. Output is in Excel (.xls) file format.

A Neural Information Field Approach to Computational Cognition

DTIC Science & Technology

2016-11-18

We have extended our perceptual decision making model to account for the effects of context in this flexible DISTRIBUTION A. Approved for public...developed a new perceptual decision making model; demonstrated adaptive motor control in a large-scale cognitive simulation with spiking neurons (Spaun...TERMS EOARD, Computational Cognition, Mixed-initiative decision making 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT SAR 18. NUMBER OF

Reason, emotion and decision-making: risk and reward computation with feeling.

PubMed

Quartz, Steven R

2009-05-01

Many models of judgment and decision-making posit distinct cognitive and emotional contributions to decision-making under uncertainty. Cognitive processes typically involve exact computations according to a cost-benefit calculus, whereas emotional processes typically involve approximate, heuristic processes that deliver rapid evaluations without mental effort. However, it remains largely unknown what specific parameters of uncertain decision the brain encodes, the extent to which these parameters correspond to various decision-making frameworks, and their correspondence to emotional and rational processes. Here, I review research suggesting that emotional processes encode in a precise quantitative manner the basic parameters of financial decision theory, indicating a reorientation of emotional and cognitive contributions to risky choice.

Using computer software to improve group decision-making.

PubMed

Mockler, R J; Dologite, D G

1991-08-01

This article provides a review of some of the work done in the area of knowledge-based systems for strategic planning. Since 1985, with the founding of the Center for Knowledge-based Systems for Business Management, the project has focused on developing knowledge-based systems (KBS) based on these models. In addition, the project also involves developing a variety of computer and non-computer methods and techniques for assisting both technical and non-technical managers and individuals to do decision modelling and KBS development. This paper presents a summary of one segment of the project: a description of integrative groupware useful in strategic planning. The work described here is part of an ongoing research project. As part of this project, for example, over 200 non-technical and technical business managers, most of them working full-time during the project, developed over 160 KBS prototype systems in conjunction with MBA course in strategic planning and management decision making. Based on replies to a survey of this test group, 28 per cent of the survey respondents reported their KBS were used at work, 21 per cent reportedly received promotions, pay rises or new jobs based on their KBS development work, and 12 per cent reported their work led to participation in other KBS development projects at work. All but two of the survey respondents reported that their work on the KBS development project led to a substantial increase in their job knowledge or performance.

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).

Comprehensible knowledge model creation for cancer treatment decision making.

PubMed

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

2017-03-01

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

Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses

PubMed Central

Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

2016-01-01

Background Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. Objective The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Methods Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Results Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than others. Integration of content control improved quality of decision making (SMD 0.59 vs 0.23 for knowledge; SMD 0.39 vs 0.29 for decisional conflict). In contrast, tailoring reduced quality of decision making (SMD 0.40 vs 0.71 for knowledge; SMD 0.25 vs 0.52 for decisional conflict). Similarly, patient narratives also reduced quality of decision making (SMD 0.43 vs 0.65 for knowledge; SMD 0.17 vs 0.46 for decisional conflict). Results were varied for different types of explicit values clarification, feedback, and social support. Conclusions Integration of media rich or interactive features into computer-based decision aids can improve quality of preference-sensitive decision making. However, this is an emerging field with limited evidence to guide use. The systematic review and thematic synthesis identified features that have been integrated into available computer-based decision aids, in an effort to facilitate reporting of these features and to promote integration of such features into decision aids. The meta-analyses and associated subgroup analyses provide preliminary evidence to support integration of specific features into future decision aids. Further research can focus on clarifying independent contributions of specific features through experimental designs and refining the designs of features to improve effectiveness. PMID:26813512

Fast Image Texture Classification Using Decision Trees

NASA Technical Reports Server (NTRS)

Thompson, David R.

2011-01-01

Texture analysis would permit improved autonomous, onboard science data interpretation for adaptive navigation, sampling, and downlink decisions. These analyses would assist with terrain analysis and instrument placement in both macroscopic and microscopic image data products. Unfortunately, most state-of-the-art texture analysis demands computationally expensive convolutions of filters involving many floating-point operations. This makes them infeasible for radiation- hardened computers and spaceflight hardware. A new method approximates traditional texture classification of each image pixel with a fast decision-tree classifier. The classifier uses image features derived from simple filtering operations involving integer arithmetic. The texture analysis method is therefore amenable to implementation on FPGA (field-programmable gate array) hardware. Image features based on the "integral image" transform produce descriptive and efficient texture descriptors. Training the decision tree on a set of training data yields a classification scheme that produces reasonable approximations of optimal "texton" analysis at a fraction of the computational cost. A decision-tree learning algorithm employing the traditional k-means criterion of inter-cluster variance is used to learn tree structure from training data. The result is an efficient and accurate summary of surface morphology in images. This work is an evolutionary advance that unites several previous algorithms (k-means clustering, integral images, decision trees) and applies them to a new problem domain (morphology analysis for autonomous science during remote exploration). Advantages include order-of-magnitude improvements in runtime, feasibility for FPGA hardware, and significant improvements in texture classification accuracy.

The role of moral utility in decision making: an interdisciplinary framework.

PubMed

Tobler, Philippe N; Kalis, Annemarie; Kalenscher, Tobias

2008-12-01

What decisions should we make? Moral values, rules, and virtues provide standards for morally acceptable decisions, without prescribing how we should reach them. However, moral theories do assume that we are, at least in principle, capable of making the right decisions. Consequently, an empirical investigation of the methods and resources we use for making moral decisions becomes relevant. We consider theoretical parallels of economic decision theory and moral utilitarianism and suggest that moral decision making may tap into mechanisms and processes that have originally evolved for nonmoral decision making. For example, the computation of reward value occurs through the combination of probability and magnitude; similar computation might also be used for determining utilitarian moral value. Both nonmoral and moral decisions may resort to intuitions and heuristics. Learning mechanisms implicated in the assignment of reward value to stimuli, actions, and outcomes may also enable us to determine moral value and assign it to stimuli, actions, and outcomes. In conclusion, we suggest that moral capabilities can employ and benefit from a variety of nonmoral decision-making and learning mechanisms.

Reinforcement learning and decision making in monkeys during a competitive game.

PubMed

Lee, Daeyeol; Conroy, Michelle L; McGreevy, Benjamin P; Barraclough, Dominic J

2004-12-01

Animals living in a dynamic environment must adjust their decision-making strategies through experience. To gain insights into the neural basis of such adaptive decision-making processes, we trained monkeys to play a competitive game against a computer in an oculomotor free-choice task. The animal selected one of two visual targets in each trial and was rewarded only when it selected the same target as the computer opponent. To determine how the animal's decision-making strategy can be affected by the opponent's strategy, the computer opponent was programmed with three different algorithms that exploited different aspects of the animal's choice and reward history. When the computer selected its targets randomly with equal probabilities, animals selected one of the targets more often, violating the prediction of probability matching, and their choices were systematically influenced by the choice history of the two players. When the computer exploited only the animal's choice history but not its reward history, animal's choice became more independent of its own choice history but was still related to the choice history of the opponent. This bias was substantially reduced, but not completely eliminated, when the computer used the choice history of both players in making its predictions. These biases were consistent with the predictions of reinforcement learning, suggesting that the animals sought optimal decision-making strategies using reinforcement learning algorithms.

System Sketch: A Visualization Tool to Improve Community Decision Making

EPA Science Inventory

Making decisions in coastal and estuarine management requires a comprehensive understanding of the linkages between environmental, social, and economic systems. SystemSketch is a web-based scoping tool designed to assist resource managers in characterizing their systems, explorin...

Improved decision making in construction using virtual site visits.

DOT National Transportation Integrated Search

2003-01-01

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

Comprehensive automatic assessment of retinal vascular abnormalities for computer-assisted retinopathy grading.

PubMed

Joshi, Vinayak; Agurto, Carla; VanNess, Richard; Nemeth, Sheila; Soliz, Peter; Barriga, Simon

2014-01-01

One of the most important signs of systemic disease that presents on the retina is vascular abnormalities such as in hypertensive retinopathy. Manual analysis of fundus images by human readers is qualitative and lacks in accuracy, consistency and repeatability. Present semi-automatic methods for vascular evaluation are reported to increase accuracy and reduce reader variability, but require extensive reader interaction; thus limiting the software-aided efficiency. Automation thus holds a twofold promise. First, decrease variability while increasing accuracy, and second, increasing the efficiency. In this paper we propose fully automated software as a second reader system for comprehensive assessment of retinal vasculature; which aids the readers in the quantitative characterization of vessel abnormalities in fundus images. This system provides the reader with objective measures of vascular morphology such as tortuosity, branching angles, as well as highlights of areas with abnormalities such as artery-venous nicking, copper and silver wiring, and retinal emboli; in order for the reader to make a final screening decision. To test the efficacy of our system, we evaluated the change in performance of a newly certified retinal reader when grading a set of 40 color fundus images with and without the assistance of the software. The results demonstrated an improvement in reader's performance with the software assistance, in terms of accuracy of detection of vessel abnormalities, determination of retinopathy, and reading time. This system enables the reader in making computer-assisted vasculature assessment with high accuracy and consistency, at a reduced reading time.

Emotion-affected decision making in human simulation.

PubMed

Zhao, Y; Kang, J; Wright, D K

2006-01-01

Human modelling is an interdisciplinary research field. The topic, emotion-affected decision making, was originally a cognitive psychology issue, but is now recognized as an important research direction for both computer science and biomedical modelling. The main aim of this paper is to attempt to bridge the gap between psychology and bioengineering in emotion-affected decision making. The work is based on Ortony's theory of emotions and bounded rationality theory, and attempts to connect the emotion process with decision making. A computational emotion model is proposed, and the initial framework of this model in virtual human simulation within the platform of Virtools is presented.

Does young adults' preferred role in decision making about health, money, and career depend on their advisors' leadership skills?

PubMed

Garcia-Retamero, Rocio; Galesic, Mirta

2013-01-01

Few empirical data exist on how decision making about health differs from that in other crucial life domains with less threatening consequences. To shed light on this issue we conducted a study with 175 young adults (average age 19 years). We presented the participants with scenarios involving advisors who provided assistance in making decisions about health, money, and career. For each scenario, participants were asked to what extent they wanted the advisor to exhibit several leadership styles and competencies and what role (active, collaborative, or passive) they preferred to play when making decisions. Results show that decision making about health is distinct from that in the other domains in three ways. First, most of the participants preferred to delegate decision making about their health to their physician, whereas they were willing to collaborate or play an active role in decision making about their career or money. Second, the competencies and leadership style preferred for the physician differed substantially from those desired for advisors in the other two domains: Participants expected physicians to show more transformational leadership--the style that is most effective in a wide range of environments--than those who provide advice about financial investments or career. Finally, participants' willingness to share medical decision making with their physician was tied to how strongly they preferred that the physician shows an effective leadership style. In contrast, motivation to participate in decision making in the other domains was not related to preferences regarding advisors' leadership style or competencies. Our results have implications for medical practice as they suggest that physicians are expected to have superior leadership skills compared to those who provide assistance in other important areas of life.

Computer-Assisted Instruction to Avert Teen Pregnancy.

ERIC Educational Resources Information Center

Starn, Jane Ryburn; Paperny, David M.

Teenage pregnancy has become a major public health problem in the United States. A study was conducted to assess an intervention based upon computer-assisted instruction (CAI) to avert teenage pregnancy. Social learning and decision theory were applied to mediate the adolescent environment through CAI so that adolescent development would be…

Linking Effective Project Management to Business Strategy in Oil and Gas Industry through Decision-making Processes

NASA Astrophysics Data System (ADS)

Adeleke, Adeyinka

The construction project in the oil and gas industry covers the entire spectrum of hydrocarbon production from the wellhead (upstream) to downstream facilities. In each of these establishments, the activities in a construction project include: consulting, studies, front-end engineering, detail engineering, procurement, program management, construction, installation, commissioning and start-up. Efficient management of each of the activities involved in construction projects is one of the driving forces for the successful completion of the project. Optimizing the crucial factors in project management during each phase of a project in an oil and gas industry can assist managers to maximize the use of available resources and drive the project to successful conclusions. One of these factors is the decision-making process in the construction project. Current research effort investigated the relationship between decision-making processes and business strategy in oil and gas industry using employee surveys. I recruited employees of different races, age group, genders, and years of experience in order understand their influence on the implementation of the decision-making process in oil and gas industry through a quantitative survey. Decision-making was assessed using five decision measures: (a) rational, (b) intuitive, (c) dependent, (d) avoidant, and (e) spontaneous. The findings indicated gender, age, years of work experience and job titles as primary variables with a negative relationship with decision-making approach for employees working in a major oil and gas industry. The study results revealed that the two most likely decision-making methods in oil and gas industry include: making a decision in a logical and systematic way and seek assistance from others when making a decision. Additionally, the two leading management approaches to decision-making in the oil and gas industry include: decision analysis is part of organization culture and management is committed to the decision-making process. Some recommendations for future studies were presented based on the need to intensify the importance of the current study and enlarge the body of knowledge regarding decision-making process in oil and gas industry.

Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.

PubMed

Park, Eun-Jun; Park, Mihyun

2015-11-01

The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.

CATTS (Computer Assisted Teacher Training System) Technology in Analyzing Observational Data from Public School Classrooms: A Study of Interactive Tactics and Decisions of Teachers.

ERIC Educational Resources Information Center

Lynch, William W.

Prompting of reading errors is a common pattern of teaching behavior occurring in reading groups. Teachers' tactics in responding to pupil errors during oral reading in public school classrooms were analyzed with the assistance of the technology of the Computer Assisted Teacher Training System (CATTS) to formulate hypotheses about teacher decision…

Decision theory, reinforcement learning, and the brain.

PubMed

Dayan, Peter; Daw, Nathaniel D

2008-12-01

Decision making is a core competence for animals and humans acting and surviving in environments they only partially comprehend, gaining rewards and punishments for their troubles. Decision-theoretic concepts permeate experiments and computational models in ethology, psychology, and neuroscience. Here, we review a well-known, coherent Bayesian approach to decision making, showing how it unifies issues in Markovian decision problems, signal detection psychophysics, sequential sampling, and optimal exploration and discuss paradigmatic psychological and neural examples of each problem. We discuss computational issues concerning what subjects know about their task and how ambitious they are in seeking optimal solutions; we address algorithmic topics concerning model-based and model-free methods for making choices; and we highlight key aspects of the neural implementation of decision making.

77 FR 43370 - TUV Rheinland of North America, Inc.; Application for Expansion of Recognition

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... scope of recognition has three elements: (1) The type of products the NRTL may test, with each type... Assistant Secretary will make the final decision on granting the application and, in making this decision... notice of this final decision in the Federal Register. Authority and Signature David Michaels, Ph.D., MPH...

16 CFR 1031.12 - Membership criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... responsibility for making final decisions, or advise those who make final decisions, on whether to rely on a... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria. (a) The Commissioners, their special assistants, and Commission officials and employees holding the...

Heuristic and optimal policy computations in the human brain during sequential decision-making.

PubMed

Korn, Christoph W; Bach, Dominik R

2018-01-23

Optimal decisions across extended time horizons require value calculations over multiple probabilistic future states. Humans may circumvent such complex computations by resorting to easy-to-compute heuristics that approximate optimal solutions. To probe the potential interplay between heuristic and optimal computations, we develop a novel sequential decision-making task, framed as virtual foraging in which participants have to avoid virtual starvation. Rewards depend only on final outcomes over five-trial blocks, necessitating planning over five sequential decisions and probabilistic outcomes. Here, we report model comparisons demonstrating that participants primarily rely on the best available heuristic but also use the normatively optimal policy. FMRI signals in medial prefrontal cortex (MPFC) relate to heuristic and optimal policies and associated choice uncertainties. Crucially, reaction times and dorsal MPFC activity scale with discrepancies between heuristic and optimal policies. Thus, sequential decision-making in humans may emerge from integration between heuristic and optimal policies, implemented by controllers in MPFC.

Effects of automation of information-processing functions on teamwork.

PubMed

Wright, Melanie C; Kaber, David B

2005-01-01

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

In the Clouds: The Implications of Cloud Computing for Higher Education Information Technology Governance and Decision Making

ERIC Educational Resources Information Center

Dulaney, Malik H.

2013-01-01

Emerging technologies challenge the management of information technology in organizations. Paradigm changing technologies, such as cloud computing, have the ability to reverse the norms in organizational management, decision making, and information technology governance. This study explores the effects of cloud computing on information technology…

An exploratory study of relational, persuasive, and nonverbal communication in requests for tissue donation.

PubMed

Siminoff, Laura A; Traino, Heather M; Gordon, Nahida H

2011-10-01

This study explores the effects of tissue requesters' relational, persuasive, and nonverbal communication on families' final donation decisions. One thousand sixteen (N = 1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation.

An Exploratory Study of Relational, Persuasive, and Nonverbal Communication in Requests for Tissue Donation

PubMed Central

SIMINOFF, LAURA A.; TRAINO, HEATHER M.; GORDON, NAHIDA H.

2011-01-01

This study explores the effects of tissue requesters’ relational, persuasive, and nonverbal communication on families’ final donation decisions. One thousand sixteen (N=1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation. PMID:21512935

Helping Health Care Providers and Clinical Scientists Understand Apparently Irrational Policy Decisions.

PubMed

Demeter, Sandor J

2016-12-21

Health care providers (HCP) and clinical scientists (CS) are generally most comfortable using evidence-based rational decision-making models. They become very frustrated when policymakers make decisions that, on the surface, seem irrational and unreasonable. However, such decisions usually make sense when analysed properly. The goal of this paper to provide a basic theoretical understanding of major policy models, to illustrate which models are most prevalent in publicly funded health care systems, and to propose a policy analysis framework to better understand the elements that drive policy decision-making. The proposed policy framework will also assist HCP and CS achieve greater success with their own proposals.

FRIEND: a brain-monitoring agent for adaptive and assistive systems.

PubMed

Morris, Alexis; Ulieru, Mihaela

2012-01-01

This paper presents an architectural design for adaptive-systems agents (FRIEND) that use brain state information to make more effective decisions on behalf of a user; measuring brain context versus situational demands. These systems could be useful for alerting users to cognitive workload levels or fatigue, and could attempt to compensate for higher cognitive activity by filtering noise information. In some cases such systems could also share control of devices, such as pulling over in an automated vehicle. These aim to assist people in everyday systems to perform tasks better and be more aware of internal states. Achieving a functioning system of this sort is a challenge, involving a unification of brain- computer-interfaces, human-computer-interaction, soft-computin deliberative multi-agent systems disciplines. Until recently, these were not able to be combined into a usable platform due largely to technological limitations (e.g., size, cost, and processing speed), insufficient research on extracting behavioral states from EEG signals, and lack of low-cost wireless sensing headsets. We aim to surpass these limitations and develop control architectures for making sense of brain state in applications by realizing an agent architecture for adaptive (human-aware) technology. In this paper we present an early, high-level design towards implementing a multi-purpose brain-monitoring agent system to improve user quality of life through the assistive applications of psycho-physiological monitoring, noise-filtering, and shared system control.

Computer Applications in Social Studies.

ERIC Educational Resources Information Center

White, Charles S.

1988-01-01

Examines "Decisions, Decisions-Revolutionary Wars: Choosing Sides," an Apple II software package that emphasizes student decision-making about the nature of revolutions. Targeted at grades 5-12, the product covers a broad range of issues. Concludes that "Decisions, Decisions" models an effective decision-making process and has…

Dynamic Decision Making under Uncertainty and Partial Information

DTIC Science & Technology

2017-01-30

order to address these problems, we investigated efficient computational methodologies for dynamic decision making under uncertainty and partial...information. In the course of this research, we developed and studied efficient simulation-based methodologies for dynamic decision making under...uncertainty and partial information; (ii) studied the application of these decision making models and methodologies to practical problems, such as those

Making Market Decisions in the Classroom.

ERIC Educational Resources Information Center

Rose, Stephen A.

1986-01-01

Computer software that will help intermediate and secondary social studies students learn to make rational decisions about personal and societal concerns are described. The courseware places students in the roles of business managers who make decisions about operating their firms. (RM)

Technology in Our Schools.

ERIC Educational Resources Information Center

Rukeyser, William L.; Kuersten, Joan

1998-01-01

Parents must be well-informed about computer technology in order to make appropriate decisions for their schools. The paper discusses pro's and con's of computers in the schools, the importance of dispelling myths about education and technology, and parents' roles in making decisions. (SM)

An Investment Behavior Analysis using by Brain Computer Interface

NASA Astrophysics Data System (ADS)

Suzuki, Kyoko; Kinoshita, Kanta; Miyagawa, Kazuhiro; Shiomi, Shinichi; Misawa, Tadanobu; Shimokawa, Tetsuya

In this paper, we will construct a new Brain Computer Interface (BCI), for the purpose of analyzing human's investment decision makings. The BCI is made up of three functional parts which take roles of, measuring brain information, determining market price in an artificial market, and specifying investment decision model, respectively. When subjects make decisions, their brain information is conveyed to the part of specifying investment decision model through the part of measuring brain information, whereas, their decisions of investment order are sent to the part of artificial market to form market prices. Both the support vector machine and the 3 layered perceptron are used to assess the investment decision model. In order to evaluate our BCI, we conduct an experiment in which subjects and a computer trader agent trade shares of stock in the artificial market and test how the computer trader agent can forecast market price formation and investment decision makings from the brain information of subjects. The result of the experiment shows that the brain information can improve the accuracy of forecasts, and so the computer trader agent can supply market liquidity to stabilize market volatility without his loss.

MoCog1: A computer simulation of recognition-primed human decision making, considering emotions

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1992-01-01

The successful results of the first stage of a research effort to develop a versatile computer model of motivated human cognitive behavior are reported. Most human decision making appears to be an experience-based, relatively straightforward, largely automatic response to situations, utilizing cues and opportunities perceived from the current environment. The development, considering emotions, of the architecture and computer program associated with such 'recognition-primed' decision-making is described. The resultant computer program (MoCog1) was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

The results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior are described. Most human decision making is an experience-based, relatively straight-forward, largely automatic response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. The development of the architecture and computer program (MoCog1) associated with such 'recognition-primed' decision making is discussed. The resultant computer program was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

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

PubMed

Gillespie, Mary

2010-11-01

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

Value encoding in single neurons in the human amygdala during decision making.

PubMed

Jenison, Rick L; Rangel, Antonio; Oya, Hiroyuki; Kawasaki, Hiroto; Howard, Matthew A

2011-01-05

A growing consensus suggests that the brain makes simple choices by assigning values to the stimuli under consideration and then comparing these values to make a decision. However, the network involved in computing the values has not yet been fully characterized. Here, we investigated whether the human amygdala plays a role in the computation of stimulus values at the time of decision making. We recorded single neuron activity from the amygdala of awake patients while they made simple purchase decisions over food items. We found 16 amygdala neurons, located primarily in the basolateral nucleus that responded linearly to the values assigned to individual items.

Technology for School-Based Assessment and Assessment for Learning: Development Principles from New Zealand

ERIC Educational Resources Information Center

Hattie, John A. C.; Brown, Gavin T. L.

2008-01-01

National assessment systems can be enhanced with effective school-based assessment (SBA) that allows teachers to focus on improvement decisions. Modern computer-assisted technology systems are often used to deploy SBA systems. Since 2000, New Zealand has researched, developed, and deployed a national, computer-assisted SBA system. Eight major…

Clinical decision making: how surgeons do it.

PubMed

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

2013-06-01

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

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

PubMed

Lewis, Judith A; Sommers, Catherine O

2003-01-01

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

10 CFR 710.7 - Application of the criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... involved in the decision-making process shall consider: the nature, extent, and seriousness of the conduct... decision as to access authorization is a comprehensive, common-sense judgment, made after consideration of... will be made as to access authorization eligibility. (b) To assist in making these determinations, on...

Risk Assessment Overview

NASA Technical Reports Server (NTRS)

Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

2011-01-01

Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

Potential of Cognitive Computing and Cognitive Systems

NASA Astrophysics Data System (ADS)

Noor, Ahmed K.

2015-01-01

Cognitive computing and cognitive technologies are game changers for future engineering systems, as well as for engineering practice and training. They are major drivers for knowledge automation work, and the creation of cognitive products with higher levels of intelligence than current smart products. This paper gives a brief review of cognitive computing and some of the cognitive engineering systems activities. The potential of cognitive technologies is outlined, along with a brief description of future cognitive environments, incorporating cognitive assistants - specialized proactive intelligent software agents designed to follow and interact with humans and other cognitive assistants across the environments. The cognitive assistants engage, individually or collectively, with humans through a combination of adaptive multimodal interfaces, and advanced visualization and navigation techniques. The realization of future cognitive environments requires the development of a cognitive innovation ecosystem for the engineering workforce. The continuously expanding major components of the ecosystem include integrated knowledge discovery and exploitation facilities (incorporating predictive and prescriptive big data analytics); novel cognitive modeling and visual simulation facilities; cognitive multimodal interfaces; and cognitive mobile and wearable devices. The ecosystem will provide timely, engaging, personalized / collaborative, learning and effective decision making. It will stimulate creativity and innovation, and prepare the participants to work in future cognitive enterprises and develop new cognitive products of increasing complexity. http://www.aee.odu.edu/cognitivecomp

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

PubMed

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

2017-12-01

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

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

PubMed

Andrea Sullivan, E

2012-11-01

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

Fault trees for decision making in systems analysis

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

Lambert, Howard E.

1975-10-09

The application of fault tree analysis (FTA) to system safety and reliability is presented within the framework of system safety analysis. The concepts and techniques involved in manual and automated fault tree construction are described and their differences noted. The theory of mathematical reliability pertinent to FTA is presented with emphasis on engineering applications. An outline of the quantitative reliability techniques of the Reactor Safety Study is given. Concepts of probabilistic importance are presented within the fault tree framework and applied to the areas of system design, diagnosis and simulation. The computer code IMPORTANCE ranks basic events and cut setsmore » according to a sensitivity analysis. A useful feature of the IMPORTANCE code is that it can accept relative failure data as input. The output of the IMPORTANCE code can assist an analyst in finding weaknesses in system design and operation, suggest the most optimal course of system upgrade, and determine the optimal location of sensors within a system. A general simulation model of system failure in terms of fault tree logic is described. The model is intended for efficient diagnosis of the causes of system failure in the event of a system breakdown. It can also be used to assist an operator in making decisions under a time constraint regarding the future course of operations. The model is well suited for computer implementation. New results incorporated in the simulation model include an algorithm to generate repair checklists on the basis of fault tree logic and a one-step-ahead optimization procedure that minimizes the expected time to diagnose system failure.« less

Goal-Directed Decision Making with Spiking Neurons.

PubMed

Friedrich, Johannes; Lengyel, Máté

2016-02-03

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. Copyright © 2016 the authors 0270-6474/16/361529-18$15.00/0.

Goal-Directed Decision Making with Spiking Neurons

PubMed Central

Lengyel, Máté

2016-01-01

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. SIGNIFICANCE STATEMENT Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. PMID:26843636

Evidence of effectiveness of health care professionals using handheld computers: a scoping review of systematic reviews.

PubMed

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

2013-10-28

Handheld computers and mobile devices provide instant access to vast amounts and types of useful information for health care professionals. Their reduced size and increased processing speed has led to rapid adoption in health care. Thus, it is important to identify whether handheld computers are actually effective in clinical practice. A scoping review of systematic reviews was designed to provide a quick overview of the documented evidence of effectiveness for health care professionals using handheld computers in their clinical work. A detailed search, sensitive for systematic reviews was applied for Cochrane, Medline, EMBASE, PsycINFO, Allied and Complementary Medicine Database (AMED), Global Health, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. All outcomes that demonstrated effectiveness in clinical practice were included. Classroom learning and patient use of handheld computers were excluded. Quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. A previously published conceptual framework was used as the basis for dual data extraction. Reported outcomes were summarized according to the primary function of the handheld computer. Five systematic reviews met the inclusion and quality criteria. Together, they reviewed 138 unique primary studies. Most reviewed descriptive intervention studies, where physicians, pharmacists, or medical students used personal digital assistants. Effectiveness was demonstrated across four distinct functions of handheld computers: patient documentation, patient care, information seeking, and professional work patterns. Within each of these functions, a range of positive outcomes were reported using both objective and self-report measures. The use of handheld computers improved patient documentation through more complete recording, fewer documentation errors, and increased efficiency. Handheld computers provided easy access to clinical decision support systems and patient management systems, which improved decision making for patient care. Handheld computers saved time and gave earlier access to new information. There were also reports that handheld computers enhanced work patterns and efficiency. This scoping review summarizes the secondary evidence for effectiveness of handheld computers and mhealth. It provides a snapshot of effective use by health care professionals across four key functions. We identified evidence to suggest that handheld computers provide easy and timely access to information and enable accurate and complete documentation. Further, they can give health care professionals instant access to evidence-based decision support and patient management systems to improve clinical decision making. Finally, there is evidence that handheld computers allow health professionals to be more efficient in their work practices. It is anticipated that this evidence will guide clinicians and managers in implementing handheld computers in clinical practice and in designing future research.

Distinct Roles of Dopamine and Subthalamic Nucleus in Learning and Probabilistic Decision Making

ERIC Educational Resources Information Center

Coulthard, Elizabeth J.; Bogacz, Rafal; Javed, Shazia; Mooney, Lucy K.; Murphy, Gillian; Keeley, Sophie; Whone, Alan L.

2012-01-01

Even simple behaviour requires us to make decisions based on combining multiple pieces of learned and new information. Making such decisions requires both learning the optimal response to each given stimulus as well as combining probabilistic information from multiple stimuli before selecting a response. Computational theories of decision making…

Health decision making: lynchpin of evidence-based practice.

PubMed

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

Health Decision Making: Lynchpin of Evidence-Based Practice

PubMed Central

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. Implications for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers’ intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed. PMID:19015288

Demonstrating Empathy: A Phenomenological Study of Instructional Designers Making Instructional Strategy Decisions for Adult Learners

ERIC Educational Resources Information Center

Vann, Linda S.

2017-01-01

Instructional designers are tasked with making instructional strategy decisions to facilitate achievement of learning outcomes as part of their professional responsibilities. While the instructional design process includes learner analysis, that analysis alone does not embody opportunities to assist instructional designers with demonstrations of…

33 CFR 331.7 - Review procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... process, and assist the division engineer in making a decision on the merits of the appeal. The division... engineer will make the decision on the merits of the appeal, and provide any instructions, as appropriate... no case shall any site visit extend the total appeals process beyond twelve months from the date of...

Augmentative Communication for Children with Deaf-Blindness: Guidelines for Decision-Making.

ERIC Educational Resources Information Center

Cress, Cynthia J.; And Others

This manual is intended to assist in developing augmentative communication systems for deaf-blind children. After a brief introduction, section II provides an overview of general augmentative communication systems and theory. Section III presents a general decision-making process for developing and selecting augmentative communication systems for…

24 CFR 576.404 - Conflicts of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... section who exercises or has exercised any functions or responsibilities with respect to activities assisted under the ESG program, or who is in a position to participate in a decision-making process or gain... withdrawn from his or her functions, responsibilities or the decision-making process with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

ERIC Educational Resources Information Center

O'Hare, Marianne M.

1989-01-01

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Gender Equity, Sport Sponsorship, and Participation

ERIC Educational Resources Information Center

Yiamouyiannis, Athena

2009-01-01

As the pressure to win in select collegiate sports escalates, financial pressures mount, and the need to comply with Title IX regulations and gender equity policies continues, athletics administrators are faced with having to make difficult decisions regarding their sport programs. To assist in the decision-making process regarding sport programs,…

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

PubMed

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

2017-06-01

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

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

DTIC Science & Technology

1988-08-19

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

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

PubMed

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

2012-09-01

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

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

ERIC Educational Resources Information Center

Hopf-Weichel, Rosemarie; And Others

This report describes results of the first year of a three-year program to develop and evaluate a new Adaptive Computerized Training System (ACTS) for electronics maintenance training. (ACTS incorporates an adaptive computer program that learns the student's diagnostic and decision value structure, compares it to that of an expert, and adapts the…

A Bayesian Attractor Model for Perceptual Decision Making

PubMed Central

Bitzer, Sebastian; Bruineberg, Jelle; Kiebel, Stefan J.

2015-01-01

Even for simple perceptual decisions, the mechanisms that the brain employs are still under debate. Although current consensus states that the brain accumulates evidence extracted from noisy sensory information, open questions remain about how this simple model relates to other perceptual phenomena such as flexibility in decisions, decision-dependent modulation of sensory gain, or confidence about a decision. We propose a novel approach of how perceptual decisions are made by combining two influential formalisms into a new model. Specifically, we embed an attractor model of decision making into a probabilistic framework that models decision making as Bayesian inference. We show that the new model can explain decision making behaviour by fitting it to experimental data. In addition, the new model combines for the first time three important features: First, the model can update decisions in response to switches in the underlying stimulus. Second, the probabilistic formulation accounts for top-down effects that may explain recent experimental findings of decision-related gain modulation of sensory neurons. Finally, the model computes an explicit measure of confidence which we relate to recent experimental evidence for confidence computations in perceptual decision tasks. PMID:26267143

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

PubMed

Wilson, Rosemary; Hubert, John

2002-01-01

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

SIGI: An Interactive Aid to Career Decision Making.

ERIC Educational Resources Information Center

Katz, Martin R.

1980-01-01

The System of Interactive Guidance and Information (SIGI) helps students make informed and rational career decisions. Interacting with a computer, students examine values, identify and explore options, gain and interpret relevant information, master strategies for decision making, and formulate plans of action. Extensively field-tested, SIGI has…

Chronic Exposure to Methamphetamine Disrupts Reinforcement-Based Decision Making in Rats.

PubMed

Groman, Stephanie M; Rich, Katherine M; Smith, Nathaniel J; Lee, Daeyeol; Taylor, Jane R

2018-03-01

The persistent use of psychostimulant drugs, despite the detrimental outcomes associated with continued drug use, may be because of disruptions in reinforcement-learning processes that enable behavior to remain flexible and goal directed in dynamic environments. To identify the reinforcement-learning processes that are affected by chronic exposure to the psychostimulant methamphetamine (MA), the current study sought to use computational and biochemical analyses to characterize decision-making processes, assessed by probabilistic reversal learning, in rats before and after they were exposed to an escalating dose regimen of MA (or saline control). The ability of rats to use flexible and adaptive decision-making strategies following changes in stimulus-reward contingencies was significantly impaired following exposure to MA. Computational analyses of parameters that track choice and outcome behavior indicated that exposure to MA significantly impaired the ability of rats to use negative outcomes effectively. These MA-induced changes in decision making were similar to those observed in rats following administration of a dopamine D2/3 receptor antagonist. These data use computational models to provide insight into drug-induced maladaptive decision making that may ultimately identify novel targets for the treatment of psychostimulant addiction. We suggest that the disruption in utilization of negative outcomes to adaptively guide dynamic decision making is a new behavioral mechanism by which MA rigidly biases choice behavior.

[Treatment Decision-Making Process of Cancer Patients].

PubMed

Lee, Shiu-Yu C Katie

2016-10-01

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

Decision Making in Computer-Simulated Experiments.

ERIC Educational Resources Information Center

Suits, J. P.; Lagowski, J. J.

A set of interactive, computer-simulated experiments was designed to respond to the large range of individual differences in aptitude and reasoning ability generally exhibited by students enrolled in first-semester general chemistry. These experiments give students direct experience in the type of decision making needed in an experimental setting.…

Modelling decision-making by pilots

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.

1993-01-01

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

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

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

Tools to support evidence-informed public health decision making.

PubMed

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

2014-07-18

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

A model for making project funding decisions at the National Cancer Institute.

PubMed

Hall, N G; Hershey, J C; Kessler, L G; Stotts, R C

1992-01-01

This paper describes the development of a model for making project funding decisions at The National Cancer Institute (NCI). The American Stop Smoking Intervention Study (ASSIST) is a multiple-year, multiple-site demonstration project, aimed at reducing smoking prevalence. The initial request for ASSIST proposals was answered by about twice as many states as could be funded. Scientific peer review of the proposals was the primary criterion used for funding decisions. However, a modified Delphi process made explicit several criteria of secondary importance. A structured questionnaire identified the relative importance of these secondary criteria, some of which we incorporated into a composite preference function. We modeled the proposal funding decision as a zero-one program, and adjusted the preference function and available budget parametrically to generate many suitable outcomes. The actual funding decision, identified by our model, offers significant advantages over manually generated solutions found by experts at NCI.

Developing Decision-Making Skills for Socio-Scientific Issues

ERIC Educational Resources Information Center

Lee, Yeung Chung

2007-01-01

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

Developing Effective Boards, Councils and Commissions. Revised.

ERIC Educational Resources Information Center

Dyer, Delwyn A.; Williams, Oscar M.

Effective board operations are an art as well as a science. Local advisory boards or governing boards/councils refer to active, duly organized, and representative bodies that hold regular meetings and make decisions on behalf of the membership, and whose members serve without pay. Advisory boards assist those who make organizational decisions but…

Building the Foundation for Data-Based Decision Making: Creating Consensus on Language and Concepts

ERIC Educational Resources Information Center

Crum, Karen

2009-01-01

Data Based Decision Making (DBDM), the process of gathering, analyzing, applying, and sharing data in order to promote school improvement, has recently become a prominent process in the quest to assist students in attaining educational success and helping schools meet accountability benchmarks (Wayman, 2005; Poynton & Carey, 2006). This…

An analytical procedure to assist decision-making in a government research organization

Treesearch

H. Dean Claxton; Giuseppe Rensi

1972-01-01

An analytical procedure to help management decision-making in planning government research is described. The objectives, activities, and restrictions of a government research organization are modeled in a consistent analytical framework. Theory and methodology is drawn from economics and mathe-matical programing. The major analytical aspects distinguishing research...

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

ERIC Educational Resources Information Center

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

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

Leaders on the Front Line--Managing Emotion for Ethical Decision Making

ERIC Educational Resources Information Center

Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.

2016-01-01

To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios…

Ethical Decision-Making by High School Principals in Evaluating Teachers

ERIC Educational Resources Information Center

Bakopoulos, Fotini

2013-01-01

The purpose of this study was to examine the ethical beliefs and preparation practices of high school principals when making decisions on the evaluation of teacher performance for retention and/or tenure. The participants consisted of a total of 10 high school principals, associate principals, and assistant principals who evaluate the performance…

Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help

PubMed Central

Yang, Qian; Zimmerman, John; Steinfeld, Aaron; Carey, Lisa; Antaki, James F.

2016-01-01

Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients’ healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations. PMID:27833397

Computer-assisted adjuncts for aneurysmal morphologic assessment: toward more precise and accurate approaches

NASA Astrophysics Data System (ADS)

Rajabzadeh-Oghaz, Hamidreza; Varble, Nicole; Davies, Jason M.; Mowla, Ashkan; Shakir, Hakeem J.; Sonig, Ashish; Shallwani, Hussain; Snyder, Kenneth V.; Levy, Elad I.; Siddiqui, Adnan H.; Meng, Hui

2017-03-01

Neurosurgeons currently base most of their treatment decisions for intracranial aneurysms (IAs) on morphological measurements made manually from 2D angiographic images. These measurements tend to be inaccurate because 2D measurements cannot capture the complex geometry of IAs and because manual measurements are variable depending on the clinician's experience and opinion. Incorrect morphological measurements may lead to inappropriate treatment strategies. In order to improve the accuracy and consistency of morphological analysis of IAs, we have developed an image-based computational tool, AView. In this study, we quantified the accuracy of computer-assisted adjuncts of AView for aneurysmal morphologic assessment by performing measurement on spheres of known size and anatomical IA models. AView has an average morphological error of 0.56% in size and 2.1% in volume measurement. We also investigate the clinical utility of this tool on a retrospective clinical dataset and compare size and neck diameter measurement between 2D manual and 3D computer-assisted measurement. The average error was 22% and 30% in the manual measurement of size and aneurysm neck diameter, respectively. Inaccuracies due to manual measurements could therefore lead to wrong treatment decisions in 44% and inappropriate treatment strategies in 33% of the IAs. Furthermore, computer-assisted analysis of IAs improves the consistency in measurement among clinicians by 62% in size and 82% in neck diameter measurement. We conclude that AView dramatically improves accuracy for morphological analysis. These results illustrate the necessity of a computer-assisted approach for the morphological analysis of IAs.

The Burn Medical Assistant: Developing Machine Learning Algorithms to Aid in the Estimation of Burn Wound Size

DTIC Science & Technology

2017-10-01

hypothesis that a computer machine learning algorithm can analyze and classify burn injures using multispectral imaging within 5% of an expert clinician...morbidity. In response to these challenges, the USAISR developed and obtained FDA 510(k) clearance of the Burn Navigator™, a computer decision support... computer decision support software (CDSS), can significantly change the CDSS algorithm’s recommendations and thus the total fluid administered to a

Exploring the experiences of bereaved families involved in assisted suicide in Southern Switzerland: a qualitative study.

PubMed

Gamondi, Claudia; Pott, Murielle; Forbes, Karen; Payne, Sheila

2015-06-01

In Switzerland, helping with assisted suicide under certain conditions is not prosecuted. With approximately 300 cases annually, this leaves behind a large group of bereaved people where its consequences are mostly unknown. The study aimed to explore family involvement in decision making prior to assisted suicide, and to examine their ways of coping during the bereavement period. A qualitative interview study used the principles of Grounded Theory analysis. Eleven relatives of eight patients, who died in Southern Switzerland after assisted suicide, participated in semistructured interviews. The large majority of family members faced moral dilemmas during the decision-making phase. Their respect for patient's autonomy was a key justification to resolve dilemmas. Two types of involvement were identified: categorised as 'passive' when the decision making was located with the patient, and 'active' when assisted suicide was proposed by the family member and/or the relative was involved in some way. The relatives reported feelings of isolation during and after assisted suicide. Family members reported fear of social stigma and did not openly disclose assisted suicide as the cause of death. None of those interviewed received formal psychological support. Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of assisted suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of assisted suicide requests should include consideration of family members' needs, in addition to those of the patient. 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.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

This report describes the successful results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior. Most human decision-making is of the experience-based, relatively straight-forward, largely automatic, type of response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. This report describes the development of the architecture and computer program associated with such 'recognition-primed' decision-making. The resultant computer program was successfully utilized as a vehicle to simulate findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior in response to their environment. The present work is an expanded version and is based on research reported while the author was an employee of NASA ARC.

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

PubMed

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

2018-01-17

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

Decision Accuracy in Computer-Mediated versus Face-to-Face Decision-Making Teams.

PubMed

Hedlund; Ilgen; Hollenbeck

1998-10-01

Changes in the way organizations are structured and advances in communication technologies are two factors that have altered the conditions under which group decisions are made. Decisions are increasingly made by teams that have a hierarchical structure and whose members have different areas of expertise. In addition, many decisions are no longer made via strictly face-to-face interaction. The present study examines the effects of two modes of communication (face-to-face or computer-mediated) on the accuracy of teams' decisions. The teams are characterized by a hierarchical structure and their members differ in expertise consistent with the framework outlined in the Multilevel Theory of team decision making presented by Hollenbeck, Ilgen, Sego, Hedlund, Major, and Phillips (1995). Sixty-four four-person teams worked for 3 h on a computer simulation interacting either face-to-face (FtF) or over a computer network. The communication mode had mixed effects on team processes in that members of FtF teams were better informed and made recommendations that were more predictive of the correct team decision, but leaders of CM teams were better able to differentiate staff members on the quality of their decisions. Controlling for the negative impact of FtF communication on staff member differentiation increased the beneficial effect of the FtF mode on overall decision making accuracy. Copyright 1998 Academic Press.

The Selection of Test Items for Decision Making with a Computer Adaptive Test.

ERIC Educational Resources Information Center

Spray, Judith A.; Reckase, Mark D.

The issue of test-item selection in support of decision making in adaptive testing is considered. The number of items needed to make a decision is compared for two approaches: selecting items from an item pool that are most informative at the decision point or selecting items that are most informative at the examinee's ability level. The first…

Technical Assistance Needs Assessments (TANAs)

EPA Pesticide Factsheets

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

Optimal and Nonoptimal Computer-Based Test Designs for Making Pass-Fail Decisions

ERIC Educational Resources Information Center

Hambleton, Ronald K.; Xing, Dehui

2006-01-01

Now that many credentialing exams are being routinely administered by computer, new computer-based test designs, along with item response theory models, are being aggressively researched to identify specific designs that can increase the decision consistency and accuracy of pass-fail decisions. The purpose of this study was to investigate the…

Depression and suicide are natural kinds: implications for physician-assisted suicide.

PubMed

Tsou, Jonathan Y

2013-01-01

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made about individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. Copyright © 2013 Elsevier Ltd. All rights reserved.

Patient participation in decision making: views of health professionals caring for people with colorectal cancer.

PubMed

Beaver, Kinta; Craven, Olive; Witham, Gary; Tomlinson, Mary; Susnerwala, Shabbir; Jones, David; Luker, Karen A

2007-04-01

The aim of this study was to explore views on patient participation in decision making, as described by health professionals caring for people with colorectal cancer. Patient participation in health-care decision making is on the policy agenda at an international level. However, many aspects of cancer care and treatment are complex and it is unclear how health professionals view their role as promoters of patient participation. A qualitative exploratory study. In depth interviews with 35 health professionals in clinical practice. Data were analysed using thematic content analysis, assisted by a computer software package for analysis of qualitative data (N-VIVO). Choices in relation to surgical treatment were viewed as limited. Although it was perceived that patients could be more involved in decisions related to adjuvant treatment, providing information on various chemotherapy regimes was challenging. It was acknowledged that patients could be involved in treatment choices but there was far less clarity concerning aspects of physical and psychological care. Age was a factor when determining which patients should be offered treatment choices. The availability and presentation of choices to patients is context specific and tailored to the preferences of individuals. If health professionals focus only on aspects of decision making related to treatment, the potential for shared partnerships with patients in relation to choices about physical and psychological care may be lost. This may be particularly pertinent for nurses and allied professions who engage with patients throughout the illness trajectory. Policy makers should arguably appreciate that health professionals have an awareness of current thinking on patient participation, but may find policy recommendations challenging to implement in clinical practice when faced with the individual needs and preferences of patients and the complexities and uncertainties of disease management.

Studying Parental Decision Making with Micro-Computers: The CPSI Technique.

ERIC Educational Resources Information Center

Holden, George W.

A technique for studying how parents think, make decisions, and solve childrearing problems, Computer-Presented Social Interactions (CPSI), is described. Two studies involving CPSI are presented. The first study concerns a common parental cognitive task: causal analysis of an undesired behavior. The task was to diagnose the cause of non-contingent…

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

PubMed

Helsloot, Ira; Groenendaal, Jelle

2011-07-01

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

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

PubMed

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

2017-04-01

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

Assessing Professional Decision-Making Abilities.

ERIC Educational Resources Information Center

McNergney, Robert; Hinson, Stephanie

1985-01-01

Describes Teacher Development Decision Exercises, a computer-based method of diagnosing abilities of elementary and secondary school supervisors (principals, staff developers, curriculum coordinators) to make professional preactive or planning decisions. This approval simulates assessment of supervisors' abilities to use professional knowledge to…

An Artificial Neural Network-Based Decision-Support System for Integrated Network Security

DTIC Science & Technology

2014-09-01

group that they need to know in order to make team-based decisions in real-time environments, (c) Employ secure cloud computing services to host mobile...THESIS Presented to the Faculty Department of Electrical and Computer Engineering Graduate School of Engineering and Management Air Force...out-of-the-loop syndrome and create complexity creep. As a result, full automation efforts can lead to inappropriate decision-making despite a

Collaborative human-machine analysis to disambiguate entities in unstructured text and structured datasets

NASA Astrophysics Data System (ADS)

Davenport, Jack H.

2016-05-01

Intelligence analysts demand rapid information fusion capabilities to develop and maintain accurate situational awareness and understanding of dynamic enemy threats in asymmetric military operations. The ability to extract relationships between people, groups, and locations from a variety of text datasets is critical to proactive decision making. The derived network of entities must be automatically created and presented to analysts to assist in decision making. DECISIVE ANALYTICS Corporation (DAC) provides capabilities to automatically extract entities, relationships between entities, semantic concepts about entities, and network models of entities from text and multi-source datasets. DAC's Natural Language Processing (NLP) Entity Analytics model entities as complex systems of attributes and interrelationships which are extracted from unstructured text via NLP algorithms. The extracted entities are automatically disambiguated via machine learning algorithms, and resolution recommendations are presented to the analyst for validation; the analyst's expertise is leveraged in this hybrid human/computer collaborative model. Military capability is enhanced by these NLP Entity Analytics because analysts can now create/update an entity profile with intelligence automatically extracted from unstructured text, thereby fusing entity knowledge from structured and unstructured data sources. Operational and sustainment costs are reduced since analysts do not have to manually tag and resolve entities.

A conceptual and computational model of moral decision making in human and artificial agents.

PubMed

Wallach, Wendell; Franklin, Stan; Allen, Colin

2010-07-01

Recently, there has been a resurgence of interest in general, comprehensive models of human cognition. Such models aim to explain higher-order cognitive faculties, such as deliberation and planning. Given a computational representation, the validity of these models can be tested in computer simulations such as software agents or embodied robots. The push to implement computational models of this kind has created the field of artificial general intelligence (AGI). Moral decision making is arguably one of the most challenging tasks for computational approaches to higher-order cognition. The need for increasingly autonomous artificial agents to factor moral considerations into their choices and actions has given rise to another new field of inquiry variously known as Machine Morality, Machine Ethics, Roboethics, or Friendly AI. In this study, we discuss how LIDA, an AGI model of human cognition, can be adapted to model both affective and rational features of moral decision making. Using the LIDA model, we will demonstrate how moral decisions can be made in many domains using the same mechanisms that enable general decision making. Comprehensive models of human cognition typically aim for compatibility with recent research in the cognitive and neural sciences. Global workspace theory, proposed by the neuropsychologist Bernard Baars (1988), is a highly regarded model of human cognition that is currently being computationally instantiated in several software implementations. LIDA (Franklin, Baars, Ramamurthy, & Ventura, 2005) is one such computational implementation. LIDA is both a set of computational tools and an underlying model of human cognition, which provides mechanisms that are capable of explaining how an agent's selection of its next action arises from bottom-up collection of sensory data and top-down processes for making sense of its current situation. We will describe how the LIDA model helps integrate emotions into the human decision-making process, and we will elucidate a process whereby an agent can work through an ethical problem to reach a solution that takes account of ethically relevant factors. Copyright © 2010 Cognitive Science Society, Inc.

Experts in offside decision making learn to compensate for their illusory perceptions.

PubMed

Put, Koen; Baldo M, V C; Cravo, André M; Wagemans, Johan; Helsen, Werner F

2013-12-01

In association football, the flash-lag effect appears to be a viable explanation for erroneous offside decision making. Due to this spatiotemporal illusion, assistant referees (ARs) perceive the player who receives the ball ahead of his real position. In this experiment, a laboratory decision-making task was used to demonstrate that international top-class ARs, compared with amateur soccer players, do not have superior perceptual sensitivity. They clearly modify their decision criterion according to the contextual needs and, therefore, show a higher response bias toward not responding to the stimulus, in particular in the most difficult situations. Thus, international ARs show evidence for response-level compensation, resulting in a specific cost (i.e., more misses), which clearly reflects the use of particular (cognitive) strategies. In summary, it appears that experts in offside decision making can be distinguished from novices more on the cognitive or decision-making level than on the perceptual level.

To close the childhood immunization gap, we need a richer understanding of parents' decision-making.

PubMed

Corben, Paul; Leask, Julie

2016-12-01

Vaccination is widely acknowledged as one of the most successful public health interventions globally and in most high-income countries childhood vaccination coverage rates are moderately high. Yet in many instances, immunisation rates remain below aspirational targets and have shown only modest progress toward those targets in recent years, despite concerted efforts to improve uptake. In part, coverage rates reflect individual parents' vaccination attitudes and decisions and, because vaccination decision-making is complex and context-specific, it remains challenging at individual and community levels to assist parents to make positive decisions. Consequently, in the search for opportunities to improve immunisation coverage, there has been a renewed research focus on parents' decision-making. This review provides an overview of the literature surrounding parents' vaccination decision-making, offering suggestions for where efforts to increase vaccination coverage should be targeted and identifying areas for further research.

Cone Beam Computed Tomographic imaging in orthodontics.

PubMed

Scarfe, W C; Azevedo, B; Toghyani, S; Farman, A G

2017-03-01

Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process. Specific recommendations provide selection guidance based on variables such as phase of treatment, clinically-assessed treatment difficulty, the presence of dental and/or skeletal modifying conditions, and pathology. CBCT imaging in orthodontics should always be considered wisely as children have conservatively, on average, a three to five times greater radiation risk compared with adults for the same exposure. The purpose of this paper is to provide an understanding of the operation of CBCT equipment as it relates to image quality and dose, highlight the benefits of the technique in orthodontic practice, and provide guidance on appropriate clinical use with respect to radiation dose and relative risk, particularly for the paediatric patient. © 2017 Australian Dental Association.

Training in Decision-Making Strategies: An Approach to Enhance Students' Competence to Deal with Socio-Scientific Issues

ERIC Educational Resources Information Center

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-01-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based…

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

PubMed

Bednar, Dell Elaine; Fisher, Terri D

2003-01-01

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

Everyday Decision Making in Individuals with Early-Stage Alzheimer's Disease: An Integrative Review of the Literature.

PubMed

Davis, Rebecca; Ziomkowski, Mary K; Veltkamp, Amy

2017-09-01

Individuals with Alzheimer's disease (AD) demonstrate fluctuation in cognitive abilities that can affect their ability to make decisions. Everyday decision making encompasses the types of decisions about typical daily activities, such as what to eat, what to do, and what to wear. Everyday decisions are encountered many times per day by individuals with AD/dementia and their caregivers. However, not much is known about the ability of individuals with AD/dementia to make these types of decisions. The purpose of the current literature review was to synthesize the evidence regarding everyday decision making in individuals with early-stage AD/dementia. Findings from the review indicate there is beginning evidence that individuals with early to moderate stages of AD/dementia desire to have input in daily decisions, have the ability to state their wishes consistently at times, and having input in decision making is important to their selfhood. The literature revealed few interventions to assist individuals with AD/dementia in everyday decision making. Findings from the review are discussed with implications for nursing practice and research. [Res Gerontol Nurs. 2017; 10(5):240-247.]. Copyright 2017, SLACK Incorporated.

Accommodations: Assisting Students with Disabilities. Third Edition

ERIC Educational Resources Information Center

Beech, Marty

2010-01-01

This document updates "Accommodations: Assisting Students with Disabilities. A Guide for Educators," published by the Florida Department of Education (FDOE) in 2003. This document is written to assist school district personnel and parents when making decisions about the use of accommodations by students with disabilities in instructional…

This "Ethical Trap" Is for Roboticists, Not Robots: On the Issue of Artificial Agent Ethical Decision-Making.

PubMed

Miller, Keith W; Wolf, Marty J; Grodzinsky, Frances

2017-04-01

In this paper we address the question of when a researcher is justified in describing his or her artificial agent as demonstrating ethical decision-making. The paper is motivated by the amount of research being done that attempts to imbue artificial agents with expertise in ethical decision-making. It seems clear that computing systems make decisions, in that they make choices between different options; and there is scholarship in philosophy that addresses the distinction between ethical decision-making and general decision-making. Essentially, the qualitative difference between ethical decisions and general decisions is that ethical decisions must be part of the process of developing ethical expertise within an agent. We use this distinction in examining publicity surrounding a particular experiment in which a simulated robot attempted to safeguard simulated humans from falling into a hole. We conclude that any suggestions that this simulated robot was making ethical decisions were misleading.

SuperPILOT: A Comprehensive Computer-Assisted Instruction Programming Language for the Apple II Computer.

ERIC Educational Resources Information Center

Falleur, David M.

This presentation describes SuperPILOT, an extended version of Apple PILOT, a programming language for developing computer-assisted instruction (CAI) with the Apple II computer that includes the features of its early PILOT (Programmed Inquiry, Learning or Teaching) ancestors together with new features that make use of the Apple computer's advanced…

Taking an Evaluative Stance to Decision-Making about Professional Development Options in Early Childhood Education and Care

ERIC Educational Resources Information Center

Brownlee, Joanne Lunn; Sumsion, Jennifer; Irvine, Susan; Berthelsen, Donna; Farrell, Ann; Walsh, Kerryann; Ryan, Sharon; Mulhearn, Gerry

2015-01-01

This article builds on our ongoing work in conceptualising an "evaluative stance" framework to assist in understanding how leaders in the field of early childhood education and care (ECEC) make decisions about the selection of professional development options for themselves and their staff. It introduces the notion that evaluative…

Longitudinal Analysis Technique to Assist School Leaders in Making Critical Curriculum and Instruction Decisions for School Improvement

ERIC Educational Resources Information Center

Bigham, Gary D.; Riney, Mark R.

2017-01-01

To meet the constantly changing needs of schools and diverse learners, educators must frequently monitor student learning, revise curricula, and improve instruction. Consequently, it is critical that careful analyses of student performance data are ongoing components of curriculum decision-making processes. The primary purpose of this study is to…

Legal Decision-Making by People with Aphasia: Critical Incidents for Speech Pathologists

ERIC Educational Resources Information Center

Ferguson, Alison; Duffield, Gemma; Worrall, Linda

2010-01-01

Background: The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. Aims: The research presented in this paper aimed to identify the main issues…

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

PubMed

Wahl, Stacy E; Thompson, Anita M

2013-10-01

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

CET exSim: mineral exploration experience via simulation

NASA Astrophysics Data System (ADS)

Wong, Jason C.; Holden, Eun-Jung; Kovesi, Peter; McCuaig, T. Campbell; Hronsky, Jon

2013-08-01

Undercover mineral exploration is a challenging task as it requires understanding of subsurface geology by relying heavily on remotely sensed (i.e. geophysical) data. Cost-effective exploration is essential in order to increase the chance of success using finite budgets. This requires effective decision-making in both the process of selecting the optimum data collection methods and in the process of achieving accuracy during subsequent interpretation. Traditionally, developing the skills, behaviour and practices of exploration decision-making requires many years of experience through working on exploration projects under various geological settings, commodities and levels of available resources. This implies long periods of sub-optimal exploration decision-making, before the necessary experience has been successfully obtained. To address this critical industry issue, our ongoing research focuses on the development of the unique and novel e-learning environment, exSim, which simulates exploration scenarios where users can test their strategies and learn the consequences of their choices. This simulator provides an engaging platform for self-learning and experimentation in exploration decision strategies, providing a means to build experience more effectively. The exSim environment also provides a unique platform on which numerous scenarios and situations (e.g. deposit styles) can be simulated, potentially allowing the user to become virtually familiarised with a broader scope of exploration practices. Harnessing the power of computer simulation, visualisation and an intuitive graphical user interface, the simulator provides a way to assess the user's exploration decisions and subsequent interpretations. In this paper, we present the prototype functionalities in exSim including: simulation of geophysical surveys, follow-up drill testing and interpretation assistive tools.

Decision technology.

PubMed

Edwards, W; Fasolo, B

2001-01-01

This review is about decision technology-the rules and tools that help us make wiser decisions. First, we review the three rules that are at the heart of most traditional decision technology-multi-attribute utility, Bayes' theorem, and subjective expected utility maximization. Since the inception of decision research, these rules have prescribed how we should infer values and probabilities and how we should combine them to make better decisions. We suggest how to make best use of all three rules in a comprehensive 19-step model. The remainder of the review explores recently developed tools of decision technology. It examines the characteristics and problems of decision-facilitating sites on the World Wide Web. Such sites now provide anyone who can use a personal computer with access to very sophisticated decision-aiding tools structured mainly to facilitate consumer decision making. It seems likely that the Web will be the mode by means of which decision tools will be distributed to lay users. But methods for doing such apparently simple things as winnowing 3000 options down to a more reasonable number, like 10, contain traps for unwary decision technologists. The review briefly examines Bayes nets and influence diagrams-judgment and decision-making tools that are available as computer programs. It very briefly summarizes the state of the art of eliciting probabilities from experts. It concludes that decision tools will be as important in the 21st century as spreadsheets were in the 20th.

Towards an Intelligent Textbook of Neurology

PubMed Central

Reggia, James A.; Pula, Thaddeus P.; Price, Thomas R.; Perricone, Barry T.

1980-01-01

We define an intelligent textbook of medicine to be a computer system that: (1) provides for storage and selective retrieval of synthesized clinical knowledge for reference purposes; and (2) supports the application by computer of its knowledge to patient information to assist physicians with decision making. This paper describes an experimental system called KMS (a Knowledge Management System) for creating and using intelligent medical textbooks. KMS is domain-independent, supports multiple inference methods and representation languages, and is designed for direct use by physicians during the knowledge acquisition process. It is presented here in the context of the development of an Intelligent Textbook of Neurology. We suggest that KMS has the potential to overcome some of the problems that have inhibited the use of knowledge-based systems by physicians in the past.

Making objective decisions in mechanical engineering problems

NASA Astrophysics Data System (ADS)

Raicu, A.; Oanta, E.; Sabau, A.

2017-08-01

Decision making process has a great influence in the development of a given project, the goal being to select an optimal choice in a given context. Because of its great importance, the decision making was studied using various science methods, finally being conceived the game theory that is considered the background for the science of logical decision making in various fields. The paper presents some basic ideas regarding the game theory in order to offer the necessary information to understand the multiple-criteria decision making (MCDM) problems in engineering. The solution is to transform the multiple-criteria problem in a one-criterion decision problem, using the notion of utility, together with the weighting sum model or the weighting product model. The weighted importance of the criteria is computed using the so-called Step method applied to a relation of preferences between the criteria. Two relevant examples from engineering are also presented. The future directions of research consist of the use of other types of criteria, the development of computer based instruments for decision making general problems and to conceive a software module based on expert system principles to be included in the Wiki software applications for polymeric materials that are already operational.

Factors Influencing the Adoption of Cloud Computing by Decision Making Managers

ERIC Educational Resources Information Center

Ross, Virginia Watson

2010-01-01

Cloud computing is a growing field, addressing the market need for access to computing resources to meet organizational computing requirements. The purpose of this research is to evaluate the factors that influence an organization in their decision whether to adopt cloud computing as a part of their strategic information technology planning.…

Impaired social decision making in patients with major depressive disorder.

PubMed

Wang, Yun; Zhou, Yuan; Li, Shu; Wang, Peng; Wu, Guo-Wei; Liu, Zhe-Ning

2014-01-23

Abnormal decision-making processes have been observed in patients with major depressive disorder (MDD). However, it is unresolved whether MDD patients show abnormalities in decision making in a social interaction context, in which decisions have actual influences on both the self-interests of the decision makers per se and those of their partners. Using a well-studied ultimatum game (UG), which is frequently used to investigate social interaction behavior, we examined whether MDD can be associated with abnormalities in social decision-making behavior by comparing the acceptance rates of MDD patients (N = 14) with those of normal controls (N = 19). The acceptance rates of the patients were lower than those of the normal controls. Additionally, unfair proposals were accepted at similar rates from computer partners and human partners in the MDD patients, unlike the acceptance rates in the normal controls, who were able to discriminatively treat unfair proposals from computer partners and human partners. Depressed patients show abnormal decision-making behavior in a social interaction context. Several possible explanations, such as increased sensitivity to fairness, negative emotional state and disturbed affective cognition, have been proposed to account for the abnormal social decision-making behavior in patients with MDD. This aberrant social decision-making behavior may provide a new perspective in the search to find biomarkers for the diagnosis and prognosis of MDD.

Assisted Dying & Disability.

PubMed

Riddle, Christopher A

2017-07-01

This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities. © 2017 John Wiley & Sons Ltd.

Making the Right Decisions: Leadership in 1-to-1 Computing in Education

ERIC Educational Resources Information Center

Towndrow, Phillip A.; Vallance, Michael

2013-01-01

Purpose: The purpose of this paper is to detail the necessity for more informed decision making and leadership in the implementation of 1-to-1 computing in education. Design/methodology/approach: The contexts of high-tech countries of Singapore and Japan are used as case studies to contextualize and support four evidence-based recommendations for…

Pilot interaction with automated airborne decision making systems

NASA Technical Reports Server (NTRS)

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

1976-01-01

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

40 CFR 35.4005 - What is a Technical Assistance Grant?

Code of Federal Regulations, 2010 CFR

2010-07-01

... public participation in decision making at eligible sites. A TAG allows your group to procure independent... Technical Assistance Grant? A Technical Assistance Grant (TAG) provides money for your group to obtain... how a technical advisor can help your group include, but are not limited to: (a) Reviewing preliminary...

Payment for Assistive Devices by the Veterans Administration.

ERIC Educational Resources Information Center

Reeb, Kenneth G., Jr.; Stripling, Thomas E.

This report provides an overview of the Veterans Administration (VA) and how it pays for assistive devices for veterans. It explains the VA payment structure and decision-making responsibilities concerning assistive equipment. Following an introductory section, the report provides background on the VA system, summarizing its legislative origins,…

Vulnerability to Elder Abuse and Neglect in Assisted Living Facilities

ERIC Educational Resources Information Center

Wood, Stacey; Stephens, Mary

2003-01-01

Purpose: The purpose of this study was to examine the decision-making abilities of residents in assisted living regarding abuse and neglect. Design and Methods: Twenty-seven residents in assisted living facilities were recruited for this descriptive study. Participants were administered an interview to assess baseline knowledge of support…

The child brain computes and utilizes internalized maternal choices

PubMed Central

Lim, Seung-Lark; Cherry, J. Bradley C.; Davis, Ann M.; Balakrishnan, S. N.; Ha, Oh-Ryeong; Bruce, Jared M.; Bruce, Amanda S.

2016-01-01

As children grow, they gradually learn how to make decisions independently. However, decisions like choosing healthy but less-tasty foods can be challenging for children whose self-regulation and executive cognitive functions are still maturing. We propose a computational decision-making process in which children estimate their mother's choices for them as well as their individual food preferences. By employing functional magnetic resonance imaging during real food choices, we find that the ventromedial prefrontal cortex (vmPFC) encodes children's own preferences and the left dorsolateral prefrontal cortex (dlPFC) encodes the projected mom's choices for them at the time of children's choice. Also, the left dlPFC region shows an inhibitory functional connectivity with the vmPFC at the time of children's own choice. Our study suggests that in part, children utilize their perceived caregiver's choices when making choices for themselves, which may serve as an external regulator of decision-making, leading to optimal healthy decisions. PMID:27218420

Computer models for economic and silvicultural decisions

Treesearch

Rosalie J. Ingram

1989-01-01

Computer systems can help simplify decisionmaking to manage forest ecosystems. We now have computer models to help make forest management decisions by predicting changes associated with a particular management action. Models also help you evaluate alternatives. To be effective, the computer models must be reliable and appropriate for your situation.

Evidence of Effectiveness of Health Care Professionals Using Handheld Computers: A Scoping Review of Systematic Reviews

PubMed Central

2013-01-01

Background Handheld computers and mobile devices provide instant access to vast amounts and types of useful information for health care professionals. Their reduced size and increased processing speed has led to rapid adoption in health care. Thus, it is important to identify whether handheld computers are actually effective in clinical practice. Objective A scoping review of systematic reviews was designed to provide a quick overview of the documented evidence of effectiveness for health care professionals using handheld computers in their clinical work. Methods A detailed search, sensitive for systematic reviews was applied for Cochrane, Medline, EMBASE, PsycINFO, Allied and Complementary Medicine Database (AMED), Global Health, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. All outcomes that demonstrated effectiveness in clinical practice were included. Classroom learning and patient use of handheld computers were excluded. Quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. A previously published conceptual framework was used as the basis for dual data extraction. Reported outcomes were summarized according to the primary function of the handheld computer. Results Five systematic reviews met the inclusion and quality criteria. Together, they reviewed 138 unique primary studies. Most reviewed descriptive intervention studies, where physicians, pharmacists, or medical students used personal digital assistants. Effectiveness was demonstrated across four distinct functions of handheld computers: patient documentation, patient care, information seeking, and professional work patterns. Within each of these functions, a range of positive outcomes were reported using both objective and self-report measures. The use of handheld computers improved patient documentation through more complete recording, fewer documentation errors, and increased efficiency. Handheld computers provided easy access to clinical decision support systems and patient management systems, which improved decision making for patient care. Handheld computers saved time and gave earlier access to new information. There were also reports that handheld computers enhanced work patterns and efficiency. Conclusions This scoping review summarizes the secondary evidence for effectiveness of handheld computers and mhealth. It provides a snapshot of effective use by health care professionals across four key functions. We identified evidence to suggest that handheld computers provide easy and timely access to information and enable accurate and complete documentation. Further, they can give health care professionals instant access to evidence-based decision support and patient management systems to improve clinical decision making. Finally, there is evidence that handheld computers allow health professionals to be more efficient in their work practices. It is anticipated that this evidence will guide clinicians and managers in implementing handheld computers in clinical practice and in designing future research. PMID:24165786

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

PubMed

Kageyama, Yoko; Asano, Midori

2017-12-01

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

42 CFR 412.278 - Administrator's review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... or computational errors, or to correct the decision if the evidence that was considered in making the... discretion, may amend the decision to correct mathematical or computational errors, or to correct the...

42 CFR 412.278 - Administrator's review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... or computational errors, or to correct the decision if the evidence that was considered in making the... discretion, may amend the decision to correct mathematical or computational errors, or to correct the...

42 CFR 412.278 - Administrator's review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... or computational errors, or to correct the decision if the evidence that was considered in making the... discretion, may amend the decision to correct mathematical or computational errors, or to correct the...

42 CFR 412.278 - Administrator's review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... or computational errors, or to correct the decision if the evidence that was considered in making the... discretion, may amend the decision to correct mathematical or computational errors, or to correct the...

Bounded Rationality, Emotions and Older Adult Decision Making: Not so Fast and yet so Frugal

ERIC Educational Resources Information Center

Hanoch, Yaniv; Wood, Stacey; Rice, Thomas

2007-01-01

Herbert Simon's work on bounded rationality has had little impact on researchers studying older adults' decision making. This omission is surprising, as human constraints on computation and memory are exacerbated in older adults. The study of older adults' decision-making processes could benefit from employing a bounded rationality perspective,…

The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes.

PubMed

Redish, A David; Schultheiss, Nathan W; Carter, Evan C

2016-01-01

The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent's perspective (rather than the experimenter's), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction.

Building Bridges between Perceptual and Economic Decision-Making: Neural and Computational Mechanisms.

PubMed

Summerfield, Christopher; Tsetsos, Konstantinos

2012-01-01

Investigation into the neural and computational bases of decision-making has proceeded in two parallel but distinct streams. Perceptual decision-making (PDM) is concerned with how observers detect, discriminate, and categorize noisy sensory information. Economic decision-making (EDM) explores how options are selected on the basis of their reinforcement history. Traditionally, the sub-fields of PDM and EDM have employed different paradigms, proposed different mechanistic models, explored different brain regions, disagreed about whether decisions approach optimality. Nevertheless, we argue that there is a common framework for understanding decisions made in both tasks, under which an agent has to combine sensory information (what is the stimulus) with value information (what is it worth). We review computational models of the decision process typically used in PDM, based around the idea that decisions involve a serial integration of evidence, and assess their applicability to decisions between good and gambles. Subsequently, we consider the contribution of three key brain regions - the parietal cortex, the basal ganglia, and the orbitofrontal cortex (OFC) - to perceptual and EDM, with a focus on the mechanisms by which sensory and reward information are integrated during choice. We find that although the parietal cortex is often implicated in the integration of sensory evidence, there is evidence for its role in encoding the expected value of a decision. Similarly, although much research has emphasized the role of the striatum and OFC in value-guided choices, they may play an important role in categorization of perceptual information. In conclusion, we consider how findings from the two fields might be brought together, in order to move toward a general framework for understanding decision-making in humans and other primates.

Building Bridges between Perceptual and Economic Decision-Making: Neural and Computational Mechanisms

PubMed Central

Summerfield, Christopher; Tsetsos, Konstantinos

2012-01-01

Investigation into the neural and computational bases of decision-making has proceeded in two parallel but distinct streams. Perceptual decision-making (PDM) is concerned with how observers detect, discriminate, and categorize noisy sensory information. Economic decision-making (EDM) explores how options are selected on the basis of their reinforcement history. Traditionally, the sub-fields of PDM and EDM have employed different paradigms, proposed different mechanistic models, explored different brain regions, disagreed about whether decisions approach optimality. Nevertheless, we argue that there is a common framework for understanding decisions made in both tasks, under which an agent has to combine sensory information (what is the stimulus) with value information (what is it worth). We review computational models of the decision process typically used in PDM, based around the idea that decisions involve a serial integration of evidence, and assess their applicability to decisions between good and gambles. Subsequently, we consider the contribution of three key brain regions – the parietal cortex, the basal ganglia, and the orbitofrontal cortex (OFC) – to perceptual and EDM, with a focus on the mechanisms by which sensory and reward information are integrated during choice. We find that although the parietal cortex is often implicated in the integration of sensory evidence, there is evidence for its role in encoding the expected value of a decision. Similarly, although much research has emphasized the role of the striatum and OFC in value-guided choices, they may play an important role in categorization of perceptual information. In conclusion, we consider how findings from the two fields might be brought together, in order to move toward a general framework for understanding decision-making in humans and other primates. PMID:22654730

An exploratory study of the Work Ability Index (WAI) and its components in a group of computer workers.

PubMed

Costa, Ana Filipa; Puga-Leal, Rogério; Nunes, Isabel L

2011-01-01

The objective of this paper is to present a study on the assessment of the work ability of a group of aged computers workers. The study was developed with the goal of creating a decision making framework oriented towards the maintenance of the health and working ability of aged workers. Fifty computer workers participated in this study. They were administrative secretaries and computer technicians working mainly with office computers. The method used to assess the work ability was the Work Ability Index (WAI). 78% of the participants had good or excellent work ability and only 2% a poor one. The average WAI score was 40.5 (SD=5.761; min=27; max=49). This study confirms the decrease in work ability of workers while aging. The group overall work ability was slightly higher than the reference values develop by the Finnish Institute of Occupational Health. The assessment of work ability is fundamental to make age-friendly workplaces. WAI is one tool designed to perform such assessment. The results obtained could assist the early identification of situations where employees are struggling with their work ability, thus helping to prioritize ergonomic interventions devoted to improve the working conditions, and allowing the continued employment of aging workers on their current job.

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

ERIC Educational Resources Information Center

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

2000-01-01

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

36 CFR 800.9 - Council review of section 106 compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Council's opinion in making a decision on whether to grant assistance to the applicant, and shall notify... decision or regarding the adequacy of the agency official's compliance with the procedures under this part... a decision on the matter in question. (b) Agency foreclosure of the Council's opportunity to comment...

Decision-making based on emotional images.

PubMed

Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato

2011-01-01

The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants' choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the "reward value" of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants' choice data, we used reinforcement learning models that have successfully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures) was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making.

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

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

PubMed

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

2015-09-01

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

Ag2S atomic switch-based `tug of war' for decision making

NASA Astrophysics Data System (ADS)

Lutz, C.; Hasegawa, T.; Chikyow, T.

2016-07-01

For a computing process such as making a decision, a software controlled chip of several transistors is necessary. Inspired by how a single cell amoeba decides its movements, the theoretical `tug of war' computing model was proposed but not yet implemented in an analogue device suitable for integrated circuits. Based on this model, we now developed a new electronic element for decision making processes, which will have no need for prior programming. The devices are based on the growth and shrinkage of Ag filaments in α-Ag2+δS gap-type atomic switches. Here we present the adapted device design and the new materials. We demonstrate the basic `tug of war' operation by IV-measurements and Scanning Electron Microscopy (SEM) observation. These devices could be the base for a CMOS-free new computer architecture.For a computing process such as making a decision, a software controlled chip of several transistors is necessary. Inspired by how a single cell amoeba decides its movements, the theoretical `tug of war' computing model was proposed but not yet implemented in an analogue device suitable for integrated circuits. Based on this model, we now developed a new electronic element for decision making processes, which will have no need for prior programming. The devices are based on the growth and shrinkage of Ag filaments in α-Ag2+δS gap-type atomic switches. Here we present the adapted device design and the new materials. We demonstrate the basic `tug of war' operation by IV-measurements and Scanning Electron Microscopy (SEM) observation. These devices could be the base for a CMOS-free new computer architecture. Electronic supplementary information (ESI) available. See DOI: 10.1039/c6nr00690f

Estimating the Reliability of the CITAR Computer Courseware Evaluation System.

ERIC Educational Resources Information Center

Micceri, Theodore

In today's complex computer-based teaching (CBT)/computer-assisted instruction market, flashy presentations frequently prove the most important purchasing element, while instructional design and content are secondary to form. Courseware purchasers must base decisions upon either a vendor's presentation or some published evaluator rating.…

Evaluation and diagnosis of low back pain.

PubMed

Manusov, Eron G

2012-09-01

The diagnosis of low back pain is complicated by the varying presentations and complex nature of pain and the nonstandardized approach by physicians to clinical decision making. Only a few physicians use evidence-based guidelines to assist with clinical decision making. This article reviews a systematic approach to the evaluation and diagnosis of low back pain. Copyright © 2012 Elsevier Inc. All rights reserved.

Fair Play: Developing Self-Concept and Decision-Making Skills in the Middle School. Implementation Handbook.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee.

This handbook is designed to assist schools in carrying out the following goals of the Fair Play program: to strengthen and expand students' female or male self-concepts, to increase their decision-making skills, and to increase their academic achievement by changing their stereotypic attitude toward particular content areas. The Fair Play program…

Use of a Computer Program for Advance Care Planning with African American Participants.

PubMed

Markham, Sarah A; Levi, Benjamin H; Green, Michael J; Schubart, Jane R

2015-02-01

The authors wish to acknowledge the support and assistance of Dr. William Lawrence for his contribution to the M.A.UT model used in the decision aid, Making Your Wishes Known: Planning Your Medical Future (MYWK), Dr. Cheryl Dellasega for her leadership in focus group activities, Charles Sabatino for his review of legal aspects of MYWK, Dr. Robert Pearlman and his collaborative team for use of the advance care planning booklet "Your Life, Your Choices," Megan Whitehead for assistance in grant preparation and project organization, and the Instructional Media Development Center at the University of Wisconsin as well as JPL Integrated Communications for production and programming of MYWK. For various cultural and historical reasons, African Americans are less likely than Caucasians to engage in advance care planning (ACP) for healthcare decisions. This pilot study tested whether an interactive computer program could help overcome barriers to effective ACP among African Americans. African American adults were recruited from traditionally Black churches to complete an interactive computer program on ACP, pre-/post-questionnaires, and a follow-up phone interview. Eighteen adults (mean age =53.2 years, 83% female) completed the program without any problems. Knowledge about ACP significantly increased following the computer intervention (44.9% → 61.3%, p=0.0004), as did individuals' sense of self-determination. Participants were highly satisfied with the ACP process (9.4; 1 = not at all satisfied, 10 = extremely satisfied), and reported that the computer-generated advance directive accurately reflected their wishes (6.4; 1 = not at all accurate, 7 = extremely accurate). Follow-up phone interviews found that >80% of participants reported having shared their advance directives with family members and spokespeople. Preliminary evidence suggests that an interactive computer program can help African Americans engage in effective advance care planning, including creating an accurate advance directive document that will be shared with loved ones. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

Image-guided decision support system for pulmonary nodule classification in 3D thoracic CT images

NASA Astrophysics Data System (ADS)

Kawata, Yoshiki; Niki, Noboru; Ohmatsu, Hironobu; Kusumoto, Masahiro; Kakinuma, Ryutaro; Mori, Kiyoshi; Yamada, Kozo; Nishiyama, Hiroyuki; Eguchi, Kenji; Kaneko, Masahiro; Moriyama, Noriyuki

2004-05-01

The purpose of this study is to develop an image-guided decision support system that assists decision-making in clinical differential diagnosis of pulmonary nodules. This approach retrieves and displays nodules that exhibit morphological and internal profiles consistent to the nodule in question. It uses a three-dimensional (3-D) CT image database of pulmonary nodules for which diagnosis is known. In order to build the system, there are following issues that should be solved: 1) to categorize the nodule database with respect to morphological and internal features, 2) to quickly search nodule images similar to an indeterminate nodule from a large database, and 3) to reveal malignancy likelihood computed by using similar nodule images. Especially, the first problem influences the design of other issues. The successful categorization of nodule pattern might lead physicians to find important cues that characterize benign and malignant nodules. This paper focuses on an approach to categorize the nodule database with respect to nodule shape and CT density patterns inside nodule.

Improved Accuracy Using Recursive Bayesian Estimation Based Language Model Fusion in ERP-Based BCI Typing Systems

PubMed Central

Orhan, U.; Erdogmus, D.; Roark, B.; Oken, B.; Purwar, S.; Hild, K. E.; Fowler, A.; Fried-Oken, M.

2013-01-01

RSVP Keyboard™ is an electroencephalography (EEG) based brain computer interface (BCI) typing system, designed as an assistive technology for the communication needs of people with locked-in syndrome (LIS). It relies on rapid serial visual presentation (RSVP) and does not require precise eye gaze control. Existing BCI typing systems which uses event related potentials (ERP) in EEG suffer from low accuracy due to low signal-to-noise ratio. Henceforth, RSVP Keyboard™ utilizes a context based decision making via incorporating a language model, to improve the accuracy of letter decisions. To further improve the contributions of the language model, we propose recursive Bayesian estimation, which relies on non-committing string decisions, and conduct an offline analysis, which compares it with the existing naïve Bayesian fusion approach. The results indicate the superiority of the recursive Bayesian fusion and in the next generation of RSVP Keyboard™ we plan to incorporate this new approach. PMID:23366432

Design and implementation of intelligent electronic warfare decision making algorithm

NASA Astrophysics Data System (ADS)

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

2017-05-01

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

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

PubMed

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

2015-10-01

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

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

PubMed

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

2011-12-01

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

Goal-Directed Decision Making as Probabilistic Inference: A Computational Framework and Potential Neural Correlates

ERIC Educational Resources Information Center

Solway, Alec; Botvinick, Matthew M.

2012-01-01

Recent work has given rise to the view that reward-based decision making is governed by two key controllers: a habit system, which stores stimulus-response associations shaped by past reward, and a goal-oriented system that selects actions based on their anticipated outcomes. The current literature provides a rich body of computational theory…

Simulation of human decision making

DOEpatents

Forsythe, J Chris [Sandia Park, NM; Speed, Ann E [Albuquerque, NM; Jordan, Sabina E [Albuquerque, NM; Xavier, Patrick G [Albuquerque, NM

2008-05-06

A method for computer emulation of human decision making defines a plurality of concepts related to a domain and a plurality of situations related to the domain, where each situation is a combination of at least two of the concepts. Each concept and situation is represented in the computer as an oscillator output, and each situation and concept oscillator output is distinguishable from all other oscillator outputs. Information is input to the computer representative of detected concepts, and the computer compares the detected concepts with the stored situations to determine if a situation has occurred.

Exploring cognitive bias in destination therapy left ventricular assist device decision making: A retrospective qualitative framework analysis.

PubMed

Magid, Molly; McIlvennan, Colleen K; Jones, Jaqueline; Nowels, Carolyn T; Allen, Larry A; Thompson, Jocelyn S; Matlock, Dan

2016-10-01

Cognitive biases are psychological influences, which cause humans to make decisions, which do not seemingly maximize utility. For people with heart failure, the left ventricular assist device (LVAD) is a surgically implantable device with complex tradeoffs. As such, it represents an excellent model within which to explore cognitive bias in a real-world decision. We conducted a framework analysis to examine for evidence of cognitive bias among people deciding whether or not to get an LVAD. The aim of this study was to explore the influence of cognitive bias on the LVAD decision-making process. We analyzed previously conducted interviews of patients who had either accepted or declined an LVAD using a deductive, predetermined framework of cognitive biases. We coded and analyzed the interviews using an inductive-deductive framework approach, which also allowed for other themes to emerge. We interviewed a total of 22 heart failure patients who had gone through destination therapy LVAD decision making (15 who had accepted the LVAD and 7 who had declined). All patients appeared influenced by state dependence, where both groups described high current state of suffering, but the groups differed in whether they believed LVAD would relieve suffering or not. We found evidence of cognitive bias that appeared to influence decision making in both patient groups, but groups differed in terms of which cognitive biases were present. Among accepters, we found evidence of anchoring bias, availability bias, optimism bias, and affective forecasting. Among decliners, we found evidence of errors in affective forecasting. Medical decision making is often a complicated and multifaceted process that includes cognitive bias as well as other influences. It is important for clinicians to recognize that patients can be affected by cognitive bias, so they can better understand and improve the decision-making process to ensure that patients are fully informed. Published by Elsevier Inc.

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

PubMed Central

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

2014-01-01

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

A Common Mechanism Underlying Food Choice and Social Decisions.

PubMed

Krajbich, Ian; Hare, Todd; Bartling, Björn; Morishima, Yosuke; Fehr, Ernst

2015-10-01

People make numerous decisions every day including perceptual decisions such as walking through a crowd, decisions over primary rewards such as what to eat, and social decisions that require balancing own and others' benefits. The unifying principles behind choices in various domains are, however, still not well understood. Mathematical models that describe choice behavior in specific contexts have provided important insights into the computations that may underlie decision making in the brain. However, a critical and largely unanswered question is whether these models generalize from one choice context to another. Here we show that a model adapted from the perceptual decision-making domain and estimated on choices over food rewards accurately predicts choices and reaction times in four independent sets of subjects making social decisions. The robustness of the model across domains provides behavioral evidence for a common decision-making process in perceptual, primary reward, and social decision making.

A Common Mechanism Underlying Food Choice and Social Decisions

PubMed Central

Krajbich, Ian; Hare, Todd; Bartling, Björn; Morishima, Yosuke; Fehr, Ernst

2015-01-01

People make numerous decisions every day including perceptual decisions such as walking through a crowd, decisions over primary rewards such as what to eat, and social decisions that require balancing own and others’ benefits. The unifying principles behind choices in various domains are, however, still not well understood. Mathematical models that describe choice behavior in specific contexts have provided important insights into the computations that may underlie decision making in the brain. However, a critical and largely unanswered question is whether these models generalize from one choice context to another. Here we show that a model adapted from the perceptual decision-making domain and estimated on choices over food rewards accurately predicts choices and reaction times in four independent sets of subjects making social decisions. The robustness of the model across domains provides behavioral evidence for a common decision-making process in perceptual, primary reward, and social decision making. PMID:26460812

Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

PubMed

Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

2013-03-06

Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings should be incorporated into the design and implementation of a computerized shared decision aid at an inner-city hospital.

Computer-Assisted Pregnancy Management

PubMed Central

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

1987-01-01

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

Monitoring and decision making by people in man machine systems

NASA Technical Reports Server (NTRS)

Johannsen, G.

1979-01-01

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

Naturalistic Decision Making: Implications for Design

DTIC Science & Technology

1993-04-01

Cognitive Task Analysis Decision Making Design Engineer Design System Human-Computer Interface System Development 15. NUMBER OF PAGES 182 16...people use to select a course of action. The SOAR explains how stress affects the decision making of both individuals and teams. COGNITIVE TASK ANALYSIS : This...procedures for Cognitive Task Analysis , contrasting the strengths and weaknesses of each, and showing how a Cognitive Task Analysis

The Impact of Information Displays on Decision Making

DTIC Science & Technology

2017-09-01

ARL-TN-0846 ● SEP 2017 US Army Research Laboratory The Impact of Information Displays on Decision Making by John Shevlin... Information Displays on Decision Making by John Shevlin VTCC Delta Company ’19, AROTC Bravo Company Marc Jackson and Sue E Kase...Computational and Information Sciences Directorate, ARL Daniel Cassenti Human Research and Engineering Directorate, ARL Approved for public

Goal-directed decision making as probabilistic inference: A computational framework and potential neural correlates

PubMed Central

Solway, A.; Botvinick, M.

2013-01-01

Recent work has given rise to the view that reward-based decision making is governed by two key controllers: a habit system, which stores stimulus-response associations shaped by past reward, and a goal-oriented system that selects actions based on their anticipated outcomes. The current literature provides a rich body of computational theory addressing habit formation, centering on temporal-difference learning mechanisms. Less progress has been made toward formalizing the processes involved in goal-directed decision making. We draw on recent work in cognitive neuroscience, animal conditioning, cognitive and developmental psychology and machine learning, to outline a new theory of goal-directed decision making. Our basic proposal is that the brain, within an identifiable network of cortical and subcortical structures, implements a probabilistic generative model of reward, and that goal-directed decision making is effected through Bayesian inversion of this model. We present a set of simulations implementing the account, which address benchmark behavioral and neuroscientific findings, and which give rise to a set of testable predictions. We also discuss the relationship between the proposed framework and other models of decision making, including recent models of perceptual choice, to which our theory bears a direct connection. PMID:22229491

Decision-Making and the Interface between Human Intelligence and Artificial Intelligence. AIR 1987 Annual Forum Paper.

ERIC Educational Resources Information Center

Henard, Ralph E.

Possible future developments in artificial intelligence (AI) as well as its limitations are considered that have implications for institutional research in higher education, and especially decision making and decision support systems. It is noted that computer software programs have been developed that store knowledge and mimic the decision-making…

Intelligent Decisions? Intelligent Support? Agenda and Participants for the Internal Workshop on Intelligent Decision Support Systems : Retrospects and Prospects, August 29 - September 2, 2005, Certosa di Pontignano (Siena), Italy

DTIC Science & Technology

2005-09-01

ENGINEERING APPROACH TO INTELLIGENT OPERATOR ASSISTANCE AND AUTONOMOUS VEHICLE GUIDANCE ..................100 27. SHARPLE, SARAH (WITH COX, GEMMA & STEDMON...104 30. TANGO, FABIO: CONCEPT OF AUTONOMIC COMPUTING APPLIED TO TRANSPORTATION ISSUES: THE SENSITIVE CAR .....105 31. TAYLOR, ROBERT: POSITION...SYSTEMS ENGINEERING APPROACH TO INTELLIGENT OPERATOR ASSISTANCE AND AUTONOMOUS VEHICLE GUIDANCE Today’s automation systems are typically introduced

Decision support systems for ecosystem management: An evaluation of existing systems

Treesearch

H. Todd Mowrer; Klaus Barber; Joe Campbell; Nick Crookston; Cathy Dahms; John Day; Jim Laacke; Jim Merzenich; Steve Mighton; Mike Rauscher; Rick Sojda; Joyce Thompson; Peter Trenchi; Mark Twery

1997-01-01

This report evaluated 24 computer-aided decision support systems (DSS) that can support management decision-making in forest ecosystems. It compares the scope of each system, spatial capabilities, computational methods, development status, input and output requirements, user support availability, and system performance. Questionnaire responses from the DSS developers (...

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

PubMed Central

Vogenberg, F. Randy

2009-01-01

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

Shared decision-making in home-care from the nurse's perspective: sitting at the kitchen table--a qualitative descriptive study.

PubMed

Truglio-Londrigan, Marie

2013-10-01

To come to know, understand and describe the experience of shared decision-making in home-care from the nurse's perspective. The literature presents the concept of shared decision-making as a complex process characterised by a partnership between the healthcare provider and the patient, which is participatory and action oriented with education and negotiation leading to agreement. Few studies have been carried out to explore and describe the events that make up the experiences of shared decision-making in home-care from the nurse's perspective. A qualitative descriptive study was implemented. Semi structured interviews were performed with 10 home-care nurses who were asked to reflect on a time in their practice when they were involved in a shared decision-making process with their patient. All data were analysed using Colaizzi's method. The following Themes were uncovered: Begin where the patient is; Education for shared decision-making; The village and shared decision-making; and Whose decision is it? Each of the four Themes contained Subthemes. The findings of this study present shared decision-making as a complex, multidimensional and fluid process. A thorough understanding of shared decision-making is essential within the multiple contexts in which care is delivered. Nurses in clinical practice need to know and understand the events of the experience of shared decision-making. A more comprehensive understanding of these facts can assist home-care nurses in their practice with regard to the application of shared decision-making. © 2013 Blackwell Publishing Ltd.

Expertise transfer for expert system design

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

Boose, J.H.

This book is about the Expertise Transfer System-a computer program which interviews experts and helps them build expert systems, i.e. computer programs that use knowledge from experts to make decisions and judgements under conditions of uncertainty. The techniques are useful to anyone who uses decision-making information based on the expertise of others. The methods can also be applied to personal decision-making. The interviewing methodology is borrowed from a branch of psychology called Personal Construct Theory. It is not necessary to use a computer to take advantage of the techniques from Personal Construction Theory; the fundamental procedures used by the Expertisemore » Transfer System can be performed using paper and pencil. It is not necessary that the reader understand very much about computers to understand the ideas in this book. The few relevant concepts from computer science and expert systems that are needed are explained in a straightforward manner. Ideas from Personal Construct Psychology are also introduced as needed.« less

The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes

PubMed Central

Schultheiss, Nathan W.; Carter, Evan C.

2015-01-01

The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent’s perspective (rather than the experimenter’s), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction. PMID:25981912

Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

PubMed

Jibaja-Weiss, Maria L; Volk, Robert J

2007-01-01

Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy.

Markers of Impaired Decision Making in Nursing Home Residents: Assessment by Nursing Home Staff in a Population-Based Study.

PubMed

Fain, Kevin M; Rosenberg, Paul B; Pirard, Sandrine; Bogunovic, Olivera; Spira, Adam P

2015-07-01

Many nursing home residents have cognitive impairment that affects their decision making. In order to identify potential markers of impaired decision making, we investigated the association between a range of nursing home resident characteristics and impaired decision making in a population-based sample. Participants were 13,013 residents in the 2004 National Nursing Home Survey. We used logistic regression to determine the association between resident characteristics (ie, gender, age, race, mood, recent pain, falls, fractures, or hospitalizations, length of stay, number of activities of daily living (ADL) requiring help, and diagnoses of dementia, anxiety disorders, and depression) and impaired (vs independent) decision making. After controlling for depression and anxiety diagnoses, as well as gender, age, race, and recent hospitalization or pain, characteristics associated with impaired decision making included depressed, sad, or anxious mood ["mild" odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.23-1.58; "severe" OR = 2.69, 95% CI = 2.27-3.20); diagnosed dementia or living on a dementia hall (OR = 5.07, 95% CI = 4.52-5.67); number of ADL requiring assistance (with 5 ADL, OR = 10.69, 95% CI = 6.82-16.75); length of nursing home stay [101-365 days (OR = 1.60, 95% CI = 1.36-1.89); 366 days-2 years (OR = 1.60, 95% CI = 1.34-1.90); >2 years (OR = 2.25, 95% CI = 1.92-2.63)]; and history of falls or fractures in the last 6 months (OR = 1.19, 95% CI = 1.07-1.32)]. Residents reporting pain in the last week were less likely to have impaired decision making (OR = 0.58, 95% CI = 0.52-0.66). We found several independent markers of impaired decision making in nursing home residents, including depressed, sad, or anxious mood (independent of depression or anxiety diagnosis); dementia; and greater need for ADL assistance. Some of these factors, in particular mood, are modifiable and addressing them may help improve decision making. These markers should be explored further to help identify residents with impaired decision making. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Decision-making for destination therapy left ventricular assist devices: implications for caregivers.

PubMed

McIlvennan, Colleen K; Jones, Jacqueline; Allen, Larry A; Lindenfeld, JoAnn; Swetz, Keith M; Nowels, Carolyn; Matlock, Daniel D

2015-03-01

Implanting centers often require the identification of a dedicated caregiver before destination therapy left ventricular assist device (DT LVAD) implantation; however, the caregiver experience surrounding this difficult decision is relatively unexplored. From October 2012 through July 2013, we conducted semistructured, in-depth interviews with caregivers of patients considering DT LVAD. Data were analyzed using a mixed inductive and deductive approach. We interviewed 17 caregivers: 10 caregivers of patients living with DT LVAD, 6 caregivers of patients who had died with DT LVAD, and 1 caregiver of a patient who had declined DT LVAD. The themes identified, which could also be considered dialectical tensions, are broadly interpreted under 3 domains mapping to decision context, process, and outcome: (1) the stark decision context, with tension between hope and reality; (2) the challenging decision process, with tension between wanting loved ones to live and wanting to respect loved ones' wishes; and (3) the downstream decision outcome, with tension between gratitude and burden. Decision-making surrounding DT LVAD should incorporate decision support for patients and caregivers. This should include a focus on caregiver burden and the predictable tensions that caregivers experience. © 2015 American Heart Association, Inc.

Sodium dietary restriction, knowledge, beliefs, and decision-making behavior of older females.

PubMed

Sheahan, Sharon L; Fields, Becky

2008-04-01

The purposes of this qualitative/descriptive study were to (a) explore experiences and decision-making behaviors associated with adoption of a sodium-restricted diet (SRD) among older women with hypertension or heart failure and (b) identify healthcare system and contextual factors that facilitate or impede adherence to SRD. Participants were 33 single older women, aged 65-98 years, residing in three congregate living facilities in the high-risk "coronary valley" area of the United States. A semistructured interview format was employed with three focus groups. The audio-taped transcribed data were content analyzed for themes by the researchers with the assistance of ATLAS.Ti computer software. Predominant themes were lack of SRD education by healthcare providers, a desire for more information about sodium, including the use of alternative herbal seasonings, and large-print informational materials. Eating alone with no motivation to cook and share meals was a contextual barrier to healthy nutrition. To prevent costly hospitalizations and rehospitalization from nonadherence to SRD, clinicians need to provide more structured SRD education supplemented with printed brochures. Exploring the client's nutritional social setting may improve SRD adherence.

Decision Analysis Using Spreadsheets.

ERIC Educational Resources Information Center

Sounderpandian, Jayavel

1989-01-01

Discussion of decision analysis and its importance in a business curriculum focuses on the use of spreadsheets instead of commercial software packages for computer assisted instruction. A hypothetical example is given of a company drilling for oil, and suggestions are provided for classroom exercises using spreadsheets. (seven references) (LRW)

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

PubMed

Klonoff, David C

2013-05-01

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

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

PubMed Central

Klonoff, David C.

2013-01-01

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

Assessment of Two Desk-Top Computer Simulations Used to Train Tactical Decision Making (TDM) of Small Unit Infantry Leaders

DTIC Science & Technology

2007-04-01

judgmental self-doubt, depression, and causal uncertainty, tend to take fewer risks, and have lower self-esteem. Results from two studies (Nygren, 2000...U.S. Army Research Institute for the Behavioral and Social Sciences Research Report 1869 Assessment of Two Desk-Top Computer Simulations Used to...SUBTITLE 5a. CONTRACT OR GRANT NUMBER Assessment of Two Desk-Top Computer Simulations Used to Train Tactical Decision Making (TDM) of Small Unit

Teaching Machines to Think Fuzzy

ERIC Educational Resources Information Center

Technology Teacher, 2004

2004-01-01

Fuzzy logic programs for computers make them more human. Computers can then think through messy situations and make smart decisions. It makes computers able to control things the way people do. Fuzzy logic has been used to control subway trains, elevators, washing machines, microwave ovens, and cars. Pretty much all the human has to do is push one…

New approaches for real time decision support systems

NASA Technical Reports Server (NTRS)

Hair, D. Charles; Pickslay, Kent

1994-01-01

NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

Understanding the Hows and Whys of Decision-Making: From Expected Utility to Divisive Normalization.

PubMed

Glimcher, Paul

2014-01-01

Over the course of the last century, economists and ethologists have built detailed models from first principles of how humans and animals should make decisions. Over the course of the last few decades, psychologists and behavioral economists have gathered a wealth of data at variance with the predictions of these economic models. This has led to the development of highly descriptive models that can often predict what choices people or animals will make but without offering any insight into why people make the choices that they do--especially when those choices reduce a decision-maker's well-being. Over the course of the last two decades, neurobiologists working with economists and psychologists have begun to use our growing understanding of how the nervous system works to develop new models of how the nervous system makes decisions. The result, a growing revolution at the interdisciplinary border of neuroscience, psychology, and economics, is a new field called Neuroeconomics. Emerging neuroeconomic models stand to revolutionize our understanding of human and animal choice behavior by combining fundamental properties of neurobiological representation with decision-theoretic analyses. In this overview, one class of these models, based on the widely observed neural computation known as divisive normalization, is presented in detail. The work demonstrates not only that a discrete class of computation widely observed in the nervous system is fundamentally ubiquitous, but how that computation shapes behaviors ranging from visual perception to financial decision-making. It also offers the hope of reconciling economic analysis of what choices we should make with psychological observations of the choices we actually do make. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.

Signal Detection Analysis of Computer Enhanced Group Decision Making Strategies

DTIC Science & Technology

2007-11-01

group decision making. 20 References American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American... Creelman , C. D. (2005). Detection theory: A user’s guide (2nd ed.). Mahwah, NJ: Lawrence Erlbaum. Sorkin, R. D. (1998). Group performance depends on...the majority rule. Psychological Science, 9, 456-463. Sorkin, R. D. (2001). Signal-detection analysis of group decision making. Psychological

Does empowering resident families or nursing home employees in decision making improve service quality?

PubMed

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

Dynamic optimization of CELSS crop photosynthetic rate by computer-assisted feedback control

NASA Astrophysics Data System (ADS)

Chun, C.; Mitchell, C. A.

1997-01-01

A procedure for dynamic optimization of net photosynthetic rate (Pn) for crop production in Controlled Ecological Life-Support Systems (CELSS) was developed using leaf lettuce as a model crop. Canopy Pn was measured in real time and fed back for environmental control. Setpoints of photosynthetic photon flux (PPF) and CO_2 concentration for each hour of the crop-growth cycle were decided by computer to reach a targeted Pn each day. Decision making was based on empirical mathematical models combined with rule sets developed from recent experimental data. Comparisons showed that dynamic control resulted in better yield per unit energy input to the growth system than did static control. With comparable productivity parameters and potential for significant energy savings, dynamic control strategies will contribute greatly to the sustainability of space-deployed CELSS.

Influences on Healthy-Eating Decision Making in Latino Adolescent Children of Migrant and Seasonal Agricultural Workers.

PubMed

Kilanowski, Jill F

2016-01-01

Latino children demonstrate high rates of unhealthy weight, and children of Latino migrant and seasonal agricultural workers are heavier than their Latino peers. This one-group, cross-sectional, mixed-methods pilot study explored healthy-eating decision making with 12- to 14-year-olds recruited from a Midwest summer migrant education program. Demographics, decision-making, self-efficacy, and social support survey instruments were used, along with gender-specific focus groups. In the convenience sample, which included 24 participants, students felt varying degrees of uncertainty when choosing healthy foods in social situations, and 67% made poor-quality decisions. Parents offered greater support for healthy eating compared with friends. Qualitative analyses identified three themes: healthy decision making includes fruits, vegetables, and physical activity; mothers have influence over health and healthy decisions; and friends encourage unhealthy food choices. Influences on healthy-eating decision making in Latino adolescent children of migrant and seasonal agricultural workers, which were previously missing from the literature, were identified. Future research includes development of interventions to assist these adolescents with healthy-eating decision making. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Identification of high versus lower risk clinical subgroups in a group of adult patients with supratentorial anaplastic astrocytomas.

PubMed

Decaestecker, C; Salmon, I; Camby, I; Dewitte, O; Pasteels, J L; Brotchi, J; Van Ham, P; Kiss, R

1995-05-01

The present work investigates whether computer-assisted techniques can contribute any significant information to the characterization of astrocytic tumor aggressiveness. Two complementary computer-assisted methods were used. The first method made use of the digital image analysis of Feulgen-stained nuclei, making it possible to compute 15 morphonuclear and 8 nuclear DNA content-related (ploidy level) parameters. The second method enabled the most discriminatory parameters to be determined. This second method is the Decision Tree technique, which forms part of the Supervised Learning Algorithms. These two techniques were applied to a series of 250 supratentorial astrocytic tumors of the adult. This series included 39 low-grade (astrocytomas, AST) and 211 high-grade (47 anaplastic astrocytomas, ANA, and 164 glioblastomas, GBM) astrocytic tumors. The results show that some AST, ANA and GBM did not fit within simple logical rules. These "complex" cases were labeled NC-AST, NC-ANA and NC-GBM because they were "non-classical" (NC) with respect to their cytological features. An analysis of survival data revealed that the patients with NC-GBM had the same survival period as patients with GBM. In sharp contrast, patients with ANA survived significantly longer than patients with NC-ANA. In fact, the patients with ANA had the same survival period as patients who died from AST, while the patients with NC-ANA had a survival period similar to those with GBM. All these data show that the computer-assisted techniques used in this study can actually provide the pathologist with significant information on the characterization of astrocytic tumor aggressiveness.

The Development of an Interactive Computer-Based Training Program for Timely and Humane On-Farm Pig Euthanasia.

PubMed

Mullins, Caitlyn R; Pairis-Garcia, Monique D; Campler, Magnus R; Anthony, Raymond; Johnson, Anna K; Coleman, Grahame J; Rault, Jean-Loup

2018-02-05

With extensive knowledge and training in the prevention, management, and treatment of disease conditions in animals, veterinarians play a critical role in ensuring good welfare on swine farms by training caretakers on the importance of timely euthanasia. To assist veterinarians and other industry professionals in training new and seasoned caretakers, an interactive computer-based training program was created. It consists of three modules, each containing five case studies, which cover three distinct production stages (breeding stock, piglets, and wean to grower-finisher pigs). Case study development was derived from five specific euthanasia criteria defined in the 2015 Common Swine Industry Audit, a nationally recognized auditing program used in the US. Case studies provide information regarding treatment history, clinical signs, and condition severity of the pig and prompt learners to make management decisions regarding pig treatment and care. Once a decision is made, feedback is provided so learners understand the appropriateness of their decision compared to current industry guidelines. In addition to training farm personnel, this program may also be a valuable resource if incorporated into veterinary, graduate, and continuing education curricula. This innovative tool represents the first interactive euthanasia-specific training program in the US swine industry and offers the potential to improve timely and humane on-farm pig euthanasia.

Computer-Aided Diagnosis in Medical Imaging: Historical Review, Current Status and Future Potential

PubMed Central

Doi, Kunio

2007-01-01

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. In this article, the motivation and philosophy for early development of CAD schemes are presented together with the current status and future potential of CAD in a PACS environment. With CAD, radiologists use the computer output as a “second opinion” and make the final decisions. CAD is a concept established by taking into account equally the roles of physicians and computers, whereas automated computer diagnosis is a concept based on computer algorithms only. With CAD, the performance by computers does not have to be comparable to or better than that by physicians, but needs to be complementary to that by physicians. In fact, a large number of CAD systems have been employed for assisting physicians in the early detection of breast cancers on mammograms. A CAD scheme that makes use of lateral chest images has the potential to improve the overall performance in the detection of lung nodules when combined with another CAD scheme for PA chest images. Because vertebral fractures can be detected reliably by computer on lateral chest radiographs, radiologists’ accuracy in the detection of vertebral fractures would be improved by the use of CAD, and thus early diagnosis of osteoporosis would become possible. In MRA, a CAD system has been developed for assisting radiologists in the detection of intracranial aneurysms. On successive bone scan images, a CAD scheme for detection of interval changes has been developed by use of temporal subtraction images. In the future, many CAD schemes could be assembled as packages and implemented as a part of PACS. For example, the package for chest CAD may include the computerized detection of lung nodules, interstitial opacities, cardiomegaly, vertebral fractures, and interval changes in chest radiographs as well as the computerized classification of benign and malignant nodules and the differential diagnosis of interstitial lung diseases. In order to assist in the differential diagnosis, it would be possible to search for and retrieve images (or lesions) with known pathology, which would be very similar to a new unknown case, from PACS when a reliable and useful method has been developed for quantifying the similarity of a pair of images for visual comparison by radiologists. PMID:17349778

A Three-Phase Decision Model of Computer-Aided Coding for the Iranian Classification of Health Interventions (IRCHI).

PubMed

Azadmanjir, Zahra; Safdari, Reza; Ghazisaeedi, Marjan; Mokhtaran, Mehrshad; Kameli, Mohammad Esmail

2017-06-01

Accurate coded data in the healthcare are critical. Computer-Assisted Coding (CAC) is an effective tool to improve clinical coding in particular when a new classification will be developed and implemented. But determine the appropriate method for development need to consider the specifications of existing CAC systems, requirements for each type, our infrastructure and also, the classification scheme. The aim of the study was the development of a decision model for determining accurate code of each medical intervention in Iranian Classification of Health Interventions (IRCHI) that can be implemented as a suitable CAC system. first, a sample of existing CAC systems was reviewed. Then feasibility of each one of CAC types was examined with regard to their prerequisites for their implementation. The next step, proper model was proposed according to the structure of the classification scheme and was implemented as an interactive system. There is a significant relationship between the level of assistance of a CAC system and integration of it with electronic medical documents. Implementation of fully automated CAC systems is impossible due to immature development of electronic medical record and problems in using language for medical documenting. So, a model was proposed to develop semi-automated CAC system based on hierarchical relationships between entities in the classification scheme and also the logic of decision making to specify the characters of code step by step through a web-based interactive user interface for CAC. It was composed of three phases to select Target, Action and Means respectively for an intervention. The proposed model was suitable the current status of clinical documentation and coding in Iran and also, the structure of new classification scheme. Our results show it was practical. However, the model needs to be evaluated in the next stage of the research.

A novel computer based expert decision making model for prostate cancer disease management.

PubMed

Richman, Martin B; Forman, Ernest H; Bayazit, Yildirim; Einstein, Douglas B; Resnick, Martin I; Stovsky, Mark D

2005-12-01

We propose a strategic, computer based, prostate cancer decision making model based on the analytic hierarchy process. We developed a model that improves physician-patient joint decision making and enhances the treatment selection process by making this critical decision rational and evidence based. Two groups (patient and physician-expert) completed a clinical study comparing an initial disease management choice with the highest ranked option generated by the computer model. Participants made pairwise comparisons to derive priorities for the objectives and subobjectives related to the disease management decision. The weighted comparisons were then applied to treatment options to yield prioritized rank lists that reflect the likelihood that a given alternative will achieve the participant treatment goal. Aggregate data were evaluated by inconsistency ratio analysis and sensitivity analysis, which assessed the influence of individual objectives and subobjectives on the final rank list of treatment options. Inconsistency ratios less than 0.05 were reliably generated, indicating that judgments made within the model were mathematically rational. The aggregate prioritized list of treatment options was tabulated for the patient and physician groups with similar outcomes for the 2 groups. Analysis of the major defining objectives in the treatment selection decision demonstrated the same rank order for the patient and physician groups with cure, survival and quality of life being more important than controlling cancer, preventing major complications of treatment, preventing blood transfusion complications and limiting treatment cost. Analysis of subobjectives, including quality of life and sexual dysfunction, produced similar priority rankings for the patient and physician groups. Concordance between initial treatment choice and the highest weighted model option differed between the groups with the patient group having 59% concordance and the physician group having only 42% concordance. This study successfully validated the usefulness of a computer based prostate cancer management decision making model to produce individualized, rational, clinically appropriate disease management decisions without physician bias.

Neural correlates and neural computations in posterior parietal cortex during perceptual decision-making

PubMed Central

Huk, Alexander C.; Meister, Miriam L. R.

2012-01-01

A recent line of work has found remarkable success in relating perceptual decision-making and the spiking activity in the macaque lateral intraparietal area (LIP). In this review, we focus on questions about the neural computations in LIP that are not answered by demonstrations of neural correlates of psychological processes. We highlight three areas of limitations in our current understanding of the precise neural computations that might underlie neural correlates of decisions: (1) empirical questions not yet answered by existing data; (2) implementation issues related to how neural circuits could actually implement the mechanisms suggested by both extracellular neurophysiology and psychophysics; and (3) ecological constraints related to the use of well-controlled laboratory tasks and whether they provide an accurate window on sensorimotor computation. These issues motivate the adoption of a more general “encoding-decoding framework” that will be fruitful for more detailed contemplation of how neural computations in LIP relate to the formation of perceptual decisions. PMID:23087623

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.

Energizing Government Decision-Makers with the Facts on Solar Technology, Policy, and Integration

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

The Solar Technical Assistance Team (STAT) is a network of solar technology and implementation experts who provide timely, unbiased expertise to assist policymakers and regulators in making informed decisions about solar programs and policies. Government officials can submit requests directly to the STAT for technical assistance. STAT then partners with experts in solar policy, regulation, finance, technology, and other areas to deliver accurate, up-to-date information to state and local decision makers. The STAT responds to requests on a wide range of issues -- including, but not limited to, feed-in tariffs, renewable portfolio standards, rate design, program design, workforce and economicmore » impacts of solar on jurisdictions, and project financing.« less

VRML Industry: Microcosms in the Making.

ERIC Educational Resources Information Center

Brown, Eric

1998-01-01

Discusses VRML (Virtual Reality Modeling Language) technology and some of its possible applications, including creating three-dimensional images on the Web, advertising, and data visualization in computer-assisted design and computer-assisted manufacturing (CAD/CAM). Future improvements are discussed, including streaming, database support, and…

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

PubMed

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

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

Using the Networked Fire Chief for ego-depletion research: measuring dynamic decision-making effort and performance.

PubMed

Barber, Larissa K; Smit, Brandon W

2014-01-01

This study replicated ego-depletion predictions from the self-control literature in a computer simulation task that requires ongoing decision-making in relation to constantly changing environmental information: the Network Fire Chief (NFC). Ego-depletion led to decreased self-regulatory effort, but not performance, on the NFC task. These effects were also buffered by task enjoyment so that individuals who enjoyed the dynamic decision-making task did not experience ego-depletion effects. These findings confirm that past ego-depletion effects on decision-making are not limited to static or isolated decision-making tasks and can be extended to dynamic, naturalistic decision-making processes more common to naturalistic settings. Furthermore, the NFC simulation provides a methodological mechanism for independently measuring effort and performance when studying ego-depletion.

Elementary and Advanced Computer Projects for the Physics Classroom and Laboratory

DTIC Science & Technology

1992-12-01

are SPF/PC, MS Word, n3, Symphony, Mathematics, and FORTRAN. The authors’ programs assist data analysis in particular laboratory experiments and make...assist data analysis in particular laboratory experiments and make use of the Monte Carlo and other numerical techniques in computer simulation and...the language of science and engineering in industry and government laboratories (alth..4h C is becoming a powerful competitor ). RM/FORTRAN (cost $400

LIFE CYCLE IMPACT ASSESSMENT FOR INCREASING INDUSTRIAL SUSTAINABILITY

EPA Science Inventory

Life Cycle Impact Assessment (LCIA) can be a very useful decision support tool for assisting in environmental decision making to allow the pursuit of increasing sustainability. Increasing sustainability will be defined and presented as a more concrete and quantifiable goal when c...

Are Physicians Likely to Adopt Emerging Mobile Technologies? Attitudes and Innovation Factors Affecting Smartphone Use in the Southeastern United States

PubMed Central

Putzer, Gavin J; Park, Yangil

2012-01-01

The smartphone has emerged as an important technological device to assist physicians with medical decision making, clinical tasks, and other computing functions. A smartphone is a device that combines mobile telecommunication with Internet accessibility as well as word processing. Moreover, smartphones have additional features such as applications pertinent to clinical medicine and practice management. The purpose of this study was to investigate the innovation factors that affect a physician's decision to adopt an emerging mobile technological device such as a smartphone. The study sample consisted of 103 physicians from community hospitals and academic medical centers in the southeastern United States. Innovation factors are elements that affect an individual's attitude toward using and adopting an emerging technology. In our model, the innovation characteristics of compatibility, job relevance, the internal environment, observability, personal experience, and the external environment were all significant predictors of attitude toward using a smartphone. These influential innovation factors presumably are salient predictors of a physician's attitude toward using a smartphone to assist with clinical tasks. Health information technology devices such as smartphones offer promise as a means to improve clinical efficiency, medical quality, and care coordination and possibly reduce healthcare costs. PMID:22737094

Evaluative methodology for prioritizing transportation energy conservation strategies

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

Pang, L.M.G.

An analytical methodology was developed for the purpose of prioritizing a set of transportation energy conservation (TEC) strategies within an urban environment. Steps involved in applying the methodology consist of 1) defining the goals, objectives and constraints of the given urban community, 2) identifying potential TEC strategies, 3) assessing the impact of the strategies, 4) applying the TEC evaluation model, and 5) utilizing a selection process to determine the optimal set of strategies for implementation. This research provides an overview of 21 TEC strategies, a quick-response technique for estimating energy savings, a multiattribute utility theory approach for assessing subjective impacts,more » and a computer program for making the strategy evaluations, all of which assist in expediting the execution of the entire methodology procedure. The critical element of the methodology is the strategy evaluation model which incorporates a number of desirable concepts including 1) a comprehensive accounting of all relevant impacts, 2) the application of multiobjective decision-making techniques, 3) an approach to assure compatibilty among quantitative and qualitative impact measures, 4) the inclusion of the decision maker's preferences in the evaluation procedure, and 5) the cost-effectiveness concept. Application of the methodolgy to Salt Lake City, Utah demonstrated its utility, ease of use and favorability by decision makers.« less

[Medical expert systems and clinical needs].

PubMed

Buscher, H P

1991-10-18

The rapid expansion of computer-based systems for problem solving or decision making in medicine, the so-called medical expert systems, emphasize the need for reappraisal of their indication and value. Where specialist knowledge is required, in particular where medical decisions are susceptible to error these systems will probably serve as a valuable support. In the near future computer-based systems should be able to aid the interpretation of findings of technical investigations and the control of treatment, especially where rapid reactions are necessary despite the need of complex analysis of investigated parameters. In the distant future complete support of diagnostic procedures from the history to final diagnosis is possible. It promises to be particularly attractive for the diagnosis of seldom diseases, for difficult differential diagnoses, and in the decision making in the case of expensive, risky or new diagnostic or therapeutic methods. The physician needs to be aware of certain dangers, ranging from misleading information up to abuse. Patient information depends often on subjective reports and error-prone observations. Although basing on problematic knowledge computer-born decisions may have an imperative effect on medical decision making. Also it must be born in mind that medical decisions should always combine the rational with a consideration of human motives.

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

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

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

2011-09-15

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

How social and non-social information influence classification decisions: A computational modelling approach.

PubMed

Puskaric, Marin; von Helversen, Bettina; Rieskamp, Jörg

2017-08-01

Social information such as observing others can improve performance in decision making. In particular, social information has been shown to be useful when finding the best solution on one's own is difficult, costly, or dangerous. However, past research suggests that when making decisions people do not always consider other people's behaviour when it is at odds with their own experiences. Furthermore, the cognitive processes guiding the integration of social information with individual experiences are still under debate. Here, we conducted two experiments to test whether information about other persons' behaviour influenced people's decisions in a classification task. Furthermore, we examined how social information is integrated with individual learning experiences by testing different computational models. Our results show that social information had a small but reliable influence on people's classifications. The best computational model suggests that in categorization people first make up their own mind based on the non-social information, which is then updated by the social information.

Titrating guidance: a model to guide physicians in assisting patients and family members who are facing complex decisions.

PubMed

Goldstein, Nathan E; Back, Anthony L; Morrison, R Sean

2008-09-08

Over the last century, developments in new medical treatments have led to an exponential increase in longevity, but, as a consequence, patients may be left with chronic illness associated with long-term severe functional and cognitive disability. Patients and their families are often forced to make a difficult and complex choice between death and long-term debility, neither of which is an acceptable outcome. Traditional models of medical decision making, however, do not fully address how clinicians should best assist with these decisions. Herein, we present a new paradigm that demonstrates how the role of the physician changes over time in response to the curved relationship between the predictability of a patient's outcome and the chance of returning to an acceptable quality of life. To translate this model into clinical practice, we propose a 5-step model for physicians with which they can (1) determine at which point the patient is on our model; (2) identify the cognitive factors and preferences for outcomes that affect the decision-making process of the patient and his or her family; (3) reflect on their own reaction to the decision at hand; (4) acknowledge how these factors can be addressed in conversation; and (5) guide the patient and his or her family in creating a plan of care. This model can help improve patient-physician communication and decision making so that complex and difficult decisions can be turned into ones that yield to medical expertise, good communication, and personal caring.

Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging.

PubMed

Reiter, Andrea M F; Heinze, Hans-Jochen; Schlagenhauf, Florian; Deserno, Lorenz

2017-02-01

Despite its clinical relevance and the recent recognition as a diagnostic category in the DSM-5, binge eating disorder (BED) has rarely been investigated from a cognitive neuroscientific perspective targeting a more precise neurocognitive profiling of the disorder. BED patients suffer from a lack of behavioral control during recurrent binge eating episodes and thus fail to adapt their behavior in the face of negative consequences, eg, high risk for obesity. To examine impairments in flexible reward-based decision-making, we exposed BED patients (n=22) and matched healthy individuals (n=22) to a reward-guided decision-making task during functional resonance imaging (fMRI). Performing fMRI analysis informed via computational modeling of choice behavior, we were able to identify specific signatures of altered decision-making in BED. On the behavioral level, we observed impaired behavioral adaptation in BED, which was due to enhanced switching behavior, a putative deficit in striking a balance between exploration and exploitation appropriately. This was accompanied by diminished activation related to exploratory decisions in the anterior insula/ventro-lateral prefrontal cortex. Moreover, although so-called model-free reward prediction errors remained intact, representation of ventro-medial prefrontal learning signatures, incorporating inference on unchosen options, was reduced in BED, which was associated with successful decision-making in the task. On the basis of a computational psychiatry account, the presented findings contribute to defining a neurocognitive phenotype of BED.

Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging

PubMed Central

Reiter, Andrea M F; Heinze, Hans-Jochen; Schlagenhauf, Florian; Deserno, Lorenz

2017-01-01

Despite its clinical relevance and the recent recognition as a diagnostic category in the DSM-5, binge eating disorder (BED) has rarely been investigated from a cognitive neuroscientific perspective targeting a more precise neurocognitive profiling of the disorder. BED patients suffer from a lack of behavioral control during recurrent binge eating episodes and thus fail to adapt their behavior in the face of negative consequences, eg, high risk for obesity. To examine impairments in flexible reward-based decision-making, we exposed BED patients (n=22) and matched healthy individuals (n=22) to a reward-guided decision-making task during functional resonance imaging (fMRI). Performing fMRI analysis informed via computational modeling of choice behavior, we were able to identify specific signatures of altered decision-making in BED. On the behavioral level, we observed impaired behavioral adaptation in BED, which was due to enhanced switching behavior, a putative deficit in striking a balance between exploration and exploitation appropriately. This was accompanied by diminished activation related to exploratory decisions in the anterior insula/ventro-lateral prefrontal cortex. Moreover, although so-called model-free reward prediction errors remained intact, representation of ventro–medial prefrontal learning signatures, incorporating inference on unchosen options, was reduced in BED, which was associated with successful decision-making in the task. On the basis of a computational psychiatry account, the presented findings contribute to defining a neurocognitive phenotype of BED. PMID:27301429

Diverse decisions. How culture affects ethical decision making.

PubMed

Wright, F; Cohen, S; Caroselli, C

1997-03-01

Even under optimal conditions, assisting patients and families in making ethical decisions is difficult at best. Often these decisions revolve around the end-of-life issues that require acknowledgement that the patient is unlikely to survive, which may be perceived as a failure to both the family and the staff. At the very least, it can be a sad time, fraught with uncertainty and indecision. When these difficulties are coupled with ineffective communication related to cultural insensitivity or unawareness, the effects can be devastating to the decision-making process. All CCNs are expected to master the skills necessary for assisting patients and families through the harrowing experience of life-threatening illness. Whereas much of critical care focuses on managing pathophysiologic disturbances, emotional needs are equally important. It follows then that the CCN must assume responsibility for assisting patients and families in coping with the crisis of critical illness and working through ethical issues, which often include end-of-life decisions and organ donation. Culturally competent care is required when addressing patient needs holistically, but it is so much more. It is an opportunity to enrich and deepen the CCN/patient/family relationship, advocate for the patient, and broaden the opportunities for communication among staff. This article has provided some beginning steps for increasing nursing cultural awareness and has offered some initial strategies to consider when designing a plan of care. Through continuing efforts, CCNs and organizations can do much to decrease the alienation that many patients and families have traditionally encountered in the CCU, an estrangement that is exacerbated when their culture is different from the predominant culture of the unit. The effort to become more culturally aware may appear to require extraordinary effort; however, the rewards of optimizing patient care are unsurpassed.

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

Using the Reliability Theory for Assessing the Decision Confidence Probability for Comparative Life Cycle Assessments.

PubMed

Wei, Wei; Larrey-Lassalle, Pyrène; Faure, Thierry; Dumoulin, Nicolas; Roux, Philippe; Mathias, Jean-Denis

2016-03-01

Comparative decision making process is widely used to identify which option (system, product, service, etc.) has smaller environmental footprints and for providing recommendations that help stakeholders take future decisions. However, the uncertainty problem complicates the comparison and the decision making. Probability-based decision support in LCA is a way to help stakeholders in their decision-making process. It calculates the decision confidence probability which expresses the probability of a option to have a smaller environmental impact than the one of another option. Here we apply the reliability theory to approximate the decision confidence probability. We compare the traditional Monte Carlo method with a reliability method called FORM method. The Monte Carlo method needs high computational time to calculate the decision confidence probability. The FORM method enables us to approximate the decision confidence probability with fewer simulations than the Monte Carlo method by approximating the response surface. Moreover, the FORM method calculates the associated importance factors that correspond to a sensitivity analysis in relation to the probability. The importance factors allow stakeholders to determine which factors influence their decision. Our results clearly show that the reliability method provides additional useful information to stakeholders as well as it reduces the computational time.

Operational Plan Ontology Model for Interconnection and Interoperability

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

Differences in Biases and Compensatory Strategies Across Discipline, Rank, and Gender among University Academics

PubMed Central

Giorgini, Vincent; Gibson, Carter; Mecca, Jensen T.; Medeiros, Kelsey E.; Mumford, Michael D.; Connelly, Shane; Devenport, Lynn D.

2014-01-01

The study of ethical behavior and ethical decision making is of increasing importance in many fields, and there is a growing literature addressing the issue. However, research examining differences in ethical decision making across fields and levels of experience is limited. In the present study, biases that undermine ethical decision making and compensatory strategies that may aid ethical decision making were identified in a series of interviews with 63 faculty members across six academic fields (e.g. biological sciences, health sciences, social sciences) and three levels of rank (assistant professor, associate professor, and full professor) as well as across gender. The degree to which certain biases and compensatory strategies were used in justifications for responses to ethical situations was compared across fields, level of experience, and gender. Major differences were found across fields for several biases and compensatory strategies, including biases and compensatory strategies related to use of professional field principles and field-specific guidelines. Furthermore, full professors tend to differ greatly from assistant and associate professors on a number of constructs, and there were differences in the consistency with which biases and compensatory strategies were displayed within these various groups. Implications of these findings for ethics training and future research are discussed. PMID:25479960

Utility of diffusion tensor imaging tractography in decision making for extratemporal resective epilepsy surgery.

PubMed

Radhakrishnan, Ashalatha; James, Jija S; Kesavadas, Chandrasekharan; Thomas, Bejoy; Bahuleyan, Biji; Abraham, Mathew; Radhakrishnan, Kurupath

2011-11-01

To assess the utility of diffusion tensor imaging tractography (DTIT) in decision making in patients considered for extratemporal resective epilepsy surgery. We subjected 49 patients with drug-resistant focal seizures due to lesions located in frontal, parietal and occipital lobes to DTIT to map the white matter fiber anatomy in relation to the planned resection zone, in addition to routine presurgical evaluation. We stratified our patients preoperatively into different grades of risk for anticipated neurological deficits as judged by the distance of the white matter tracts from the resection zones and functional cortical areas. Thirty-seven patients underwent surgery; surgery was abandoned in 12 (24.5%) patients because of the high risk of postoperative neurological deficit. DTIT helped us to modify the surgical procedures in one-fourth of occipital, one-third of frontal, and two-thirds of parietal and multilobar resections. Overall, DTIT assisted us in surgical decision making in two-thirds of our patients. DTIT is a noninvasive imaging strategy that can be used effectively in planning resection of epileptogenic lesions at or close to eloquent cortical areas. DTIT helps in predicting postoperative neurological outcome and thereby assists in surgical decision making and in preoperative counseling of patients with extratemporal focal epilepsies. Copyright © 2011 Elsevier B.V. All rights reserved.

KARL: A Knowledge-Assisted Retrieval Language. M.S. Thesis Final Report, 1 Jul. 1985 - 31 Dec. 1987

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Triantafyllopoulos, Spiros

1985-01-01

Data classification and storage are tasks typically performed by application specialists. In contrast, information users are primarily non-computer specialists who use information in their decision-making and other activities. Interaction efficiency between such users and the computer is often reduced by machine requirements and resulting user reluctance to use the system. This thesis examines the problems associated with information retrieval for non-computer specialist users, and proposes a method for communicating in restricted English that uses knowledge of the entities involved, relationships between entities, and basic English language syntax and semantics to translate the user requests into formal queries. The proposed method includes an intelligent dictionary, syntax and semantic verifiers, and a formal query generator. In addition, the proposed system has a learning capability that can improve portability and performance. With the increasing demand for efficient human-machine communication, the significance of this thesis becomes apparent. As human resources become more valuable, software systems that will assist in improving the human-machine interface will be needed and research addressing new solutions will be of utmost importance. This thesis presents an initial design and implementation as a foundation for further research and development into the emerging field of natural language database query systems.

75 FR 6839 - Technical Service Provider Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-12

... Executive Order 12866, the Office of Management and Budget determined that this final rule is not a... or are eligible to participate in conservation programs to help them make land management decisions...: Covered Programs. The interim final rule incorporated reference to the Agricultural Management Assistance...

Battle Environment Assessment for Commanders: A Concept of Support for Joint and Component Strategy and Operations.

DTIC Science & Technology

1988-03-14

focused application of decision aids. These decision aids must incorporate standardized processes, computer assisted artificial intelligence, linkage...Theater Planning. A Strategic-Operational Perspective,’ by COL MIke ,or i n Olesak, John, LTC Office of the Deputy Chief of Staff, Inteligence , U S

Distinct roles of dopamine and subthalamic nucleus in learning and probabilistic decision making.

PubMed

Coulthard, Elizabeth J; Bogacz, Rafal; Javed, Shazia; Mooney, Lucy K; Murphy, Gillian; Keeley, Sophie; Whone, Alan L

2012-12-01

Even simple behaviour requires us to make decisions based on combining multiple pieces of learned and new information. Making such decisions requires both learning the optimal response to each given stimulus as well as combining probabilistic information from multiple stimuli before selecting a response. Computational theories of decision making predict that learning individual stimulus-response associations and rapid combination of information from multiple stimuli are dependent on different components of basal ganglia circuitry. In particular, learning and retention of memory, required for optimal response choice, are significantly reliant on dopamine, whereas integrating information probabilistically is critically dependent upon functioning of the glutamatergic subthalamic nucleus (computing the 'normalization term' in Bayes' theorem). Here, we test these theories by investigating 22 patients with Parkinson's disease either treated with deep brain stimulation to the subthalamic nucleus and dopaminergic therapy or managed with dopaminergic therapy alone. We use computerized tasks that probe three cognitive functions-information acquisition (learning), memory over a delay and information integration when multiple pieces of sequentially presented information have to be combined. Patients performed the tasks ON or OFF deep brain stimulation and/or ON or OFF dopaminergic therapy. Consistent with the computational theories, we show that stopping dopaminergic therapy impairs memory for probabilistic information over a delay, whereas deep brain stimulation to the region of the subthalamic nucleus disrupts decision making when multiple pieces of acquired information must be combined. Furthermore, we found that when participants needed to update their decision on the basis of the last piece of information presented in the decision-making task, patients with deep brain stimulation of the subthalamic nucleus region did not slow down appropriately to revise their plan, a pattern of behaviour that mirrors the impulsivity described clinically in some patients with subthalamic nucleus deep brain stimulation. Thus, we demonstrate distinct mechanisms for two important facets of human decision making: first, a role for dopamine in memory consolidation, and second, the critical importance of the subthalamic nucleus in successful decision making when multiple pieces of information must be combined.

Prospective Architectures for Onboard vs Cloud-Based Decision Making for Unmanned Aerial Systems

NASA Technical Reports Server (NTRS)

Sankararaman, Shankar; Teubert, Christopher

2017-01-01

This paper investigates propsective architectures for decision-making in unmanned aerial systems. When these unmanned vehicles operate in urban environments, there are several sources of uncertainty that affect their behavior, and decision-making algorithms need to be robust to account for these different sources of uncertainty. It is important to account for several risk-factors that affect the flight of these unmanned systems, and facilitate decision-making by taking into consideration these various risk-factors. In addition, there are several technical challenges related to autonomous flight of unmanned aerial systems; these challenges include sensing, obstacle detection, path planning and navigation, trajectory generation and selection, etc. Many of these activities require significant computational power and in many situations, all of these activities need to be performed in real-time. In order to efficiently integrate these activities, it is important to develop a systematic architecture that can facilitate real-time decision-making. Four prospective architectures are discussed in this paper; on one end of the spectrum, the first architecture considers all activities/computations being performed onboard the vehicle whereas on the other end of the spectrum, the fourth and final architecture considers all activities/computations being performed in the cloud, using a new service known as Prognostics as a Service that is being developed at NASA Ames Research Center. The four different architectures are compared, their advantages and disadvantages are explained and conclusions are presented.

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

PubMed

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

2006-12-04

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

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

PubMed Central

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

2006-01-01

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

Decision Making for Destination Therapy Left Ventricular Assist Devices: “There was no choice” versus “I thought about it an awful lot”

PubMed Central

McIlvennan, Colleen K.; Allen, Larry A.; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C.; Matlock, Daniel D.

2014-01-01

Background Destination therapy left ventricular assist devices (DT LVAD) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Methods and Results Between October 2012–September 2013, we conducted semi-structured, in-depth interviews to understand patients’ decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being “automatic” and others (3 accepters, 7 decliners) being “reflective” in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: “[LVAD] was the only option I had…that or push up daisies…so I automatically took this”. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: “There are worse things than death.” Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Conclusion Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. PMID:24823949

Decision making for destination therapy left ventricular assist devices: "there was no choice" versus "I thought about it an awful lot".

PubMed

McIlvennan, Colleen K; Allen, Larry A; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C; Matlock, Daniel D

2014-05-01

Destination therapy left ventricular assist devices (DT LVADs) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Between October 2012 and September 2013, we conducted semistructured, in-depth interviews to understand patients' decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an over-riding desire to live as long as possible: "[LVAD] was the only option I had…that or push up daisies…so I automatically took this." By contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: "There are worse things than death." Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. © 2014 American Heart Association, Inc.

Decision making in urological surgery.

PubMed

Abboudi, Hamid; Ahmed, Kamran; Normahani, Pasha; Abboudi, May; Kirby, Roger; Challacombe, Ben; Khan, Mohammed Shamim; Dasgupta, Prokar

2012-06-01

Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft. The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality. Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees. Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.

19 CFR 122.176 - Removal from ACSPP.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commissioner. (c) Notice of decision. The Assistant Commissioner, Office of Field Operations, shall notify the participating carrier in writing of the decision concerning continued participation in the program. (d) Use of uniform criteria. When making any determination regarding a carrier's participation or continuation in the...

A Semantic Approach with Decision Support for Safety Service in Smart Home Management

PubMed Central

Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

2016-01-01

Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate. PMID:27527170

A Semantic Approach with Decision Support for Safety Service in Smart Home Management.

PubMed

Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

2016-08-03

Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate.

Developing an Advanced Environment for Collaborative Computing

NASA Technical Reports Server (NTRS)

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

1999-01-01

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

Selection criteria and facilitation training for the study of groupware

NASA Technical Reports Server (NTRS)

Robichaux, Barry P.

1993-01-01

Computer support for planning and decision making groups is a growing trend in the 90s. Groupware is a name often applied to group software and has been defined as 'computer-based systems that support groups engaged in a common task (or goal) and that provide an interface to a shared environment'. Unlike most single-user software, groupware assists user groups in their collaboration, coordination, and communication efforts. This paper focuses on groupware to support the meeting process. These systems are often called group decision support systems (GDSS), electronic meeting systems (EMS), or group support systems (GSS). The term 'meeting support groupware' is used here to include any computer-based system to support meetings. In order to understand this technology, one must first understand groups, what they do and the problems they face, and groupware, a wide range of technology to support group work. Guidelines for selecting groups for study as part of an overall research plan are provided in this document. These were taken from the literature and from persons for whom the information in this paper was targeted. Also, guidelines for facilitation training are discussed. Familiarity with known and accepted techniques are the principle duties of the facilitator and any form of training must include practice in using these techniques.

Toward the Computational Representation of Individual Cultural, Cognitive, and Physiological State: The Sensor Shooter Simulation

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

RAYBOURN,ELAINE M.; FORSYTHE,JAMES C.

2001-08-01

This report documents an exploratory FY 00 LDRD project that sought to demonstrate the first steps toward a realistic computational representation of the variability encountered in individual human behavior. Realism, as conceptualized in this project, required that the human representation address the underlying psychological, cultural, physiological, and environmental stressors. The present report outlines the researchers' approach to representing cognitive, cultural, and physiological variability of an individual in an ambiguous situation while faced with a high-consequence decision that would greatly impact subsequent events. The present project was framed around a sensor-shooter scenario as a soldier interacts with an unexpected target (twomore » young Iraqi girls). A software model of the ''Sensor Shooter'' scenario from Desert Storm was developed in which the framework consisted of a computational instantiation of Recognition Primed Decision Making in the context of a Naturalistic Decision Making model [1]. Recognition Primed Decision Making was augmented with an underlying foundation based on our current understanding of human neurophysiology and its relationship to human cognitive processes. While the Gulf War scenario that constitutes the framework for the Sensor Shooter prototype is highly specific, the human decision architecture and the subsequent simulation are applicable to other problems similar in concept, intensity, and degree of uncertainty. The goal was to provide initial steps toward a computational representation of human variability in cultural, cognitive, and physiological state in order to attain a better understanding of the full depth of human decision-making processes in the context of ambiguity, novelty, and heightened arousal.« less

Pest management in Douglas-fir seed orchards: a microcomputer decision method

Treesearch

James B. Hoy; Michael I. Haverty

1988-01-01

The computer program described provides a Douglas-fir seed orchard manager (user) with a quantitative method for making insect pest management decisions on a desk-top computer. The decision system uses site-specific information such as estimates of seed crop size, insect attack rates, insecticide efficacy and application costs, weather, and crop value. At sites where...

Artificial intelligence in cardiology.

PubMed

Bonderman, Diana

2017-12-01

Decision-making is complex in modern medicine and should ideally be based on available data, structured knowledge and proper interpretation in the context of an individual patient. Automated algorithms, also termed artificial intelligence that are able to extract meaningful patterns from data collections and build decisions upon identified patterns may be useful assistants in clinical decision-making processes. In this article, artificial intelligence-based studies in clinical cardiology are reviewed. The text also touches on the ethical issues and speculates on the future roles of automated algorithms versus clinicians in cardiology and medicine in general.

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

PubMed

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

2013-02-01

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

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

PubMed Central

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

2012-01-01

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

A framework for multi-stakeholder decision-making and ...

EPA Pesticide Factsheets

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimization problem. The CVaR problem is parameterized by a probability level that shapes the tail of the dissatisfaction distribution. The proposed approach allows us to compute a family of compromise solutions and generalizes multi-stakeholder settings previously proposed in the literature that minimize average and worst-case dissatisfactions. We use the concept of the CVaR norm to give a geometric interpretation to this problem +and use the properties of this norm to prove that the CVaR minimization problem yields Pareto optimal solutions for any choice of the probability level. We discuss a broad range of potential applications of the framework that involve complex decision-making processes. We demonstrate the developments using a biowaste facility location case study in which we seek to balance stakeholder priorities on transportation, safety, water quality, and capital costs. This manuscript describes the methodology of a new decision-making framework that computes compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives as needed for SHC Decision Science and Support Tools project. A biowaste facility location is employed as the case study

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.

Emotion and decision-making: affect-driven belief systems in anxiety and depression.

PubMed

Paulus, Martin P; Yu, Angela J

2012-09-01

Emotion processing and decision-making are integral aspects of daily life. However, our understanding of the interaction between these constructs is limited. In this review, we summarize theoretical approaches that link emotion and decision-making, and focus on research with anxious or depressed individuals to show how emotions can interfere with decision-making. We integrate the emotional framework based on valence and arousal with a Bayesian approach to decision-making in terms of probability and value processing. We discuss how studies of individuals with emotional dysfunctions provide evidence that alterations of decision-making can be viewed in terms of altered probability and value computation. We argue that the probabilistic representation of belief states in the context of partially observable Markov decision processes provides a useful approach to examine alterations in probability and value representation in individuals with anxiety and depression, and outline the broader implications of this approach. Copyright © 2012. Published by Elsevier Ltd.

A cognitive prosthesis for complex decision-making.

PubMed

Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

2017-01-01

While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emotion and decision-making: affect-driven belief systems in anxiety and depression

PubMed Central

Paulus, Martin P.; Yu, Angela J.

2012-01-01

Emotion processing and decision-making are integral aspects of daily life. However, our understanding of the interaction between these constructs is limited. In this review, we summarize theoretical approaches to the link between emotion and decision-making, and focus on research with anxious or depressed individuals that reveals how emotions can interfere with decision-making. We integrate the emotional framework based on valence and arousal with a Bayesian approach to decision-making in terms of probability and value processing. We then discuss how studies of individuals with emotional dysfunctions provide evidence that alterations of decision-making can be viewed in terms of altered probability and value computation. We argue that the probabilistic representation of belief states in the context of partially observable Markov decision processes provides a useful approach to examine alterations in probability and value representation in individuals with anxiety and depression and outline the broader implications of this approach. PMID:22898207

A qualitative analysis of parental decision making for childhood immunisation.

PubMed

Marshall, S; Swerissen, H

1999-10-01

Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

Towards a cyber-physical era: soft computing framework based multi-sensor array for water quality monitoring

NASA Astrophysics Data System (ADS)

Bhardwaj, Jyotirmoy; Gupta, Karunesh K.; Gupta, Rajiv

2018-02-01

New concepts and techniques are replacing traditional methods of water quality parameter measurement systems. This paper introduces a cyber-physical system (CPS) approach for water quality assessment in a distribution network. Cyber-physical systems with embedded sensors, processors and actuators can be designed to sense and interact with the water environment. The proposed CPS is comprised of sensing framework integrated with five different water quality parameter sensor nodes and soft computing framework for computational modelling. Soft computing framework utilizes the applications of Python for user interface and fuzzy sciences for decision making. Introduction of multiple sensors in a water distribution network generates a huge number of data matrices, which are sometimes highly complex, difficult to understand and convoluted for effective decision making. Therefore, the proposed system framework also intends to simplify the complexity of obtained sensor data matrices and to support decision making for water engineers through a soft computing framework. The target of this proposed research is to provide a simple and efficient method to identify and detect presence of contamination in a water distribution network using applications of CPS.

Computer assisted surgery with 3D robot models and visualisation of the telesurgical action.

PubMed

Rovetta, A

2000-01-01

This paper deals with the support of virtual reality computer action in the procedures of surgical robotics. Computer support gives a direct representation of the surgical theatre. The modelization of the procedure in course and in development gives a psychological reaction towards safety and reliability. Robots similar to the ones used by the manufacturing industry can be used with little modification as very effective surgical tools. They have high precision, repeatability and are versatile in integrating with the medical instrumentation. Now integrated surgical rooms, with computer and robot-assisted intervention, are operating. The computer is the element for a decision taking aid, and the robot works as a very effective tool.

Self-Organized Service Negotiation for Collaborative Decision Making

PubMed Central

Zhang, Bo; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM. PMID:25243228

Self-organized service negotiation for collaborative decision making.

PubMed

Zhang, Bo; Huang, Zhenhua; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM.

FMS: The New Wave of Manufacturing Technology.

ERIC Educational Resources Information Center

Industrial Education, 1986

1986-01-01

Flexible manufacturing systems (FMS) are described as a marriage of all of the latest technologies--robotics, numerical control, CAD/CAM (computer-assisted design/computer-assisted manufacturing), etc.--into a cost-efficient, optimized production process yielding the greatest flexibility in making various parts. A typical curriculum to teach FMS…

The decision neuroscience perspective on suicidal behavior: evidence and hypotheses

PubMed Central

Dombrovski, Alexandre Y.; Hallquist, Michael N.

2017-01-01

Purpose of review Suicide attempts are usually regretted by people who survive them. Furthermore, addiction and gambling are over-represented among people who attempt or die by suicide, raising the question whether their decision-making is impaired. Advances in decision neuroscience have enabled us to investigate decision processes in suicidal people and to elucidate putative neural substrates of disadvantageous decision-making. Recent findings Early studies have linked attempted suicide to poor performance on gambling tasks. More recently, functional MRI augmented with a reinforcement learning computational model revealed that impaired decision-making in suicide attempters is paralleled by disrupted expected value (expected reward) signals in the ventromedial prefrontal cortex. Behavioral studies have linked increased delay discounting to low-lethality/poorly planned attempts, multiple attempts, and the co-occurrence of attempted suicide and addiction. This behavioral tendency may be related to altered integrity of the basal ganglia. By contrast, well-planned, serious suicide attempts were associated with intact/diminished delay discounting. One study has linked high-lethality suicide attempts and impaired social decision-making. Summary This emerging literature supports the notion that various impairments in decision-making – often broadly related to impulsivity – may mark different pathways to suicide. We propose that aggressive and self-destructive responses to social stressors in people prone to suicide result from a predominance of automatic, Pavlovian processes over goal-directed computations. PMID:27875379

Representing Farmer Irrigation Decisions in Northern India: Model Development from the Bottom Up.

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Brozovic, N.; Mijic, A.

2017-12-01

The plains of northern India are among the most intensely populated and irrigated regions of the world. Sustaining water demand has been made possible by exploiting the vast and hugely productive aquifers underlying the Indo-Gangetic basin. However, an increasing demand from a growing population and highly variable socio-economic and environmental variables mean present resources may not be sustainable, resulting in water security becoming one of India's biggest challenges. Unless solutions which take into consideration the regions evolving anthropogenic and environmental conditions are found, the sustainability of India's water resources looks bleak. Understanding water user decisions and their potential outcome is important for development of suitable water resource management options. Computational models are commonly used to assist water use decision making, typically representing natural processes well. The inclusion of human decision making however, one of the dominant drivers of change, has lagged behind. Improved representation of irrigation water user behaviour within models provides more accurate, relevant information for irrigation management. This research conceptualizes and proceduralizes observed farmer irrigation practices, highlighting feedbacks between the environment and livelihood. It is developed using a bottom up approach, informed through field experience and stakeholder interaction in Uttar Pradesh, northern India. Real world insights are incorporated through collected information creating a realistic representation of field conditions, providing a useful tool for policy analysis and water management. The modelling framework is applied to four districts. Results suggest predicted future climate will have little direct impact on water resources, crop yields or farmer income. In addition, increased abstraction may be sustainable in some areas under carefully managed conditions. By simulating dynamic decision making, feedbacks and interactions between water users, irrigation officials, agricultural practices, and external influences such as energy pricing and farming subsidies, this work highlights the importance of directly including water user behaviour in policy making and operational tools, which will help achieve water and livelihood security.

Exchanging environmental information and decision making: developing the local Pilot Environmental Virtual Observatory with stakeholder communities

NASA Astrophysics Data System (ADS)

Mackay, E.; Beven, K.; Brewer, P.; M, Haygarth, P.; Macklin, M.; Marshall, K.; Quinn, P.; Stutter, M.; Thomas, N.; Wilkinson, M.

2012-04-01

Public participation in the development of flood risk management and river basin management plans are explicit components of both the Water Framework and Floods Directives. At the local level, involving communities in land and water management has been found to (i) aid better environmental decision making, (ii) enhance social, economic and environmental benefits, and (iii) increase a sense of ownership. Facilitating the access and exchange of information on the local environment is an important part of this new approach to the land and water management process, which also includes local community stakeholders in decisions about the design and content of the information provided. As part of the Natural Environment Research Council's pilot Environment Virtual Observatory (EVO), the Local Level group are engaging with local community stakeholders in three different catchments in the UK (the rivers Eden, Tarland and Dyfi) to start the process of developing prototype visualisation tools to address the specific land and water management issues identified in each area. Through this local collaboration, we will provide novel visualisation tools through which to communicate complex catchment science outcomes and bring together different sources of environmental data in ways that better meet end-user needs as well as facilitate a far broader participatory approach in environmental decision making. The Local Landscape Visualisation Tools are being evolved iteratively during the project to reflect the needs, interests and capabilities of a wide range of stakeholders. The tools will use the latest concepts and technologies to communicate with and provide opportunities for the provision and exchange of information between the public, government agencies and scientists. This local toolkit will reside within a wider EVO platform that will include national datasets, models and state of the art cloud computer systems. As such, local stakeholder groups are assisting the EVO's development and participating in local decision making alongside policy makers, government agencies and scientists.

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.

78 FR 58897 - Pipeline Safety: Administrative Procedures; Updates and Technical Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... incorporate increased transparency into the decision making process, the regulations must explicitly recognize... certainty, and due process. II. Discussion of Comments The comments received from the trade organizations... assistance through these processes by assisting OPS in the development of written responses to requests for...

An Employee Assistance Curriculum: The Ultimate Collaborative Function.

ERIC Educational Resources Information Center

Epstein, Howard V.; Perryman, William J.

Employees who abuse alcohol and drugs experience lost efficiency, absenteeism, poor decision making, and accidents. The economic losses to employers resulting from such abuse and the belief that employers should help employees with personal problems have stimulated corporations and unions to develop employee assistance programs (EAPs). These…

Stress-induced cortisol facilitates threat-related decision making among police officers.

PubMed

Akinola, Modupe; Mendes, Wendy Berry

2012-02-01

Previous research suggests that cortisol can affect cognitive functions such as memory, decision making, and attentiveness to threat-related cues. Here, we examine whether increases in cortisol, brought on by an acute social stressor, influence threat-related decision making. Eighty-one police officers completed a standardized laboratory stressor and then immediately completed a computer simulated decision-making task designed to examine decisions to accurately shoot or not shoot armed and unarmed Black and White targets. Results indicated that police officers who had larger cortisol increases to the social-stress task subsequently made fewer errors when deciding to shoot armed Black targets relative to armed White targets, suggesting that hypothalamic pituitary adrenal (HPA) activation may exacerbate vigilance for threat cues. We conclude with a discussion of the implications of threat-initiated decision making.

The future of intelligent assistive technologies for cognition: devices under development to support independent living and aging-with-choice.

PubMed

Boger, Jennifer; Mihailidis, Alex

2011-01-01

A person's ability to be independent is dependent on his or her overall health, mobility, and ability to complete activities of daily living. Intelligent assistive technologies (IATs) are devices that incorporate context into their decision-making process, which enables them to provide customised and dynamic assistance in an appropriate manner. IATs have tremendous potential to support people with cognitive impairments as they can be used to support many facets of well-being; from augmenting memory and decision making tasks to providing autonomous and early detection of possible changes in health. This paper presents IATs that are currently in development in the research community to support tasks that can be impacted by compromised cognition. While they are not yet ready for the general public, these devices showcase the capabilities of technologies one can expect to see in the consumer marketplace in the near future.

Interprofessional practice and decision support: an organizational framework applied to a mental health setting.

PubMed

Campbell, Susan; Stowe, Karen; Ozanne, Elissa M

2011-11-01

Decision support as a means to assist people in making healthcare decisions has been discussed extensively in the medical literature. However, the potential for use of decision support and decision aids with people with psychiatric disabilities in order to promote recovery has only begun to be researched and discussed in the mental health literature. Organizational factors that foster interprofessional practice within a decision support environment focused on mental health issues are examined in this paper.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-04-22

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

A Review of Issues in Computer-Assisted Counseling and a New Approach to Its Applications in College Selection.

ERIC Educational Resources Information Center

Colburn, Kenneth A.

Issues and approaches in computer-assisted counseling are presented in this thesis. Reasons are considered for the ineffectiveness of school guidance counselors in helping students make college selections, and a reconceptualization of counseling as a technology of helping is suggested. The uses of computers in counseling are examined along with…

A Landsat-based inventory procedure for agriculture in California

NASA Technical Reports Server (NTRS)

Wall, S. L.; Thomas, R. W.; Brown, C. E.; Bauer, E. H.

1982-01-01

Agriculture, which occupies a vital position in the economy of the State of California, depends crucially on the available water. The California Department of Water Resources (DWR) is, therefore, greatly concerned with the total water requirements for agricultural applications. In view of the limitations of an area-limited, single-date survey system, the DWR has been cooperating with NASA and the University of California in a study of the applicability of Landsat imagery and digital data as an aid in making decisions concerning the management of water resources. Attention is given to a statewide inventory of irrigated land, computer-assisted estimation and mapping of irrigated land, and a crop type analysis using Landsat digital data.

Dicoogle Mobile: a medical imaging platform for Android.

PubMed

Viana-Ferreira, Carlos; Ferreira, Daniel; Valente, Frederico; Monteiro, Eriksson; Costa, Carlos; Oliveira, José Luís

2012-01-01

Mobile computing technologies are increasingly becoming a valuable asset in healthcare information systems. The adoption of these technologies helps to assist in improving quality of care, increasing productivity and facilitating clinical decision support. They provide practitioners with ubiquitous access to patient records, being actually an important component in telemedicine and tele-work environments. We have developed Dicoogle Mobile, an Android application that provides remote access to distributed medical imaging data through a cloud relay service. Besides, this application has the capability to store and index local imaging data, so that they can also be searched and visualized. In this paper, we will describe Dicoogle Mobile concept as well the architecture of the whole system that makes it running.

A Framework Incorporating Community Preferences in Use Attainment and Related Water Quality Decision-Making (2010 Final)

EPA Science Inventory

The report is intended to assist water quality officials, watershed managers, members of stakeholder groups, and other interested individuals in fully evaluating ecological and socioeconomic objectives and the gains and losses that often are involved in use attainment decisions. ...

32 CFR 806.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Records are classified; originated with a nongovernment source; are part of the Air Force's decision... managers to assist IDAs in making decisions on FOIA requests. (f) OCR. A DoD element with an official... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION AIR FORCE FREEDOM OF...

Integrated Risk-Informed Decision-Making for an ALMR PRISM

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

Muhlheim, Michael David; Belles, Randy; Denning, Richard S.

Decision-making is the process of identifying decision alternatives, assessing those alternatives based on predefined metrics, selecting an alternative (i.e., making a decision), and then implementing that alternative. The generation of decisions requires a structured, coherent process, or a decision-making process. The overall objective for this work is that the generalized framework is adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace ormore » supplement human decision makers with reconfigurable decision-making modules that can perform a given set of tasks rationally, consistently, and reliably. Risk-informed decision-making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The probabilistic portion of the decision-making engine of the supervisory control system is based on the control actions associated with an ALMR PRISM. Newly incorporated into the probabilistic models are the prognostic/diagnostic models developed by Pacific Northwest National Laboratory. These allow decisions to incorporate the health of components into the decision–making process. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic portion of the decision-making engine uses thermal-hydraulic modeling and components for an advanced liquid-metal reactor Power Reactor Inherently Safe Module. The deterministic multi-attribute decision-making framework uses various sensor data (e.g., reactor outlet temperature, steam generator drum level) and calculates its position within the challenge state, its trajectory, and its margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. The metrics that are evaluated are based on reactor trip set points. The integration of the deterministic calculations using multi-physics analyses and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermalhydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies, and developing a user interface to mimic display panels at a modern nuclear power plant.« less

Neural substrates of decision-making.

PubMed

Broche-Pérez, Y; Herrera Jiménez, L F; Omar-Martínez, E

2016-06-01

Decision-making is the process of selecting a course of action from among 2 or more alternatives by considering the potential outcomes of selecting each option and estimating its consequences in the short, medium and long term. The prefrontal cortex (PFC) has traditionally been considered the key neural structure in decision-making process. However, new studies support the hypothesis that describes a complex neural network including both cortical and subcortical structures. The aim of this review is to summarise evidence on the anatomical structures underlying the decision-making process, considering new findings that support the existence of a complex neural network that gives rise to this complex neuropsychological process. Current evidence shows that the cortical structures involved in decision-making include the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex (DLPFC). This process is assisted by subcortical structures including the amygdala, thalamus, and cerebellum. Findings to date show that both cortical and subcortical brain regions contribute to the decision-making process. The neural basis of decision-making is a complex neural network of cortico-cortical and cortico-subcortical connections which includes subareas of the PFC, limbic structures, and the cerebellum. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Determining the Effectiveness and Evaluating the Implementation Process of a Quality/Performance Circles System Model to Assist in Institutional Decision Making and Problem Solving at Lakeshore Technical Institute.

ERIC Educational Resources Information Center

Ladwig, Dennis J.

During the 1982-83 school year, a quality/performance circles system model was implemented at Lakeshore Technical Institute (LTI) to promote greater participation by staff in decision making and problem solving. All management staff at the college (N=45) were invited to participate in the process, and 39 volunteered. Non-management staff (N=240)…

A framework for multi-stakeholder decision-making and conflict resolution

EPA Science Inventory

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimiz...

Uncertainty in sample estimates and the implicit loss function for soil information.

NASA Astrophysics Data System (ADS)

Lark, Murray

2015-04-01

One significant challenge in the communication of uncertain information is how to enable the sponsors of sampling exercises to make a rational choice of sample size. One way to do this is to compute the value of additional information given the loss function for errors. The loss function expresses the costs that result from decisions made using erroneous information. In certain circumstances, such as remediation of contaminated land prior to development, loss functions can be computed and used to guide rational decision making on the amount of resource to spend on sampling to collect soil information. In many circumstances the loss function cannot be obtained prior to decision making. This may be the case when multiple decisions may be based on the soil information and the costs of errors are hard to predict. The implicit loss function is proposed as a tool to aid decision making in these circumstances. Conditional on a logistical model which expresses costs of soil sampling as a function of effort, and statistical information from which the error of estimates can be modelled as a function of effort, the implicit loss function is the loss function which makes a particular decision on effort rational. In this presentation the loss function is defined and computed for a number of arbitrary decisions on sampling effort for a hypothetical soil monitoring problem. This is based on a logistical model of sampling cost parameterized from a recent geochemical survey of soil in Donegal, Ireland and on statistical parameters estimated with the aid of a process model for change in soil organic carbon. It is shown how the implicit loss function might provide a basis for reflection on a particular choice of sample size by comparing it with the values attributed to soil properties and functions. Scope for further research to develop and apply the implicit loss function to help decision making by policy makers and regulators is then discussed.

Correcting Spellings in Second Language Learners' Computer-Assisted Collaborative Writing

ERIC Educational Resources Information Center

Musk, Nigel

2016-01-01

The present study uses multimodal conversation analysis to examine how pupils studying English as a foreign language make spelling corrections in real time while doing collaborative computer-assisted project work. Unlike most previous related investigations, this study focuses on the "process" rather than evaluating the final…

Assisting Adult Higher Education via Personal Computer: Technology and Distance Education.

ERIC Educational Resources Information Center

Spradley, Evelyn

1993-01-01

Thomas Edison State College (New Jersey) has developed a computer-assisted distance learning system to make undergraduate study more accessible, efficient, and effective for nontraditional students. The three main components: an infrastructure to provide varied technical services; an independent study course system; and diagnostic, online pretests…

Three-Dimensional Computer-Assisted Two-Layer Elastic Models of the Face.

PubMed

Ueda, Koichi; Shigemura, Yuka; Otsuki, Yuki; Fuse, Asuka; Mitsuno, Daisuke

2017-11-01

To make three-dimensional computer-assisted elastic models for the face, we decided on five requirements: (1) an elastic texture like skin and subcutaneous tissue; (2) the ability to take pen marking for incisions; (3) the ability to be cut with a surgical knife; (4) the ability to keep stitches in place for a long time; and (5) a layered structure. After testing many elastic solvents, we have made realistic three-dimensional computer-assisted two-layer elastic models of the face and cleft lip from the computed tomographic and magnetic resonance imaging stereolithographic data. The surface layer is made of polyurethane and the inner layer is silicone. Using this elastic model, we taught residents and young doctors how to make several typical local flaps and to perform cheiloplasty. They could experience realistic simulated surgery and understand three-dimensional movement of the flaps.

Aid-Assisted Decision-Making and Colorectal Cancer Screening

PubMed Central

Schroy, Paul C.; Emmons, Karen M.; Peters, Ellen; Glick, Julie T.; Robinson, Patricia A.; Lydotes, Maria A.; Mylvaganam, Shamini R.; Coe, Alison M.; Chen, Clara A.; Chaisson, Christine E.; Pignone, Michael P.; Prout, Marianne N.; Davidson, Peter K.; Heeren, Timothy C.

2014-01-01

Background Shared decision-making (SDM) is a widely recommended yet unproven strategy for increasing colorectal cancer (CRC) screening uptake. Previous trials of decision aids to increase SDM and CRC screening uptake have yielded mixed results. Purpose To assess the impact of decision aid–assisted SDM on CRC screening uptake. Design RCT. Setting/participants The study was conducted at an urban, academic safety-net hospital and community health center between 2005 and 2010. Participants were asymptomatic, average-risk patients aged 50–75 years due for CRC screening. Intervention Study participants (n=825) were randomized to one of two intervention arms (decision aid plus personalized risk assessment or decision aid alone) or control arm. The interventions took place just prior to a routine office visit with their primary care providers. Main outcome measures The primary outcome was completion of a CRC screening test within 12 months of the study visit. Logistic regression was used to identify predictors of test completion and mediators of the intervention effect. Analysis was completed in 2011. Results Patients in the decision-aid group were more likely to complete a screening test than control patients (43.1% vs 34.8%; p=0.046) within 12 months of the study visit; conversely, test uptake for the decision aid and decision aid plus personalized risk assessment arms was similar (43.1% vs 37.1%; p=0.15). Assignment to the decision-aid arm (AOR 1.48; 95% CI=1.04, 2.10), black race (AOR 1.52, 95% CI=1.12, 2.06) and a preference for a patient-dominant decisionmaking approach (AOR, 1.55; 95% CI=1.02, 2.35) were independent determinants of test completion. Activation of the screening discussion and enhanced screening intentions mediated the intervention effect. Conclusions Decision aid–assisted SDM has a modest impact on CRC screening uptake. A decision aid plus personalized risk assessment tool is no more effective than a decision aid alone. PMID:23159252

Energy-Aware Computation Offloading of IoT Sensors in Cloudlet-Based Mobile Edge Computing.

PubMed

Ma, Xiao; Lin, Chuang; Zhang, Han; Liu, Jianwei

2018-06-15

Mobile edge computing is proposed as a promising computing paradigm to relieve the excessive burden of data centers and mobile networks, which is induced by the rapid growth of Internet of Things (IoT). This work introduces the cloud-assisted multi-cloudlet framework to provision scalable services in cloudlet-based mobile edge computing. Due to the constrained computation resources of cloudlets and limited communication resources of wireless access points (APs), IoT sensors with identical computation offloading decisions interact with each other. To optimize the processing delay and energy consumption of computation tasks, theoretic analysis of the computation offloading decision problem of IoT sensors is presented in this paper. In more detail, the computation offloading decision problem of IoT sensors is formulated as a computation offloading game and the condition of Nash equilibrium is derived by introducing the tool of a potential game. By exploiting the finite improvement property of the game, the Computation Offloading Decision (COD) algorithm is designed to provide decentralized computation offloading strategies for IoT sensors. Simulation results demonstrate that the COD algorithm can significantly reduce the system cost compared with the random-selection algorithm and the cloud-first algorithm. Furthermore, the COD algorithm can scale well with increasing IoT sensors.

Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-10-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

A Model of Human Teamwork for Agent-Assisted Search Operations

DTIC Science & Technology

2008-04-01

agent technology in providing effective team assistance , better understanding of robust human-agent teamwork is crucial. The goal of our research project...to various unexpected events. In order to fulfil the promise of agent technology in providing effective team assistance , better understanding of...distributed decision making. In Command and Control Research and Technology Symposium, 2004. A MODEL OF AGENT- ASSISTED SEARCH OPERATIONS 20 - 20 PUB REF NBR (e.g. RTO-MP-IST-999)

Enrollment Planning Using Computer Decision Model: A Case Study at Grambling State University.

ERIC Educational Resources Information Center

Ghosh, Kalyan; Lundy, Harold W.

Achieving enrollment goals continues to be a major administrative concern in higher education. Enrollment management can be assisted through the use of computerized planning and forecast models. Although commercially available Markov transition type curve fitting models have been developed and used, a microcomputer-based decision planning model…

Effects of Acculturation on Assistive Technology Service Delivery

ERIC Educational Resources Information Center

Parette, Howard P.; Huer, Mary Blake; Scherer, Marcia

2004-01-01

Given the increasing number of students with disabilities from diverse cultural backgrounds who are being served in special education settings (Harry, 1992), professionals have begun to focus attention on processes and strategies for ensuring culturally sensitive assistive technology (AT) decision-making (Parette, Huer, & VanBiervliet, in press;…

State Tuition, Fees, and Financial Assistance Policies: For Public Colleges and Universities, 2010-11

ERIC Educational Resources Information Center

Bell, Allison C.; Carnahan, Julie; L'Orange, Hans P.

2011-01-01

This report, "State Tuition, Fees, and Financial Assistance Policies for Public Colleges and Universities: 2010-11", examines the philosophies, policies, and procedures that influence decision-making regarding public college and university tuition, student fees, and student financial aid programs. This report also provides information…

Assistive Technology and Literacy Partnerships

ERIC Educational Resources Information Center

Gillette, Yvonne

2006-01-01

Assistive technology (AT) has the potential to support the literacy skills of students with disabilities as they participate in the general education curriculum. Empirical evidence is presented to support the use of AT, at least for some students. A case study interwoven within the article illustrates team decision-making regarding software and…

Bibliography: Equal Educational Opportunity: Myth or Reality?

ERIC Educational Resources Information Center

Mills, Gladys H.

The stated purpose of this bibliography is to assist school administrators, legislators, governors, and others in identifying documents already in their libraries which might assist in decision making at their respective levels, encourage effective action, and enhance the sense of urgency which the great American dream of equal educational…

Using Circle Time Books to Increase Participation in the Morning Circle Routine

ERIC Educational Resources Information Center

Simpson, Lisa A.; Oh, Kevin

2013-01-01

Assistive technology enables young children with disabilities to more effectively access their environment, facilitating the development of social-emotional, communicative, and cognitive skills. Research indicates that when service providers make decisions about assistive technology, they are more likely to choose low-tech options over high-tech…

Can Sophie's Choice Be Adequately Captured by Cold Computation of Minimizing Losses? An fMRI Study of Vital Loss Decisions

PubMed Central

Li, Qi; Qin, Shaozheng; Rao, Li-Lin; Zhang, Wencai; Ying, Xiaoping; Guo, Xiuyan; Guo, Chunyan; Ding, Jinghong; Li, Shu; Luo, Jing

2011-01-01

The vast majority of decision-making research is performed under the assumption of the value maximizing principle. This principle implies that when making decisions, individuals try to optimize outcomes on the basis of cold mathematical equations. However, decisions are emotion-laden rather than cool and analytic when they tap into life-threatening considerations. Using functional magnetic resonance imaging (fMRI), this study investigated the neural mechanisms underlying vital loss decisions. Participants were asked to make a forced choice between two losses across three conditions: both losses are trivial (trivial-trivial), both losses are vital (vital-vital), or one loss is trivial and the other is vital (vital-trivial). Our results revealed that the amygdala was more active and correlated positively with self-reported negative emotion associated with choice during vital-vital loss decisions, when compared to trivial-trivial loss decisions. The rostral anterior cingulate cortex was also more active and correlated positively with self-reported difficulty of choice during vital-vital loss decisions. Compared to the activity observed during trivial-trivial loss decisions, the orbitofrontal cortex and ventral striatum were more active and correlated positively with self-reported positive emotion of choice during vital-trivial loss decisions. Our findings suggest that vital loss decisions involve emotions and cannot be adequately captured by cold computation of minimizing losses. This research will shed light on how people make vital loss decisions. PMID:21412428

Practical (?) considerations for implementing assisted migration strategies for trees in North America

NASA Astrophysics Data System (ADS)

McKenney, D.; Pedlar, J.

2011-12-01

Climate is one of the major influences on forests and much effort has gone into projecting the impacts of rapid climate change on forest distribution and productivity. Such efforts are premised on the notion that the current generation of Global Climate Models (GCMs) provide reasonably accurate representations of future climate. But what is the appropriate level of faith to put in these projections when making relatively fine-scale resource management decisions such as the movement of plant genetic material? In this talk we review recent outcomes of climate envelope models for North American tree species that suggest optimal climate regimes could move on average ~700km within the next 100 years. Newer generation GCMs seem to confirm these results but much uncertainty remains for practical decision-making. Despite these uncertainties, assisted migration has been suggested as a climate change adaptation tool wherein populations of trees are moved up to a few hundred kilometers north (or a few hundred meters upslope) to keep pace with the anticipated changes in optimal climate regimes. A continent-wide web based tool (SEEDWHERE) is presented, which assists in identifying appropriate translocation distances for assisted migration initiatives. We finish with some suggestions for future work on the topic of forest regeneration decisions under an evolving and uncertain future climate.

Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2013-01-01

To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

"I've never been a yes person": Decision-making participation and self-conceptualization after severe traumatic brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2017-11-01

Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved. Self-conceptualization emerged as a complex and multifaceted process, as individuals with TBI aimed to reestablish a sense of autonomy. We describe a recursive relationship in which decision-making participation assists the dynamic construction of self, and self-concept contributes to the experience of making decisions. The role of an individual's social support network in acting as a bridge between participation and self-conceptualization is presented. Findings emphasize that contributing to decisions about one's own goals across a range of life areas can reinforce a positive self-concept. It is vital that supporters understand that participation in decision making provides a pathway to conceptualizing self and aim to maximize the person's participation in the decision-making process. Implications for Rehabilitation Previous research has identified that the experience of sustaining TBI has a significant impact on a person's conceptualization of self. This study identified that decision-making experiences play an important role in the ongoing process of self-conceptualization after injury. Decision-making experiences can reinforce a person's self-concept or lead them to revise (positively or negatively) their sense of self. By maximizing the person's decision-making participation, those around them can support them to develop positive self-attributes and contribute to shaping their future goals.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes.

PubMed

Clarinval, Caroline; Biller-Andorno, Nikola

2014-06-23

This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

Web Tutorials on Systems Thinking Using the Driver-Pressure-State-Impact-Response (DPSIR) Framework

EPA Science Inventory

This set of tutorials provides an overview of incorporating systems thinking into decision-making, an introduction to the DPSIR framework as one approach that can assist in the decision analysis process, and an overview of DPSIR tools, including concept mapping and keyword lists,...

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

EPA Science Inventory

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

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

PubMed

Banks, Victoria A; Stanton, Neville A

2015-01-01

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

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

PubMed

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

2017-09-01

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

End-of-life decision-making in India.

PubMed

Freckelton, Ian

2014-09-01

The extraordinary circumstances and the tragic life of Aruna Shanbaug, together with the landmark Supreme Court of India decision in Shanbaug v Union of India (2011) 4 SCC 454, have provided a fillip and focus to debate within India about end-of-life decision-making. This extends to passive euthanasia, decision-making about withdrawal of nutrition, hydration and medical treatment from persons in a permanent vegetative or quasi-vegetative state, the role of the courts in such matters, the risks of corruption and misconduct, the criminal status of attempted suicide, and even the contentious issue of physician-assisted active euthanasia. The debates have been promoted further by important reports of the Law Commission of India. This editorial reviews the current state of the law and debate about such issues in India.

Locus of decision making in multinational corporations and its relationship to subsidiary performance

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

Goehle, D.G.

1978-01-01

A conceptual model was developed which drew from the existing research in organization theory, comparative management, and international business which assisted in the delineation of the relevant variables and suggested the nature of their relationship to the locus of decision making. The conceptual model incorporated certain corporate and subsidiary factors considered an influence on the determination of the locus of decision making. Corporate factors included product line or industry, size and complexity of international operations, organization structure, availability of managerial talent, and corporate philosophy. Subsidiary characteristics included subsidiary age and size, availability of local managerial talent, geographic distance from headquartersmore » and other affiliated units, and subsidiary environmental characteristics. The locus of desicion making was measured by the level of participation the headquarters and subsidiary management had in decision making for twenty-nine decisions, representing six functional areas. Levels of participation for headquarters and subsidiary managers were measured for each decision based on responses to a five-point scale of decision process categories which indicated varying levels of headquarters and subsidiary participation. The sample included ten US multinational corporations representing five industries: pharmaceuticals, tire and rubber, automobiles, capital equipment, and food processing.« less

Exploring the role of religiosity and spirituality in amniocentesis decision-making among Latinas.

PubMed

Seth, Sarah Guerra; Goka, Thomas; Harbison, Andrea; Hollier, Lisa; Peterson, Susan; Ramondetta, Lois; Noblin, Sarah Jane

2011-12-01

Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas' spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas' daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God's will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.

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

PubMed

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

2005-10-01

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

A dynamic, embodied paradigm to investigate the role of serotonin in decision-making

PubMed Central

Asher, Derrik E.; Craig, Alexis B.; Zaldivar, Andrew; Brewer, Alyssa A.; Krichmar, Jeffrey L.

2013-01-01

Serotonin (5-HT) is a neuromodulator that has been attributed to cost assessment and harm aversion. In this review, we look at the role 5-HT plays in making decisions when subjects are faced with potential harmful or costly outcomes. We review approaches for examining the serotonergic system in decision-making. We introduce our group’s paradigm used to investigate how 5-HT affects decision-making. In particular, our paradigm combines techniques from computational neuroscience, socioeconomic game theory, human–robot interaction, and Bayesian statistics. We will highlight key findings from our previous studies utilizing this paradigm, which helped expand our understanding of 5-HT’s effect on decision-making in relation to cost assessment. Lastly, we propose a cyclic multidisciplinary approach that may aid in addressing the complexity of exploring 5-HT and decision-making by iteratively updating our assumptions and models of the serotonergic system through exhaustive experimentation. PMID:24319413

Effect of regulating anger and sadness on decision-making.

PubMed

Szasz, Paul Lucian; Hofmann, Stefan G; Heilman, Renata M; Curtiss, Joshua

2016-11-01

The aim of the current study was to investigate the effects of reappraisal, acceptance, and rumination for regulating anger and sadness on decision-making. Participants (N = 165) were asked to recall two autobiographical events in which they felt intense anger and sadness, respectively. Participants were then instructed to reappraise, accept, ruminate, or not use any strategies to regulate their feelings of anger and sadness. Following this manipulation, risk aversion, and decision-making strategies were measured using a computer-based measure of risk-taking and a simulated real-life decision-making task. Participants who were instructed to reappraise their emotions showed the least anger and sadness, the most adaptive decision-making strategies, but the least risk aversion as compared to the participants in the other conditions. These findings suggest that emotion regulation strategies of negative affective states have an immediate effect on decision-making and risk-taking behaviors.

Computer-Aided Decision Making.

DTIC Science & Technology

1988-04-01

Center at Gunter APS, Alabama, 1% predicts that 150.000 more microcomputers, with integrated software, will be VP aided !,: the A:r Fcrce inventory...a computer’s power when he said, ’it is also useful to anticipate or predict changes in the data Pondering ’what if’ situations enabled me to answer... predict future b) experts forecast In Isolation, then consensus is found C. Group decision making (3t30-34) Slide i-i 1. Advantages a. broader background 1

Analytic hierarchy process (AHP) as a tool in asset allocation

NASA Astrophysics Data System (ADS)

Zainol Abidin, Siti Nazifah; Mohd Jaffar, Maheran

2013-04-01

Allocation capital investment into different assets is the best way to balance the risk and reward. This can prevent from losing big amount of money. Thus, the aim of this paper is to help investors in making wise investment decision in asset allocation. This paper proposes modifying and adapting Analytic Hierarchy Process (AHP) model. The AHP model is widely used in various fields of study that are related in decision making. The results of the case studies show that the proposed model can categorize stocks and determine the portion of capital investment. Hence, it can assist investors in decision making process and reduce the risk of loss in stock market investment.

"Sugar-Ray" School-Based Decision Groups.

ERIC Educational Resources Information Center

Hunt, John J.; And Others

1992-01-01

Investigates differences between high-achieving and low-achieving school-based decision groups in decision making. Decision groups (207 groups of 3 members each) used computer simulations to address problems facing principals concerning fourth grade academic achievement. Higher-achieving groups made more decisions and made a combination of related…

Decision making: the neuroethological turn

PubMed Central

Pearson, John M.; Watson, Karli K.; Platt, Michael L.

2014-01-01

Neuroeconomics applies models from economics and psychology to inform neurobiological studies of choice. This approach has revealed neural signatures of concepts like value, risk, and ambiguity, which are known to influence decision-making. Such observations have led theorists to hypothesize a single, unified decision process that mediates choice behavior via a common neural currency for outcomes like food, money, or social praise. In parallel, recent neuroethological studies of decision-making have focused on natural behaviors like foraging, mate choice, and social interactions. These decisions strongly impact evolutionary fitness and thus are likely to have played a key role in shaping the neural circuits that mediate decision-making. This approach has revealed a suite of computational motifs that appear to be shared across a wide variety of organisms. We argue that the existence of deep homologies in the neural circuits mediating choice may have profound implications for understanding human decision-making in health and disease. PMID:24908481

Training Students as Technology Assistants.

ERIC Educational Resources Information Center

Onishi, Esther; Peto, Erica

1996-01-01

Describes a program where fifth and sixth graders are trained as school technology assistants. The childrens' duties include installation of software, making minor repairs, cleaning computer equipment, and assisting teachers and students. Outlines components of the program, lists forms the assistants use and skills they are taught, and provides…

Medicine, psychiatry and euthanasia: an argument against mandatory psychiatric review.

PubMed

Parker, M

2000-04-01

The paper critically appraises the argument that requests for active assistance to die should be subject to mandatory psychiatric assessment. The argument for mandatory psychiatric assessment is usually supported by an appeal to the need for safeguards against errors and omissions in both the diagnosis of psychiatric conditions affecting the terminally ill and the exploration of the meanings of their requests. This intuitively appealing view is challenged through a broader analysis which examines connections between medicine's traditional adherence to the moral distinction between acts and omissions and the following issues: the historical relationship between medical practice and dying, the recent development of research into treatment-withdrawal decisions, the scientific status of psychiatry, the logic of rationality and decision-making competence. The analysis reveals a number of hitherto unexamined and unacknowledged influences which would make psychiatric review of requests for assisted death a much less objective and impartial process than is assumed. Mandatory psychiatric review is an instance of the medicalisation of death and dying which could abridge the freedom of certain individuals to make decisions about their deaths.

Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis.

PubMed

Anolik, Rachel A; Allori, Alexander C; Pourtaheri, Navid; Rogers, Gary F; Marcus, Jeffrey R

2016-05-01

The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making. An expert panel was asked to study 30 cases ranging from minor to severe metopic synostosis. Based on computed tomographic images of the skull and clinical photographs, they classified the severity of trigonocephaly (1 = normal, 2 = mild, 3 = moderate, and 4 = severe) and management (0 = nonoperative and 1 = operative). The severity scores and management reported by experts were then pooled and matched with the interfrontal angle computed from each respective computed tomographic scan. A threshold was identified at which most experts agree on operative management. Expert severity scores were higher for more acute interfrontal angles. There was a high concordance at the extremes of classifications, severe (4) and normal (1) (p < 0.0001); however, between interfrontal angles of 114.3 and 136.1 degrees, there exists a "gray zone," with severe discordance in expert rankings. An operative threshold of 118.2 degrees was identified, with the interfrontal angle able to predict the expert panel's decision to proceed with surgery 87.6 percent of the time. The interfrontal angle has been previously validated as a simple, accurate, and reproducible means for diagnosing trigonocephaly, but must be obtained from computed tomographic data. In this article, the authors demonstrate that the interfrontal angle can be used to further characterize the severity of trigonocephaly. It also correlated with expert decision-making for operative versus nonoperative management. This tool may be used as an adjunct to clinical decision-making when the decision to proceed with surgery may not be straightforward. Diagnostic, V.

7 CFR 1209.3 - Consumer information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Definitions § 1209.3 Consumer information. Consumer information means information and programs that will assist consumers and other persons in making evaluations and decisions regarding the purchase...

Instructional Computing. An Action Guide for Educators.

ERIC Educational Resources Information Center

Dennis, J. Richard; Kansky, Robert J.

This book is directed to any educator who is interested in the use of the computer to improve classroom instruction. It is a book about the materials, human factors, and decision-making procedures that make up the instructional application of computers. This document's single goal is to promote educators' thoughtful selection and use of both…

Primary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care.

PubMed

Huang, Kevin B; Weber, Urs; Johnson, Jennifer; Anderson, Nathanial; Knies, Andrea K; Nhundu, Belinda; Bautista, Cynthia; Poskus, Kelly; Sheth, Kevin N; Hwang, David Y

2018-01-01

An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients. We compared the mean score for the survey subsection regarding shared decision making (graded on a 100-point scale), as well as individual survey items, between those who reported the patient's PCP involvement in any medical decision making versus those who did not. Among 263 respondents, there was no difference in mean overall decision-making satisfaction scores for those who reported involvement (81.1; SD = 15.2) versus those who did not (80.1; SD = 12.8; P = .16). However, a higher proportion reporting involvement felt completely satisfied with their 1) inclusion in the ICU decision making process (75.9% vs 61.4%; P = .055), and 2) control over the care of the patient (73.6% vs 55.6%; P = .02), with no difference regarding consistency of clinical information provided by the medical team (64.8% vs 63.5%; P = 1.00). Families who report involvement of a patient's PCP in medical decision making for critically ill patients may be more satisfied than those who do not with regard to specific aspects of ICU decision making. Further research would help understand how best to engage PCPs in shared decisions. © Copyright 2018 by the American Board of Family Medicine.

Parents' Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care.

PubMed

Coxeter, Peter D; Mar, Chris Del; Hoffmann, Tammy C

2017-03-01

Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents' beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. © 2017 Annals of Family Medicine, Inc.

Parents’ Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care

PubMed Central

Coxeter, Peter D.; Mar, Chris Del; Hoffmann, Tammy C.

2017-01-01

PURPOSE Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents’ beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. METHODS We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. RESULTS Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. CONCLUSIONS Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. PMID:28289114

Soil Ecosystem Recovery Should Be Quantifiable

USDA-ARS?s Scientific Manuscript database

Conservation Reserve Program (CRP) costs close to two billion dollars in federal funds every year; and yet, it is challenging to evaluate its effectiveness to assist the decision making process. Using a combination of physical properties and microbial indicators, we found that it is possible to make...

The Role of Scientific Studies in Building Consensus in Environmental Decision Making: a Coral Reef Example

EPA Science Inventory

We present a new approach for characterizing the potential of scientific studies to reduce conflict among stakeholders in an analytic-deliberative environmental decision-making process. The approach computes a normalized metric, the Expected Consensus Index of New Research (ECINR...

A Computer-Assisted-Instruction Course in Vocabulary Building through Latin and Greek Roots

ERIC Educational Resources Information Center

Scanlan, Richard T.

1976-01-01

A course in the enlargement of students' English vocabulary through the study of Latin and Greek roots and their derivatives was developed by the Department of Classics at the University of Illinois. The class makes use of computer assisted instruction on the PLATO IV system. (Author/RM)

Integration of an OWL-DL knowledge base with an EHR prototype and providing customized information.

PubMed

Jing, Xia; Kay, Stephen; Marley, Tom; Hardiker, Nicholas R

2014-09-01

When clinicians use electronic health record (EHR) systems, their ability to obtain general knowledge is often an important contribution to their ability to make more informed decisions. In this paper we describe a method by which an external, formal representation of clinical and molecular genetic knowledge can be integrated into an EHR such that customized knowledge can be delivered to clinicians in a context-appropriate manner.Web Ontology Language-Description Logic (OWL-DL) is a formal knowledge representation language that is widely used for creating, organizing and managing biomedical knowledge through the use of explicit definitions, consistent structure and a computer-processable format, particularly in biomedical fields. In this paper we describe: 1) integration of an OWL-DL knowledge base with a standards-based EHR prototype, 2) presentation of customized information from the knowledge base via the EHR interface, and 3) lessons learned via the process. The integration was achieved through a combination of manual and automatic methods. Our method has advantages for scaling up to and maintaining knowledge bases of any size, with the goal of assisting clinicians and other EHR users in making better informed health care decisions.

An Integrated DEMATEL-VIKOR Method-Based Approach for Cotton Fibre Selection and Evaluation

NASA Astrophysics Data System (ADS)

Chakraborty, Shankar; Chatterjee, Prasenjit; Prasad, Kanika

2018-01-01

Selection of the most appropriate cotton fibre type for yarn manufacturing is often treated as a multi-criteria decision-making (MCDM) problem as the optimal selection decision needs to be taken in presence of several conflicting fibre properties. In this paper, two popular MCDM methods in the form of decision making trial and evaluation laboratory (DEMATEL) and VIse Kriterijumska Optimizacija kompromisno Resenje (VIKOR) are integrated to aid the cotton fibre selection decision. DEMATEL method addresses the interrelationships between various physical properties of cotton fibres while segregating them into cause and effect groups, whereas, VIKOR method helps in ranking all the considered 17 cotton fibres from the best to the worst. The derived ranking of cotton fibre alternatives closely matches with that obtained by the past researchers. This model can assist the spinning industry personnel in the blending process while making accurate fibre selection decision when cotton fibre properties are numerous and interrelated.

An Integrated DEMATEL-VIKOR Method-Based Approach for Cotton Fibre Selection and Evaluation

NASA Astrophysics Data System (ADS)

Chakraborty, Shankar; Chatterjee, Prasenjit; Prasad, Kanika

2018-06-01

Selection of the most appropriate cotton fibre type for yarn manufacturing is often treated as a multi-criteria decision-making (MCDM) problem as the optimal selection decision needs to be taken in presence of several conflicting fibre properties. In this paper, two popular MCDM methods in the form of decision making trial and evaluation laboratory (DEMATEL) and VIse Kriterijumska Optimizacija kompromisno Resenje (VIKOR) are integrated to aid the cotton fibre selection decision. DEMATEL method addresses the interrelationships between various physical properties of cotton fibres while segregating them into cause and effect groups, whereas, VIKOR method helps in ranking all the considered 17 cotton fibres from the best to the worst. The derived ranking of cotton fibre alternatives closely matches with that obtained by the past researchers. This model can assist the spinning industry personnel in the blending process while making accurate fibre selection decision when cotton fibre properties are numerous and interrelated.

[Adoption of new technologies by health services: the challenge of analyzing relevant factors].

PubMed

Trindade, Evelinda

2008-05-01

The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

Cognitive and Emotional Factors Predicting Decisional Conflict among High-Risk Breast Cancer Survivors Who Receive Uninformative BRCA1/2 Results

PubMed Central

Rini, Christine; O’Neill, Suzanne C.; Valdimarsdottir, Heiddis; Goldsmith, Rachel E.; DeMarco, Tiffani A.; Peshkin, Beth N.; Schwartz, Marc D.

2012-01-01

Objective To investigate high-risk breast cancer survivors’ risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test. Design Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months post-disclosure. Measures Primary predictors were health beliefs and emotional responses to testing assessed 1-month post-disclosure. 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. Results 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 non-decision 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 post-disclosure found that, after accounting for controls and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important one month after test disclosure and health beliefs more important one year later. Conclusion Many of these women may benefit from decision making assistance. PMID:19751083

Usability of an Adaptive Computer Assistant that Improves Self-care and Health Literacy of Older Adults

PubMed Central

Blanson Henkemans, O. A.; Rogers, W. A.; Fisk, A. D.; Neerincx, M. A.; Lindenberg, J.; van der Mast, C. A. P. G.

2014-01-01

Summary Objectives We developed an adaptive computer assistant for the supervision of diabetics’ self-care, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient’s electronic diary. Accordingly, it provides context-aware feedback. The objective was to evaluate whether older adults in general can make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy. Methods We conducted a laboratory experiment in the Georgia Tech Aware Home wherein 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. We evaluated the assistant on effectiveness, efficiency, satisfaction, and educational value. Finally, we studied the moderating effects of the subjects’ personal characteristics. Results Logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects’ knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and health-critical situations, and, generally, it led to more time efficiency. Subjects’ personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants. Conclusions Older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics’ self care while maintaining quality of life. PMID:18213433

[Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values].

PubMed

Palazzo, Salvatore; Filice, Aldo; Mastroianni, Candida; Biamonte, Rosalbino; Conforti, Serafino; Liguori, Virginia; Turano, Salvatore; De Simone, Rosanna; Rovito, Antonio; Manfredi, Caterina; Minardi, Stefano; Vilardo, Emmanuelle; Loizzo, Monica; Oriolo, Carmela

2016-04-01

Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.

The influence of spatiotemporal structure of noisy stimuli in decision making.

PubMed

Insabato, Andrea; Dempere-Marco, Laura; Pannunzi, Mario; Deco, Gustavo; Romo, Ranulfo

2014-04-01

Decision making is a process of utmost importance in our daily lives, the study of which has been receiving notable attention for decades. Nevertheless, the neural mechanisms underlying decision making are still not fully understood. Computational modeling has revealed itself as a valuable asset to address some of the fundamental questions. Biophysically plausible models, in particular, are useful in bridging the different levels of description that experimental studies provide, from the neural spiking activity recorded at the cellular level to the performance reported at the behavioral level. In this article, we have reviewed some of the recent progress made in the understanding of the neural mechanisms that underlie decision making. We have performed a critical evaluation of the available results and address, from a computational perspective, aspects of both experimentation and modeling that so far have eluded comprehension. To guide the discussion, we have selected a central theme which revolves around the following question: how does the spatiotemporal structure of sensory stimuli affect the perceptual decision-making process? This question is a timely one as several issues that still remain unresolved stem from this central theme. These include: (i) the role of spatiotemporal input fluctuations in perceptual decision making, (ii) how to extend the current results and models derived from two-alternative choice studies to scenarios with multiple competing evidences, and (iii) to establish whether different types of spatiotemporal input fluctuations affect decision-making outcomes in distinctive ways. And although we have restricted our discussion mostly to visual decisions, our main conclusions are arguably generalizable; hence, their possible extension to other sensory modalities is one of the points in our discussion.

The Influence of Spatiotemporal Structure of Noisy Stimuli in Decision Making

PubMed Central

Deco, Gustavo; Romo, Ranulfo

2014-01-01

Decision making is a process of utmost importance in our daily lives, the study of which has been receiving notable attention for decades. Nevertheless, the neural mechanisms underlying decision making are still not fully understood. Computational modeling has revealed itself as a valuable asset to address some of the fundamental questions. Biophysically plausible models, in particular, are useful in bridging the different levels of description that experimental studies provide, from the neural spiking activity recorded at the cellular level to the performance reported at the behavioral level. In this article, we have reviewed some of the recent progress made in the understanding of the neural mechanisms that underlie decision making. We have performed a critical evaluation of the available results and address, from a computational perspective, aspects of both experimentation and modeling that so far have eluded comprehension. To guide the discussion, we have selected a central theme which revolves around the following question: how does the spatiotemporal structure of sensory stimuli affect the perceptual decision-making process? This question is a timely one as several issues that still remain unresolved stem from this central theme. These include: (i) the role of spatiotemporal input fluctuations in perceptual decision making, (ii) how to extend the current results and models derived from two-alternative choice studies to scenarios with multiple competing evidences, and (iii) to establish whether different types of spatiotemporal input fluctuations affect decision-making outcomes in distinctive ways. And although we have restricted our discussion mostly to visual decisions, our main conclusions are arguably generalizable; hence, their possible extension to other sensory modalities is one of the points in our discussion. PMID:24743140

A canonical theory of dynamic decision-making.

PubMed

Fox, John; Cooper, Richard P; Glasspool, David W

2013-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering.

A Canonical Theory of Dynamic Decision-Making

PubMed Central

Fox, John; Cooper, Richard P.; Glasspool, David W.

2012-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering. PMID:23565100

Factors Influencing Cloud-Computing Technology Adoption in Developing Countries

ERIC Educational Resources Information Center

Hailu, Alemayehu

2012-01-01

Adoption of new technology has complicating components both from the selection, as well as decision-making criteria and process. Although new technology such as cloud computing provides great benefits especially to the developing countries, it has challenges that may complicate the selection decision and subsequent adoption process. This study…

Decision-making without a brain: how an amoeboid organism solves the two-armed bandit.

PubMed

Reid, Chris R; MacDonald, Hannelore; Mann, Richard P; Marshall, James A R; Latty, Tanya; Garnier, Simon

2016-06-01

Several recent studies hint at shared patterns in decision-making between taxonomically distant organisms, yet few studies demonstrate and dissect mechanisms of decision-making in simpler organisms. We examine decision-making in the unicellular slime mould Physarum polycephalum using a classical decision problem adapted from human and animal decision-making studies: the two-armed bandit problem. This problem has previously only been used to study organisms with brains, yet here we demonstrate that a brainless unicellular organism compares the relative qualities of multiple options, integrates over repeated samplings to perform well in random environments, and combines information on reward frequency and magnitude in order to make correct and adaptive decisions. We extend our inquiry by using Bayesian model selection to determine the most likely algorithm used by the cell when making decisions. We deduce that this algorithm centres around a tendency to exploit environments in proportion to their reward experienced through past sampling. The algorithm is intermediate in computational complexity between simple, reactionary heuristics and calculation-intensive optimal performance algorithms, yet it has very good relative performance. Our study provides insight into ancestral mechanisms of decision-making and suggests that fundamental principles of decision-making, information processing and even cognition are shared among diverse biological systems. © 2016 The Authors.

Decision support systems for robotic surgery and acute care

NASA Astrophysics Data System (ADS)

Kazanzides, Peter

2012-06-01

Doctors must frequently make decisions during medical treatment, whether in an acute care facility, such as an Intensive Care Unit (ICU), or in an operating room. These decisions rely on a various information sources, such as the patient's medical history, preoperative images, and general medical knowledge. Decision support systems can assist by facilitating access to this information when and where it is needed. This paper presents some research eorts that address the integration of information with clinical practice. The example systems include a clinical decision support system (CDSS) for pediatric traumatic brain injury, an augmented reality head- mounted display for neurosurgery, and an augmented reality telerobotic system for minimally-invasive surgery. While these are dierent systems and applications, they share the common theme of providing information to support clinical decisions and actions, whether the actions are performed with the surgeon's own hands or with robotic assistance.

Breast Cancer

MedlinePlus

... a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing to assist you with shared decision-making. Risk ...

7 CFR 1220.105 - Consumer information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... term consumer information means information that will assist consumers and other persons in making evaluations and decisions regarding the purchase, preparation, and use of soybeans or soybean products. ...

Brain mechanisms controlling decision making and motor planning.

PubMed

Ramakrishnan, Arjun; Murthy, Aditya

2013-01-01

Accumulator models of decision making provide a unified framework to understand decision making and motor planning. In these models, the evolution of a decision is reflected in the accumulation of sensory information into a motor plan that reaches a threshold, leading to choice behavior. While these models provide an elegant framework to understand performance and reaction times, their ability to explain complex behaviors such as decision making and motor control of sequential movements in dynamic environments is unclear. To examine and probe the limits of online modification of decision making and motor planning, an oculomotor "redirect" task was used. Here, subjects were expected to change their eye movement plan when a new saccade target appeared. Based on task performance, saccade reaction time distributions, computational models of behavior, and intracortical microstimulation of monkey frontal eye fields, we show how accumulator models can be tested and extended to study dynamic aspects of decision making and motor control. Copyright © 2013 Elsevier B.V. All rights reserved.

Development of a theory-guided pan-European computer-assisted safer sex intervention.

PubMed

Nöstlinger, Christiana; Borms, Ruth; Dec-Pietrowska, Joanna; Dias, Sonia; Rojas, Daniela; Platteau, Tom; Vanden Berghe, Wim; Kok, Gerjo

2016-12-01

HIV is a growing public health problem in Europe, with men-having-sex-with-men and migrants from endemic regions as the most affected key populations. More evidence on effective behavioral interventions to reduce sexual risk is needed. This article describes the systematic development of a theory-guided computer-assisted safer sex intervention, aiming at supporting people living with HIV in sexual risk reduction. We applied the Intervention Mapping (IM) protocol to develop this counseling intervention in the framework of a European multicenter study. We conducted a needs assessment guided by the information-motivation-behavioral (IMB) skills model, formulated change objectives and selected theory-based methods and practical strategies, i.e. interactive computer-assisted modules as supporting tools for provider-delivered counseling. Theoretical foundations were the IMB skills model, social cognitive theory and the transtheoretical model, complemented by dual process models of affective decision making to account for the specifics of sexual behavior. The counseling approach for delivering three individual sessions was tailored to participants' needs and contexts, adopting elements of motivational interviewing and cognitive-behavioral therapy. We implemented and evaluated the intervention using a randomized controlled trial combined with a process evaluation. IM provided a useful framework for developing a coherent intervention for heterogeneous target groups, which was feasible and effective across the culturally diverse settings. This article responds to the need for transparent descriptions of the development and content of evidence-based behavior change interventions as potential pillars of effective combination prevention strategies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sequential decision making in computational sustainability via adaptive submodularity

USGS Publications Warehouse

Krause, Andreas; Golovin, Daniel; Converse, Sarah J.

2015-01-01

Many problems in computational sustainability require making a sequence of decisions in complex, uncertain environments. Such problems are generally notoriously difficult. In this article, we review the recently discovered notion of adaptive submodularity, an intuitive diminishing returns condition that generalizes the classical notion of submodular set functions to sequential decision problems. Problems exhibiting the adaptive submodularity property can be efficiently and provably near-optimally solved using simple myopic policies. We illustrate this concept in several case studies of interest in computational sustainability: First, we demonstrate how it can be used to efficiently plan for resolving uncertainty in adaptive management scenarios. Secondly, we show how it applies to dynamic conservation planning for protecting endangered species, a case study carried out in collaboration with the US Geological Survey and the US Fish and Wildlife Service.

Clinical-decision support based on medical literature: A complex network approach

NASA Astrophysics Data System (ADS)

Jiang, Jingchi; Zheng, Jichuan; Zhao, Chao; Su, Jia; Guan, Yi; Yu, Qiubin

2016-10-01

In making clinical decisions, clinicians often review medical literature to ensure the reliability of diagnosis, test, and treatment because the medical literature can answer clinical questions and assist clinicians making clinical decisions. Therefore, finding the appropriate literature is a critical problem for clinical-decision support (CDS). First, the present study employs search engines to retrieve relevant literature about patient records. However, the result of the traditional method is usually unsatisfactory. To improve the relevance of the retrieval result, a medical literature network (MLN) based on these retrieved papers is constructed. Then, we show that this MLN has small-world and scale-free properties of a complex network. According to the structural characteristics of the MLN, we adopt two methods to further identify the potential relevant literature in addition to the retrieved literature. By integrating these potential papers into the MLN, a more comprehensive MLN is built to answer the question of actual patient records. Furthermore, we propose a re-ranking model to sort all papers by relevance. We experimentally find that the re-ranking model can improve the normalized discounted cumulative gain of the results. As participants of the Text Retrieval Conference 2015, our clinical-decision method based on the MLN also yields higher scores than the medians in most topics and achieves the best scores for topics: #11 and #12. These research results indicate that our study can be used to effectively assist clinicians in making clinical decisions, and the MLN can facilitate the investigation of CDS.

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

PubMed

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

2013-04-01

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

A group decision-making tool for the application of membrane technologies in different water reuse scenarios.

PubMed

Sadr, S M K; Saroj, D P; Kouchaki, S; Ilemobade, A A; Ouki, S K

2015-06-01

A global challenge of increasing concern is diminishing fresh water resources. A growing practice in many communities to supplement diminishing fresh water availability has been the reuse of water. Novel methods of treating polluted waters, such as membrane assisted technologies, have recently been developed and successfully implemented in many places. Given the diversity of membrane assisted technologies available, the current challenge is how to select a reliable alternative among numerous technologies for appropriate water reuse. In this research, a fuzzy logic based multi-criteria, group decision making tool has been developed. This tool has been employed in the selection of appropriate membrane treatment technologies for several non-potable and potable reuse scenarios. Robust criteria, covering technical, environmental, economic and socio-cultural aspects, were selected, while 10 different membrane assisted technologies were assessed in the tool. The results show this approach capable of facilitating systematic and rigorous analysis in the comparison and selection of membrane assisted technologies for advanced wastewater treatment and reuse. Copyright © 2015 Elsevier Ltd. All rights reserved.