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

ERIC Educational Resources Information Center

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

2018-01-01

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

What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis.

PubMed

Dror, David Mark; Hossain, S A Shahed; Majumdar, Atanu; Pérez Koehlmoos, Tracey Lynn; John, Denny; Panda, Pradeep Kumar

2016-01-01

This research article reports on factors influencing initial voluntary uptake of community-based health insurance (CBHI) schemes in low- and middle-income countries (LMIC), and renewal decisions. Following PRISMA protocol, we conducted a comprehensive search of academic and gray literature, including academic databases in social science, economics and medical sciences (e.g., Econlit, Global health, Medline, Proquest) and other electronic resources (e.g., Eldis and Google scholar). Search strategies were developed using the thesaurus or index terms (e.g., MeSH) specific to the databases, combined with free text terms related to CBHI or health insurance. Searches were conducted from May 2013 to November 2013 in English, French, German, and Spanish. From the initial search yield of 15,770 hits, 54 relevant studies were retained for analysis of factors influencing enrolment and renewal decisions. The quantitative synthesis (informed by meta-analysis) and the qualitative analysis (informed by thematic synthesis) were compared to gain insight for an overall synthesis of findings/statements. Meta-analysis suggests that enrolments in CBHI were positively associated with household income, education and age of the household head (HHH), household size, female-headed household, married HHH and chronic illness episodes in the household. The thematic synthesis suggests the following factors as enablers for enrolment: (a) knowledge and understanding of insurance and CBHI, (b) quality of healthcare, (c) trust in scheme management. Factors found to be barriers to enrolment include: (a) inappropriate benefits package, (b) cultural beliefs, (c) affordability, (d) distance to healthcare facility, (e) lack of adequate legal and policy frameworks to support CBHI, and (f) stringent rules of some CBHI schemes. HHH education, household size and trust in the scheme management were positively associated with member renewal decisions. Other motivators were: (a) knowledge and understanding of insurance and CBHI, (b) healthcare quality, (c) trust in scheme management, and (d) receipt of an insurance payout the previous year. The barriers to renewal decisions were: (a) stringent rules of some CBHI schemes, (b) inadequate legal and policy frameworks to support CBHI and (c) inappropriate benefits package. The demand-side factors positively affecting enrolment in CBHI include education, age, female household heads, and the socioeconomic status of households. Moreover, when individuals understand how their CBHI functions they are more likely to enroll and when people have a positive claims experience, they are more likely to renew. A higher prevalence of chronic conditions or the perception that healthcare is of good quality and nearby act as factors enhancing enrolment. The perception that services are distant or deficient leads to lower enrolments. The second insight is that trust in the scheme enables enrolment. Thirdly, clarity about the legal or policy framework acts as a factor influencing enrolments. This is significant, as it points to hitherto unpublished evidence that governments can effectively broaden their outreach to grassroots groups that are excluded from social protection by formulating supportive regulatory and policy provisions even if they cannot fund such schemes in full, by leveraging people's willingness to exercise voluntary and contributory enrolment in a community-based health insurance.

MDCT quantification is the dominant parameter in decision–making regarding chest tube drainage for stable patients with traumatic pneumothorax

PubMed Central

Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

2013-01-01

It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. PMID:22560899

MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax.

PubMed

Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

2012-07-01

It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. Copyright © 2012 Elsevier Ltd. All rights reserved.

Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

PubMed

Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

2002-02-01

Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

Human health improvement in Sub-Saharan Africa through integrated management of arthropod transmitted diseases and natural resources.

PubMed

Baumgärtner, J; Bieri, M; Buffoni, G; Gilioli, G; Gopalan, H; Greiling, J; Tikubet, G; Van Schayk, I

2001-01-01

A concept of an ecosystem approach to human health improvement in Sub-Saharan Africa is presented here. Three factors mainly affect the physical condition of the human body: the abiotic environment, vector-transmitted diseases, and natural resources. Our concept relies on ecological principles embedded in a social context and identifies three sets of subsystems for study and management: human disease subsystems, natural resource subsystems, and decision-support subsystems. To control human diseases and to secure food from resource subsystems including livestock or crops, integrated preventive approaches are preferred over exclusively curative and sectorial approaches. Environmental sustainability - the basis for managing matter and water flows - contributes to a healthy human environment and constitutes the basis for social sustainability. For planning and implementation of the human health improvement scheme, participatory decision-support subsystems adapted to the local conditions need to be designed through institutional arrangements. The applicability of this scheme is demonstrated in urban and rural Ethiopia.

A Real-Time Decision Support System for Voltage Collapse Avoidance in Power Supply Networks

NASA Astrophysics Data System (ADS)

Chang, Chen-Sung

This paper presents a real-time decision support system (RDSS) based on artificial intelligence (AI) for voltage collapse avoidance (VCA) in power supply networks. The RDSS scheme employs a fuzzy hyperrectangular composite neural network (FHRCNN) to carry out voltage risk identification (VRI). In the event that a threat to the security of the power supply network is detected, an evolutionary programming (EP)-based algorithm is triggered to determine the operational settings required to restore the power supply network to a secure condition. The effectiveness of the RDSS methodology is demonstrated through its application to the American Electric Power Provider System (AEP, 30-bus system) under various heavy load conditions and contingency scenarios. In general, the numerical results confirm the ability of the RDSS scheme to minimize the risk of voltage collapse in power supply networks. In other words, RDSS provides Power Provider Enterprises (PPEs) with a viable tool for performing on-line voltage risk assessment and power system security enhancement functions.

A fast and efficient segmentation scheme for cell microscopic image.

PubMed

Lebrun, G; Charrier, C; Lezoray, O; Meurie, C; Cardot, H

2007-04-27

Microscopic cellular image segmentation schemes must be efficient for reliable analysis and fast to process huge quantity of images. Recent studies have focused on improving segmentation quality. Several segmentation schemes have good quality but processing time is too expensive to deal with a great number of images per day. For segmentation schemes based on pixel classification, the classifier design is crucial since it is the one which requires most of the processing time necessary to segment an image. The main contribution of this work is focused on how to reduce the complexity of decision functions produced by support vector machines (SVM) while preserving recognition rate. Vector quantization is used in order to reduce the inherent redundancy present in huge pixel databases (i.e. images with expert pixel segmentation). Hybrid color space design is also used in order to improve data set size reduction rate and recognition rate. A new decision function quality criterion is defined to select good trade-off between recognition rate and processing time of pixel decision function. The first results of this study show that fast and efficient pixel classification with SVM is possible. Moreover posterior class pixel probability estimation is easy to compute with Platt method. Then a new segmentation scheme using probabilistic pixel classification has been developed. This one has several free parameters and an automatic selection must dealt with, but criteria for evaluate segmentation quality are not well adapted for cell segmentation, especially when comparison with expert pixel segmentation must be achieved. Another important contribution in this paper is the definition of a new quality criterion for evaluation of cell segmentation. The results presented here show that the selection of free parameters of the segmentation scheme by optimisation of the new quality cell segmentation criterion produces efficient cell segmentation.

An integrated decision support system for wastewater nutrient recovery and recycling to agriculture

NASA Astrophysics Data System (ADS)

Roy, E. D.; Bomeisl, L.; Cornbrooks, P.; Mo, W.

2017-12-01

Nutrient recovery and recycling has become a key research topic within the wastewater engineering and nutrient management communities. Several technologies now exist that can effectively capture nutrients from wastewater, and innovation in this area continues to be an important research pursuit. However, practical nutrient recycling solutions require more than capable nutrient capture technologies. We also need to understand the role that wastewater nutrient recovery and recycling can play within broader nutrient management schemes at the landscape level, including important interactions at the nexus of food, energy, and water. We are developing an integrated decision support system that combines wastewater treatment data, agricultural data, spatial nutrient balance modeling, life cycle assessment, stakeholder knowledge, and multi-criteria decision making. Our goals are to: (1) help guide design decisions related to the implementation of sustainable nutrient recovery technology, (2) support innovations in watershed nutrient management that operate at the interface of the built environment and agriculture, and (3) aid efforts to protect aquatic ecosystems while supporting human welfare in a circular nutrient economy. These goals will be realized partly through the assessment of plausible alternative scenarios for the future. In this presentation, we will describe the tool and focus on nutrient balance results for the New England region. These results illustrate that both centralized and decentralized wastewater nutrient recovery schemes have potential to transform nutrient flows in many New England watersheds, diverting wastewater N and P away from aquatic ecosystems and toward local or regional agricultural soils where they can offset a substantial percentage of imported fertilizer. We will also highlight feasibility criteria and next steps to integrate stakeholder knowledge, economics, and life cycle assessment into the tool.

Is Roesleria subterranea a primary pathogen or a minor parasite of grapevines? Risk assessment and a diagnostic decision scheme

PubMed Central

2011-01-01

In the past the root rot pathogen Roesleria subterranea (Ascomycota) was generally considered as a minor parasite, a view with which we were often confronted during field work in German wine-growing regions where this ascomycete recently caused serious problems in established vineyards and at replant sites. To irrevocably demonstrate that R. subterranea is not a minor, but a primary pathogen of grapevines (and fruit trees) a pest risk analysis was carried out according to the guidelines defined by EPPO standard series PM 5, which defines the information needed, and contains standardised, detailed key questions and a decision support scheme for risk analysis. Following the provided decision scheme, it becomes apparent that R. subterranea must be considered as a serious, primary pathogen for grapevines and fruit trees that can cause massive economic losses. Based on the literature, the pathogen seems to be ubiquitous in wine growing regions in cool climates of the northern hemisphere. It is likely that because of its growth below ground, the small fruiting bodies, and ambiguous symptoms above ground, R. subterranea has been overlooked in the past and therefore, has not been considered as primary pathogen for grapevine. Available published information together with experience from field trials was implemented into a diagnostic decision scheme which will, together with the comprehensive literature provided, be the basis (a) to implement quick and efficient diagnosis of this pathogen in the field and (b) to conduct risk analysis and management in areas where R. subterranea has not established yet. PMID:22318129

What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis

PubMed Central

Hossain, S. A. Shahed; Pérez Koehlmoos, Tracey Lynn; John, Denny

2016-01-01

Introduction This research article reports on factors influencing initial voluntary uptake of community-based health insurance (CBHI) schemes in low- and middle-income countries (LMIC), and renewal decisions. Methods Following PRISMA protocol, we conducted a comprehensive search of academic and gray literature, including academic databases in social science, economics and medical sciences (e.g., Econlit, Global health, Medline, Proquest) and other electronic resources (e.g., Eldis and Google scholar). Search strategies were developed using the thesaurus or index terms (e.g., MeSH) specific to the databases, combined with free text terms related to CBHI or health insurance. Searches were conducted from May 2013 to November 2013 in English, French, German, and Spanish. From the initial search yield of 15,770 hits, 54 relevant studies were retained for analysis of factors influencing enrolment and renewal decisions. The quantitative synthesis (informed by meta-analysis) and the qualitative analysis (informed by thematic synthesis) were compared to gain insight for an overall synthesis of findings/statements. Results Meta-analysis suggests that enrolments in CBHI were positively associated with household income, education and age of the household head (HHH), household size, female-headed household, married HHH and chronic illness episodes in the household. The thematic synthesis suggests the following factors as enablers for enrolment: (a) knowledge and understanding of insurance and CBHI, (b) quality of healthcare, (c) trust in scheme management. Factors found to be barriers to enrolment include: (a) inappropriate benefits package, (b) cultural beliefs, (c) affordability, (d) distance to healthcare facility, (e) lack of adequate legal and policy frameworks to support CBHI, and (f) stringent rules of some CBHI schemes. HHH education, household size and trust in the scheme management were positively associated with member renewal decisions. Other motivators were: (a) knowledge and understanding of insurance and CBHI, (b) healthcare quality, (c) trust in scheme management, and (d) receipt of an insurance payout the previous year. The barriers to renewal decisions were: (a) stringent rules of some CBHI schemes, (b) inadequate legal and policy frameworks to support CBHI and (c) inappropriate benefits package. Conclusion and Policy Implications The demand-side factors positively affecting enrolment in CBHI include education, age, female household heads, and the socioeconomic status of households. Moreover, when individuals understand how their CBHI functions they are more likely to enroll and when people have a positive claims experience, they are more likely to renew. A higher prevalence of chronic conditions or the perception that healthcare is of good quality and nearby act as factors enhancing enrolment. The perception that services are distant or deficient leads to lower enrolments. The second insight is that trust in the scheme enables enrolment. Thirdly, clarity about the legal or policy framework acts as a factor influencing enrolments. This is significant, as it points to hitherto unpublished evidence that governments can effectively broaden their outreach to grassroots groups that are excluded from social protection by formulating supportive regulatory and policy provisions even if they cannot fund such schemes in full, by leveraging people’s willingness to exercise voluntary and contributory enrolment in a community-based health insurance. PMID:27579731

Deep learning aided decision support for pulmonary nodules diagnosing: a review.

PubMed

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

2018-04-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

On the security of two remote user authentication schemes for telecare medical information systems.

PubMed

Kim, Kee-Won; Lee, Jae-Dong

2014-05-01

The telecare medical information systems (TMISs) support convenient and rapid health-care services. A secure and efficient authentication scheme for TMIS provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Kumari et al. proposed a password based user authentication scheme using smart cards for TMIS, and claimed that the proposed scheme could resist various malicious attacks. However, we point out that their scheme is still vulnerable to lost smart card and cannot provide forward secrecy. Subsequently, Das and Goswami proposed a secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. They simulated their scheme for the formal security verification using the widely-accepted automated validation of Internet security protocols and applications (AVISPA) tool to ensure that their scheme is secure against passive and active attacks. However, we show that their scheme is still vulnerable to smart card loss attacks and cannot provide forward secrecy property. The proposed cryptanalysis discourages any use of the two schemes under investigation in practice and reveals some subtleties and challenges in designing this type of schemes.

Rural health prepayment schemes in China: towards a more active role for government.

PubMed

Bloom, G; Shenglan, T

1999-04-01

A large majority of China's rural population were members of health prepayment schemes in the 1970's. Most of these schemes collapsed during the transition to a market economy. Some localities subsequently reestablished schemes. In early 1997 a new government policy identified health prepayment as a major potential source of rural health finance. This paper draws on the experience of existing schemes to explore how government can support implementation of this policy. The decision to support the establishment of health prepayment schemes is part of the government's effort to establish new sources of finance for social services. It believes that individuals are more likely to accept voluntary contributions to a prepayment scheme than tax increases. The voluntary nature of the contributions limits the possibilities for risk-sharing and redistribution between rich and poor. This underlines the need for the government to fund a substantial share of health expenditure out of general revenues, particularly in poor localities. The paper notes that many successful prepayment schemes depend on close supervision by local political leaders. It argues that the national programme will have to translate these measures into a regulatory system which defines the responsibilities of scheme management bodies and local governments. A number of prepayment schemes have collapsed because members did not feel they got value for money. Local health bureaux will have to cooperate with prepayment schemes to ensure that health facilities provide good quality services at a reasonable cost. Users' representatives can also monitor performance. The paper concludes that government needs to clarify the relationship between health prepayment schemes and other actors in rural localities in order to increase the chance that schemes will become a major source rural health finance.

Social capital and active membership in the Ghana National Health Insurance Scheme - a mixed method study.

PubMed

Fenenga, Christine J; Nketiah-Amponsah, Edward; Ogink, Alice; Arhinful, Daniel K; Poortinga, Wouter; Hutter, Inge

2015-11-02

People's decision to enroll in a health insurance scheme is determined by socio-cultural and socio-economic factors. On request of the National health Insurance Authority (NHIA) in Ghana, our study explores the influence of social relationships on people's perceptions, behavior and decision making to enroll in the National Health Insurance Scheme. This social scheme, initiated in 2003, aims to realize accessible quality healthcare services for the entire population of Ghana. We look at relationships of trust and reciprocity between individuals in the communities (so called horizontal social capital) and between individuals and formal health institutions (called vertical social capital) in order to determine whether these two forms of social capital inhibit or facilitate enrolment of clients in the scheme. Results can support the NHIA in exploiting social capital to reach their objective and strengthen their policy and practice. We conducted 20 individual- and seven key-informant interviews, 22 focus group discussions, two stakeholder meetings and a household survey, using a random sample of 1903 households from the catchment area of 64 primary healthcare facilities. The study took place in Greater Accra Region and Western Regions in Ghana between June 2011 and March 2012. While social developments and increased heterogeneity seem to reduce community solidarity in Ghana, social networks remain common in Ghana and are valued for their multiple benefits (i.e. reciprocal trust and support, information sharing, motivation, risk sharing). Trusting relations with healthcare and insurance providers are, according healthcare clients, based on providers' clear communication, attitude, devotion, encouragement and reliability of services. Active membership of the NHIS is positive associated with community trust, trust in healthcare providers and trust in the NHIS (p-values are .009, .000 and .000 respectively). Social capital can motivate clients to enroll in health insurance. Fostering social capital through improving information provision to communities and engaging community groups in health care and NHIS services can facilitate peoples' trust in these institutions and their active participation in the scheme.

A proposal for a computer-based framework of support for public health in the management of biological incidents: the Czech Republic experience.

PubMed

Bures, Vladimír; Otcenásková, Tereza; Cech, Pavel; Antos, Karel

2012-11-01

Biological incidents jeopardising public health require decision-making that consists of one dominant feature: complexity. Therefore, public health decision-makers necessitate appropriate support. Based on the analogy with business intelligence (BI) principles, the contextual analysis of the environment and available data resources, and conceptual modelling within systems and knowledge engineering, this paper proposes a general framework for computer-based decision support in the case of a biological incident. At the outset, the analysis of potential inputs to the framework is conducted and several resources such as demographic information, strategic documents, environmental characteristics, agent descriptors and surveillance systems are considered. Consequently, three prototypes were developed, tested and evaluated by a group of experts. Their selection was based on the overall framework scheme. Subsequently, an ontology prototype linked with an inference engine, multi-agent-based model focusing on the simulation of an environment, and expert-system prototypes were created. All prototypes proved to be utilisable support tools for decision-making in the field of public health. Nevertheless, the research revealed further issues and challenges that might be investigated by both public health focused researchers and practitioners.

Deep learning aided decision support for pulmonary nodules diagnosing: a review

PubMed Central

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping

2018-01-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing. PMID:29780633

Comparing the diversity of information by word-of-mouth vs. web spread

NASA Astrophysics Data System (ADS)

Sela, Alon; Shekhtman, Louis; Havlin, Shlomo; Ben-Gal, Irad

2016-06-01

Many studies have explored spreading and diffusion through complex networks. The following study examines a specific case of spreading of opinions in modern society through two spreading schemes —defined as being either through “word of mouth” (WOM), or through online search engines (WEB). We apply both modelling and real experimental results and compare the opinions people adopt through an exposure to their friend's opinions, as opposed to the opinions they adopt when using a search engine based on the PageRank algorithm. A simulated study shows that when members in a population adopt decisions through the use of the WEB scheme, the population ends up with a few dominant views, while other views are barely expressed. In contrast, when members adopt decisions based on the WOM scheme, there is a far more diverse distribution of opinions in that population. The simulative results are further supported by an online experiment which finds that people searching information through a search engine end up with far more homogenous opinions as compared to those asking their friends.

Lessons from community-based payment for ecosystem service schemes: from forests to rangelands.

PubMed

Dougill, Andrew J; Stringer, Lindsay C; Leventon, Julia; Riddell, Mike; Rueff, Henri; Spracklen, Dominick V; Butt, Edward

2012-11-19

Climate finance investments and international policy are driving new community-based projects incorporating payments for ecosystem services (PES) to simultaneously store carbon and generate livelihood benefits. Most community-based PES (CB-PES) research focuses on forest areas. Rangelands, which store globally significant quantities of carbon and support many of the world's poor, have seen little CB-PES research attention, despite benefitting from several decades of community-based natural resource management (CBNRM) projects. Lessons from CBNRM suggest institutional considerations are vital in underpinning the design and implementation of successful community projects. This study uses documentary analysis to explore the institutional characteristics of three African community-based forest projects that seek to deliver carbon-storage and poverty-reduction benefits. Strong existing local institutions, clear land tenure, community control over land management decision-making and up-front, flexible payment schemes are found to be vital. Additionally, we undertake a global review of rangeland CBNRM literature and identify that alongside the lessons learned from forest projects, rangeland CB-PES project design requires specific consideration of project boundaries, benefit distribution, capacity building for community monitoring of carbon storage together with awareness-raising using decision-support tools to display the benefits of carbon-friendly land management. We highlight that institutional analyses must be undertaken alongside improved scientific studies of the carbon cycle to enable links to payment schemes, and for them to contribute to poverty alleviation in rangelands.

Lessons from community-based payment for ecosystem service schemes: from forests to rangelands

PubMed Central

Dougill, Andrew J.; Stringer, Lindsay C.; Leventon, Julia; Riddell, Mike; Rueff, Henri; Spracklen, Dominick V.; Butt, Edward

2012-01-01

Climate finance investments and international policy are driving new community-based projects incorporating payments for ecosystem services (PES) to simultaneously store carbon and generate livelihood benefits. Most community-based PES (CB-PES) research focuses on forest areas. Rangelands, which store globally significant quantities of carbon and support many of the world's poor, have seen little CB-PES research attention, despite benefitting from several decades of community-based natural resource management (CBNRM) projects. Lessons from CBNRM suggest institutional considerations are vital in underpinning the design and implementation of successful community projects. This study uses documentary analysis to explore the institutional characteristics of three African community-based forest projects that seek to deliver carbon-storage and poverty-reduction benefits. Strong existing local institutions, clear land tenure, community control over land management decision-making and up-front, flexible payment schemes are found to be vital. Additionally, we undertake a global review of rangeland CBNRM literature and identify that alongside the lessons learned from forest projects, rangeland CB-PES project design requires specific consideration of project boundaries, benefit distribution, capacity building for community monitoring of carbon storage together with awareness-raising using decision-support tools to display the benefits of carbon-friendly land management. We highlight that institutional analyses must be undertaken alongside improved scientific studies of the carbon cycle to enable links to payment schemes, and for them to contribute to poverty alleviation in rangelands. PMID:23045714

Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

PubMed

Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

1999-08-01

Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

Privacy-Preserving Patient-Centric Clinical Decision Support System on Naïve Bayesian Classification.

PubMed

Liu, Ximeng; Lu, Rongxing; Ma, Jianfeng; Chen, Le; Qin, Baodong

2016-03-01

Clinical decision support system, which uses advanced data mining techniques to help clinician make proper decisions, has received considerable attention recently. The advantages of clinical decision support system include not only improving diagnosis accuracy but also reducing diagnosis time. Specifically, with large amounts of clinical data generated everyday, naïve Bayesian classification can be utilized to excavate valuable information to improve a clinical decision support system. Although the clinical decision support system is quite promising, the flourish of the system still faces many challenges including information security and privacy concerns. In this paper, we propose a new privacy-preserving patient-centric clinical decision support system, which helps clinician complementary to diagnose the risk of patients' disease in a privacy-preserving way. In the proposed system, the past patients' historical data are stored in cloud and can be used to train the naïve Bayesian classifier without leaking any individual patient medical data, and then the trained classifier can be applied to compute the disease risk for new coming patients and also allow these patients to retrieve the top- k disease names according to their own preferences. Specifically, to protect the privacy of past patients' historical data, a new cryptographic tool called additive homomorphic proxy aggregation scheme is designed. Moreover, to leverage the leakage of naïve Bayesian classifier, we introduce a privacy-preserving top- k disease names retrieval protocol in our system. Detailed privacy analysis ensures that patient's information is private and will not be leaked out during the disease diagnosis phase. In addition, performance evaluation via extensive simulations also demonstrates that our system can efficiently calculate patient's disease risk with high accuracy in a privacy-preserving way.

Assessment strategies for municipal selective waste collection schemes.

PubMed

Ferreira, Fátima; Avelino, Catarina; Bentes, Isabel; Matos, Cristina; Teixeira, Carlos Afonso

2017-01-01

An important strategy to promote a strong sustainable growth relies on an efficient municipal waste management, and phasing out waste landfilling through waste prevention and recycling emerges as a major target. For this purpose, effective collection schemes are required, in particular those regarding selective waste collection, pursuing a more efficient and high quality recycling of reusable materials. This paper addresses the assessment and benchmarking of selective collection schemes, relevant to guide future operational improvements. In particular, the assessment is based on the monitoring and statistical analysis of a core-set of performance indicators that highlights collection trends, complemented with a performance index that gathers a weighted linear combination of these indicators. This combined analysis underlines a potential tool to support decision makers involved in the process of selecting the collection scheme with best overall performance. The presented approach was applied to a case study conducted in Oporto Municipality, with data gathered from two distinct selective collection schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

TIUPAM: A Framework for Trustworthiness-Centric Information Sharing

NASA Astrophysics Data System (ADS)

Xu, Shouhuai; Sandhu, Ravi; Bertino, Elisa

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

Assessing patient-centered communication in a family practice setting: how do we measure it, and whose opinion matters?

PubMed

Clayton, Margaret F; Latimer, Seth; Dunn, Todd W; Haas, Leonard

2011-09-01

This study evaluated variables thought to influence patient's perceptions of patient-centeredness. We also compared results from two coding schemes that purport to evaluate patient-centeredness, the Measure of Patient-Centered Communication (MPCC) and the 4 Habits Coding Scheme (4HCS). 174 videotaped family practice office visits, and patient self-report measures were analyzed. Patient factors contributing to positive perceptions of patient-centeredness were successful negotiation of decision-making roles and lower post-visit uncertainty. MPCC coding found visits were on average 59% patient-centered (range 12-85%). 4HCS coding showed an average of 83 points (maximum possible 115). However, patients felt their visits were highly patient-centered (mean 3.7, range 1.9-4; maximum possible 4). There was a weak correlation between coding schemes, but no association between coding results and patient variables (number of pre-visit concerns, attainment of desired decision-making role, post-visit uncertainty, patients' perception of patient-centeredness). Coder inter-rater reliability was lower than expected; convergent and divergent validity were not supported. The 4HCS and MPCC operationalize patient-centeredness differently, illustrating a lack of conceptual clarity. The patient's perspective is important. Family practice providers can facilitate a more positive patient perception of patient-centeredness by addressing patient concerns to help reduce patient uncertainty, and by negotiating decision-making roles. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Relating practitioner needs to research activities

NASA Technical Reports Server (NTRS)

Feather, M. S.; Menzies, T.; Connelly, J. R.

2003-01-01

We present an approach to matching needs (practioner requirements) to solutions (researcher activities). A taxonomical classification scheme acts as intermediary between needs and activities. Expert practitioners exprss their needs in terms of this taxonomy. Researchers express their activities in the same terms. A decision support tool is used to assist in the combination and study of their expressions of needs and activities.

The GIS map coloring support decision-making system based on case-based reasoning and simulated annealing algorithm

NASA Astrophysics Data System (ADS)

Deng, Shuang; Xiang, Wenting; Tian, Yangge

2009-10-01

Map coloring is a hard task even to the experienced map experts. In the GIS project, usually need to color map according to the customer, which make the work more complex. With the development of GIS, more and more programmers join the project team, which lack the training of cartology, their coloring map are harder to meet the requirements of customer. From the experience, customers with similar background usually have similar tastes for coloring map. So, we developed a GIS color scheme decision-making system which can select color schemes of similar customers from case base for customers to select and adjust. The system is a BS/CS mixed system, the client side use JSP and make it possible for the system developers to go on remote calling of the colors scheme cases in the database server and communicate with customers. Different with general case-based reasoning, even the customers are very similar, their selection may have difference, it is hard to provide a "best" option. So, we select the Simulated Annealing Algorithm (SAA) to arrange the emergence order of different color schemes. Customers can also dynamically adjust certain features colors based on existing case. The result shows that the system can facilitate the communication between the designers and the customers and improve the quality and efficiency of coloring map.

The design and implementation of urban earthquake disaster loss evaluation and emergency response decision support systems based on GIS

NASA Astrophysics Data System (ADS)

Yang, Kun; Xu, Quan-li; Peng, Shuang-yun; Cao, Yan-bo

2008-10-01

Based on the necessity analysis of GIS applications in earthquake disaster prevention, this paper has deeply discussed the spatial integration scheme of urban earthquake disaster loss evaluation models and visualization technologies by using the network development methods such as COM/DCOM, ActiveX and ASP, as well as the spatial database development methods such as OO4O and ArcSDE based on ArcGIS software packages. Meanwhile, according to Software Engineering principles, a solution of Urban Earthquake Emergency Response Decision Support Systems based on GIS technologies have also been proposed, which include the systems logical structures, the technical routes,the system realization methods and function structures etc. Finally, the testing systems user interfaces have also been offered in the paper.

Advanced control design for hybrid turboelectric vehicle

NASA Technical Reports Server (NTRS)

Abban, Joseph; Norvell, Johnesta; Momoh, James A.

1995-01-01

The new environment standards are a challenge and opportunity for industry and government who manufacture and operate urban mass transient vehicles. A research investigation to provide control scheme for efficient power management of the vehicle is in progress. Different design requirements using functional analysis and trade studies of alternate power sources and controls have been performed. The design issues include portability, weight and emission/fuel efficiency of induction motor, permanent magnet and battery. A strategic design scheme to manage power requirements using advanced control systems is presented. It exploits fuzzy logic, technology and rule based decision support scheme. The benefits of our study will enhance the economic and technical feasibility of technological needs to provide low emission/fuel efficient urban mass transit bus. The design team includes undergraduate researchers in our department. Sample results using NASA HTEV simulation tool are presented.

Economic considerations and decision support tool for wastewater reuse scheme planning.

PubMed

Hochstrat, R; Joksimovic, D; Wintgens, T; Melin, T; Savic, D

2007-01-01

The reuse of upgraded wastewater for beneficial uses is increasingly adopted and accepted as a tool in water management. However, funding of schemes is still a critical issue. The focus of this paper is on economic considerations of water reuse planning. A survey of pricing mechanisms for reclaimed water revealed that most schemes are subsidised to a great extent. In order to minimise these state contributions to the implementation and operation of reuse projects, their planning should identify a least cost design option. This also has to take into account the established pricing structure for conventional water resources and the possibility of gaining revenues from reclaimed water pricing. The paper presents a case study which takes into account these aspects. It evaluates different scheme designs with regard to their Net Present Value (NPV). It could be demonstrated that for the same charging level, quite different amounts of reclaimed water can be delivered while still producing an overall positive NPV. Moreover, the economic feasibility and competitiveness of a reuse scheme is highly determined by the cost structure of the conventional water market.

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

PubMed

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

2007-08-25

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

Uncertainty analysis for effluent trading planning using a Bayesian estimation-based simulation-optimization modeling approach.

PubMed

Zhang, J L; Li, Y P; Huang, G H; Baetz, B W; Liu, J

2017-06-01

In this study, a Bayesian estimation-based simulation-optimization modeling approach (BESMA) is developed for identifying effluent trading strategies. BESMA incorporates nutrient fate modeling with soil and water assessment tool (SWAT), Bayesian estimation, and probabilistic-possibilistic interval programming with fuzzy random coefficients (PPI-FRC) within a general framework. Based on the water quality protocols provided by SWAT, posterior distributions of parameters can be analyzed through Bayesian estimation; stochastic characteristic of nutrient loading can be investigated which provides the inputs for the decision making. PPI-FRC can address multiple uncertainties in the form of intervals with fuzzy random boundaries and the associated system risk through incorporating the concept of possibility and necessity measures. The possibility and necessity measures are suitable for optimistic and pessimistic decision making, respectively. BESMA is applied to a real case of effluent trading planning in the Xiangxihe watershed, China. A number of decision alternatives can be obtained under different trading ratios and treatment rates. The results can not only facilitate identification of optimal effluent-trading schemes, but also gain insight into the effects of trading ratio and treatment rate on decision making. The results also reveal that decision maker's preference towards risk would affect decision alternatives on trading scheme as well as system benefit. Compared with the conventional optimization methods, it is proved that BESMA is advantageous in (i) dealing with multiple uncertainties associated with randomness and fuzziness in effluent-trading planning within a multi-source, multi-reach and multi-period context; (ii) reflecting uncertainties existing in nutrient transport behaviors to improve the accuracy in water quality prediction; and (iii) supporting pessimistic and optimistic decision making for effluent trading as well as promoting diversity of decision alternatives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Balancing ecosystem services with energy and food security - assessing trade-offs for reservoir operation and irrigation investment in Kenya's Tana basin

NASA Astrophysics Data System (ADS)

Hurford, A. P.; Harou, J. J.

2014-01-01

Competition for water between key economic sectors and the environment means agreeing on allocation is challenging. Managing releases from the three major dams in Kenya's Tana River basin with its 4.4 million inhabitants, 567 MW of installed hydropower capacity, 33 000 ha of irrigation and ecologically important wetlands and forests is a pertinent example. This research seeks to identify and help decision-makers visualise reservoir management strategies which result in the best possible (Pareto-optimal) allocation of benefits between sectors. Secondly we seek to show how trade-offs between achievable benefits shift with the implementation of new proposed rice, cotton and biofuel irrigation projects. To identify the Pareto-optimal trade-offs we link a water resources management model to a multi-criteria search algorithm. The decisions or "levers" of the management problem are volume dependent release rules for the three major dams and extent of investment in new irrigation schemes. These decisions are optimised for objectives covering provision of water supply and irrigation, energy generation and maintenance of ecosystem services which underpin tourism and local livelihoods. Visual analytic plots allow decision makers to assess multi-reservoir rule-sets by understanding their impacts on different beneficiaries. Results quantify how economic gains from proposed irrigation schemes trade-off against disturbance of the flow regime which supports ecosystem services. Full implementation of the proposed schemes is shown to be Pareto-optimal, but at high environmental and social cost. The clarity and comprehensiveness of "best-case" trade-off analysis is a useful vantage point from which to tackle the interdependence and complexity of water-energy-food "nexus" challenges.

On Developing a Taxonomy for Multidisciplinary Design Optimization: A Decision-Based Perspective

NASA Technical Reports Server (NTRS)

Lewis, Kemper; Mistree, Farrokh

1995-01-01

In this paper, we approach MDO from a Decision-Based Design (DBD) perspective and explore classification schemes for designing complex systems and processes. Specifically, we focus on decisions, which are only a small portion of the Decision Support Problem (DSP) Technique, our implementation of DBD. We map coupled nonhierarchical and hierarchical representations from the DSP Technique into the Balling-Sobieski (B-S) framework (Balling and Sobieszczanski-Sobieski, 1994), and integrate domain-independent linguistic terms to complete our taxonomy. Application of DSPs to the design of complex, multidisciplinary systems include passenger aircraft, ships, damage tolerant structural and mechanical systems, and thermal energy systems. In this paper we show that Balling-Sobieski framework is consistent with that of the Decision Support Problem Technique through the use of linguistic entities to describe the same type of formulations. We show that the underlying linguistics of the solution approaches are the same and can be coalesced into a homogeneous framework with which to base the research, application, and technology MDO upon. We introduce, in the Balling-Sobieski framework, examples of multidisciplinary design, namely, aircraft, damage tolerant structural and mechanical systems, and thermal energy systems.

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

PubMed

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

2018-04-13

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

Proof of concept for a banding scheme to support risk assessments related to multi-product biologics manufacturing.

PubMed

Card, Jeffrey W; Fikree, Hana; Haighton, Lois A; Blackwell, James; Felice, Brian; Wright, Teresa L

2015-11-01

A banding scheme theory has been proposed to assess the potency/toxicity of biologics and assist with decisions regarding the introduction of new biologic products into existing manufacturing facilities. The current work was conducted to provide a practical example of how this scheme could be applied. Information was identified for representatives from the following four proposed bands: Band A (lethal toxins); Band B (toxins and apoptosis signals); Band C (cytokines and growth factors); and Band D (antibodies, antibody fragments, scaffold molecules, and insulins). The potency/toxicity of the representative substances was confirmed as follows: Band A, low nanogram quantities exert lethal effects; Band B, repeated administration of microgram quantities is tolerated in humans; Band C, endogenous substances and recombinant versions administered to patients in low (interferons), intermediate (growth factors), and high (interleukins) microgram doses, often on a chronic basis; and Band D, endogenous substances present or produced in the body in milligram quantities per day (insulin, collagen) or protein therapeutics administered in milligram quantities per dose (mAbs). This work confirms that substances in Bands A, B, C, and D represent very high, high, medium, and low concern with regard to risk of cross-contamination in manufacturing facilities, thus supporting the proposed banding scheme. Copyright © 2015 Elsevier Inc. All rights reserved.

Framing of Uncertainty in Scientific Publications: Towards Recommendations for Decision Support

NASA Astrophysics Data System (ADS)

Guillaume, J. H. A.; Helgeson, C.; Elsawah, S.; Jakeman, A. J.; Kummu, M.

2016-12-01

Uncertainty is recognised as an essential issue in environmental decision making and decision support. As modellers, we notably use a variety of tools and techniques within an analysis, for example related to uncertainty quantification and model validation. We also address uncertainty by how we present results. For example, experienced modellers are careful to distinguish robust conclusions from those that need further work, and the precision of quantitative results is tailored to their accuracy. In doing so, the modeller frames how uncertainty should be interpreted by their audience. This is an area which extends beyond modelling to fields such as philosophy of science, semantics, discourse analysis, intercultural communication and rhetoric. We propose that framing of uncertainty deserves greater attention in the context of decision support, and that there are opportunities in this area for fundamental research, synthesis and knowledge transfer, development of teaching curricula, and significant advances in managing uncertainty in decision making. This presentation reports preliminary results of a study of framing practices. Specifically, we analyse the framing of uncertainty that is visible in the abstracts from a corpus of scientific articles. We do this through textual analysis of the content and structure of those abstracts. Each finding that appears in an abstract is classified according to the uncertainty framing approach used, using a classification scheme that was iteratively revised based on reflection and comparison amongst three coders. This analysis indicates how frequently the different framing approaches are used, and provides initial insights into relationships between frames, how the frames relate to interpretation of uncertainty, and how rhetorical devices are used by modellers to communicate uncertainty in their work. We propose initial hypotheses for how the resulting insights might influence decision support, and help advance decision making to better address uncertainty.

Decision-aided ICI mitigation with time-domain average approximation in CO-OFDM

NASA Astrophysics Data System (ADS)

Ren, Hongliang; Cai, Jiaxing; Ye, Xin; Lu, Jin; Cao, Quanjun; Guo, Shuqin; Xue, Lin-lin; Qin, Yali; Hu, Weisheng

2015-07-01

We introduce and investigate the feasibility of a novel iterative blind phase noise inter-carrier interference (ICI) mitigation scheme for coherent optical orthogonal frequency division multiplexing (CO-OFDM) systems. The ICI mitigation scheme is performed through the combination of frequency-domain symbol decision-aided estimation and the ICI phase noise time-average approximation. An additional initial decision process with suitable threshold is introduced in order to suppress the decision error symbols. Our proposed ICI mitigation scheme is proved to be effective in removing the ICI for a simulated CO-OFDM with 16-QAM modulation format. With the slightly high computational complexity, it outperforms the time-domain average blind ICI (Avg-BL-ICI) algorithm at a relatively wide laser line-width and high OSNR.

The impact of patient participation direct enhanced service on patient reference groups in primary care: a qualitative study.

PubMed

Pollard, Lorraine; Agarwal, Shona; Harrad, Fawn; Lester, Louise; Cross, Ainsley; Wray, Paula; Smith, Gordon; Locke, Anthony; Sinfield, Paul

2014-01-01

NHS policy documents continue to make a wide-ranging commitment to patient involvement. The Patient Participation Direct Enhanced Service (PP-DES), launched in 2011, aimed to ensure patients are involved in decisions about the range and quality of services provided and commissioned by their practice through patient reference groups (PRGs). The aim of this exploratory study is to review the impact of the PP-DES (2011-13) on a sample of PRGs and assess how far it has facilitated their involvement in decisions about the services of their general practices. A qualitative methods design, using semi- structured interviews and focus groups, was employed to explore the experiences and views of GP practice staff (n = 24), PRG members (n = 80) at 12 GP practices, and other stakeholders (n = 4). Wide variation in the role and remit of the participating PRGs was found, which broadly ranged from activities to improve practice resources to supporting health promotion activities. The majority of PRG members were unfamiliar with the PP-DES scheme and its aims and purpose. Stakeholders and practice staff felt strongly that the main success of the PP-DES was that it had led to an increase in the number of PRGs being established in the locality. The PP-DES scheme has been a catalyst to establish PRGs. However, the picture was mixed in terms of the PRGs involvement in decisions about the services provided at their general practice as there was wide variation in the PRGs role and remit. The financial incentive alone, provided via the DES scheme, did not secure greater depth of PRG activity and power, however, as social factors were identified as playing an important role in PRGs' level of participation in decision making. Many PRGs have to become more firmly established before they are involved as partners in commissioning decisions at their practice.

GIS-based integrated assessment and decision support system for land use planning in consideration of carbon sequestration benefits

NASA Astrophysics Data System (ADS)

Wang, Jun; Chen, J. M.; Li, Manchun; Ju, Weimin

2007-06-01

As the major eligible land use activities in the Clean Development Mechanism (CDM), afforestation and reforestation offer opportunities and potential economic benefits for developing countries to participate in carbon-trade in the potential international carbon (C) sink markets. However, the design and selection of appropriate afforestation and reforestation locations in CDM are complex processes which need integrated assessment (IA) of C sequestration (CS) potential, environmental effects, and socio-economic impacts. This paper promotes the consideration of CS benefits in local land use planning and presents a GIS-based integrated assessment and spatial decision support system (IA-SDSS) to support decision-making on 'where' and 'how' to afforest. It integrates an Integrated Terrestrial Ecosystem Carbon Model (InTEC) and a GIS platform for modeling regional long-term CS potential and assessment of geo-referenced land use criteria including CS consequence, and produces ranking of plantation schemes with different tree species using the Analytic hierarchy process (AHP) method. Three land use scenarios are investigated: (i) traditional land use planning criteria without C benefits, (ii) land use for CS with low C price, and (iii) land use for CS with high price. Different scenarios and consequences will influence the weights of tree-species selection in the AHP decision process.

Costs and economic consequences of a help-at-home scheme for older people in England.

PubMed

Bauer, Annette; Knapp, Martin; Wistow, Gerald; Perkins, Margaret; King, Derek; Iemmi, Valentina

2017-03-01

Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of well-being needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals' well-being and the economic consequences for local and central government can contribute to decisions about sustainable long-term care financing. This article presents results from a mixed-methods study of a voluntary sector-provided help-at-home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care-related quality of life was measured with the Adult Social Care Outcomes Toolkit for 24 service users (59% response rate) when they started using the scheme and 4-6 months later. A customised questionnaire that captured resource use and well-being information was sent to 1064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1568 per person from a local government and National Health Service (NHS) perspective and £3766 from the perspective of the individual. An expenditure of £2851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector-run help-at-home schemes to an affordable welfare system for ageing societies. © 2016 John Wiley & Sons Ltd.

Improving the Slum Planning Through Geospatial Decision Support System

NASA Astrophysics Data System (ADS)

Shekhar, S.

2014-11-01

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

Multi-criteria decision-making on assessment of proposed tidal barrage schemes in terms of environmental impacts.

PubMed

Wu, Yunna; Xu, Chuanbo; Ke, Yiming; Chen, Kaifeng; Xu, Hu

2017-12-15

For tidal range power plants to be sustainable, the environmental impacts caused by the implement of various tidal barrage schemes must be assessed before construction. However, several problems exist in the current researches: firstly, evaluation criteria of the tidal barrage schemes environmental impact assessment (EIA) are not adequate; secondly, uncertainty of criteria information fails to be processed properly; thirdly, correlation among criteria is unreasonably measured. Hence the contributions of this paper are as follows: firstly, an evaluation criteria system is established from three dimensions of hydrodynamic, biological and morphological aspects. Secondly, cloud model is applied to describe the uncertainty of criteria information. Thirdly, Choquet integral with respect to λ-fuzzy measure is introduced to measure the correlation among criteria. On the above bases, a multi-criteria decision-making decision framework for tidal barrage scheme EIA is established to select the optimal scheme. Finally, a case study demonstrates the effectiveness of the proposed framework. Copyright © 2017 Elsevier Ltd. All rights reserved.

From information to participation and self-organization: Visions for European river basin management.

PubMed

Euler, Johannes; Heldt, Sonja

2018-04-15

The European Union Water Framework Directive (EU WFD, 2000) calls for active inclusion of the public in the governance of waterbodies to enhance the effectiveness and legitimacy of water management schemes across the EU. As complex socio-ecological systems, river basins in western Europe could benefit from further support for inclusive management schemes. This paper makes use of case studies from Germany, England and Spain to explore the potential opportunities and challenges of different participatory management approaches. Grounded in theoretical considerations around participation within ecological management schemes, including Arnstein's Ladder of Participation and commons theories, this work provides an evaluation of each case study based on key indicators, such as inclusivity, representativeness, self-organization, decision-making power, spatial fit and temporal continuity. As investors and the public develop a heightened awareness for long-term sustainability of industrial projects, this analysis supports the suggestion that increased participatory river basin management is both desirable and economically feasible, and should thus be considered a viable option for future projects aiming to move beyond current requirements of the European Union Water Framework Directive. Copyright © 2017. Published by Elsevier B.V.

Implementation of Open-Source Web Mapping Technologies to Support Monitoring of Governmental Schemes

NASA Astrophysics Data System (ADS)

Pulsani, B. R.

2015-10-01

Several schemes are undertaken by the government to uplift social and economic condition of people. The monitoring of these schemes is done through information technology where involvement of Geographic Information System (GIS) is lacking. To demonstrate the benefits of thematic mapping as a tool for assisting the officials in making decisions, a web mapping application for three government programs such as Mother and Child Tracking system (MCTS), Telangana State Housing Corporation Limited (TSHCL) and Ground Water Quality Mapping (GWQM) has been built. Indeed the three applications depicted the distribution of various parameters thematically and helped in identifying the areas with higher and weaker distributions. Based on the three applications, the study tends to find similarities of many government schemes reflecting the nature of thematic mapping and hence deduces to implement this kind of approach for other schemes as well. These applications have been developed using SharpMap Csharp library which is a free and open source mapping library for developing geospatial applications. The study highlights upon the cost benefits of SharpMap and brings out the advantage of this library over proprietary vendors and further discusses its advantages over other open source libraries as well.

Valuing investments in sustainable land management using an integrated modelling framework to support a watershed conservation scheme in the Upper Tana River, Kenya

NASA Astrophysics Data System (ADS)

Hunink, Johannes E.; Bryant, Benjamin P.; Vogl, Adrian; Droogers, Peter

2015-04-01

We analyse the multiple impacts of investments in sustainable land use practices on ecosystem services in the Upper Tana basin (Kenya) to support a watershed conservation scheme (a "water fund"). We apply an integrated modelling framework, building on previous field-based and modelling studies in the basin, and link biophysical outputs to economic benefits for the main actors in the basin. The first step in the modelling workflow is the use of a high-resolution spatial prioritization tool (Resource Investment Optimization System -- RIOS) to allocate the type and location of conservation investments in the different subbasins, subject to budget constraints and stakeholder concerns. We then run the Soil and Water Assessment Tool (SWAT) using the RIOS-identified investment scenarios to produce spatially explicit scenarios that simulate changes in water yield and suspended sediment. Finally, in close collaboration with downstream water users (urban water supply and hydropower) we link those biophysical outputs to monetary metrics, including: reduced water treatment costs, increased hydropower production, and crop yield benefits for upstream farmers in the conservation area. We explore how different budgets and different spatial targeting scenarios influence the return of the investments and the effectiveness of the water fund scheme. This study is novel in that it presents an integrated analysis targeting interventions in a decision context that takes into account local environmental and socio-economic conditions, and then relies on detailed, process-based, biophysical models to demonstrate the economic return on those investments. We conclude that the approach allows for an analysis on different spatial and temporal scales, providing conclusive evidence to stakeholders and decision makers on the contribution and benefits of the land-based investments in this basin. This is serving as foundational work to support the implementation of the Upper Tana-Nairobi Water Fund, a public-private partnership to safeguard ecosystem service provision and food security.

A problem of optimal control and observation for distributed homogeneous multi-agent system

NASA Astrophysics Data System (ADS)

Kruglikov, Sergey V.

2017-12-01

The paper considers the implementation of a algorithm for controlling a distributed complex of several mobile multi-robots. The concept of a unified information space of the controlling system is applied. The presented information and mathematical models of participants and obstacles, as real agents, and goals and scenarios, as virtual agents, create the base forming the algorithmic and software background for computer decision support system. The controlling scheme assumes the indirect management of the robotic team on the basis of optimal control and observation problem predicting intellectual behavior in a dynamic, hostile environment. A basic content problem is a compound cargo transportation by a group of participants in the case of a distributed control scheme in the terrain with multiple obstacles.

A two-stage spectrum sensing scheme based on energy detection and a novel multitaper method

NASA Astrophysics Data System (ADS)

Qi, Pei-Han; Li, Zan; Si, Jiang-Bo; Xiong, Tian-Yi

2015-04-01

Wideband spectrum sensing has drawn much attention in recent years since it provides more opportunities to the secondary users. However, wideband spectrum sensing requires a long time and a complex mechanism at the sensing terminal. A two-stage wideband spectrum sensing scheme is considered to proceed spectrum sensing with low time consumption and high performance to tackle this predicament. In this scheme, a novel multitaper spectrum sensing (MSS) method is proposed to mitigate the poor performance of energy detection (ED) in the low signal-to-noise ratio (SNR) region. The closed-form expression of the decision threshold is derived based on the Neyman-Pearson criterion and the probability of detection in the Rayleigh fading channel is analyzed. An optimization problem is formulated to maximize the probability of detection of the proposed two-stage scheme and the average sensing time of the two-stage scheme is analyzed. Numerical results validate the efficiency of MSS and show that the two-stage spectrum sensing scheme enjoys higher performance in the low SNR region and lower time cost in the high SNR region than the single-stage scheme. Project supported by the National Natural Science Foundation of China (Grant No. 61301179), the China Postdoctoral Science Foundation (Grant No. 2014M550479), and the Doctorial Programs Foundation of the Ministry of Education, China (Grant No. 20110203110011).

Decision support tool for diagnosing the source of variation

NASA Astrophysics Data System (ADS)

Masood, Ibrahim; Azrul Azhad Haizan, Mohamad; Norbaya Jumali, Siti; Ghazali, Farah Najihah Mohd; Razali, Hazlin Syafinaz Md; Shahir Yahya, Mohd; Azlan, Mohd Azwir bin

2017-08-01

Identifying the source of unnatural variation (SOV) in manufacturing process is essential for quality control. The Shewhart control chart patterns (CCPs) are commonly used to monitor the SOV. However, a proper interpretation of CCPs associated to its SOV requires a high skill industrial practitioner. Lack of knowledge in process engineering will lead to erroneous corrective action. The objective of this study is to design the operating procedures of computerized decision support tool (DST) for process diagnosis. The DST is an embedded tool in CCPs recognition scheme. Design methodology involves analysis of relationship between geometrical features, manufacturing process and CCPs. The DST contents information about CCPs and its possible root cause error and description on SOV phenomenon such as process deterioration in tool bluntness, offsetting tool, loading error, and changes in materials hardness. The DST will be useful for an industrial practitioner in making effective troubleshooting.

Refugee Students at College and University: Improving Access and Support

NASA Astrophysics Data System (ADS)

Hannah, Janet

1999-03-01

This article summarizes the findings and recommendations of a study into access to, and experience of, colleges of further education and universities by refugees in Sydney, Australia. The study sought to identify examples of institutional good practice which are potentially transferable to other major host countries for refugees in the developed world. It focuses upon the factors influencing the decision to enter college or university, sources and usefulness of information and advice, access courses and special entry schemes, the recognition of prior learning and overseas qualifications and institutional sensitivity and support. It concludes with a series of recommendations for providers of further and higher education to improve access and support for students from refugee backgrounds.

An Investigation of Employee Involvement Schemes and Governance Structures in Professional Employment.

ERIC Educational Resources Information Center

Douglas, Joel M.

1995-01-01

Employee Involvement Schemes (EIS) are modeled after Western European worker participation models. These are grounded in collaborative labor relations and encourage employees to participate in work place decision-making. If employees, as the term is defined in the National Labor Relations Act, take part in EIS decision-making processes, they may…

An Iterative Information-Reduced Quadriphase-Shift-Keyed Carrier Synchronization Scheme Using Decision Feedback for Low Signal-to-Noise Ratio Applications

NASA Technical Reports Server (NTRS)

Simon, M.; Tkacenko, A.

2006-01-01

In a previous publication [1], an iterative closed-loop carrier synchronization scheme for binary phase-shift keyed (BPSK) modulation was proposed that was based on feeding back data decisions to the input of the loop, the purpose being to remove the modulation prior to carrier synchronization as opposed to the more conventional decision-feedback schemes that incorporate such feedback inside the loop. The idea there was that, with sufficient independence between the received data and the decisions on it that are fed back (as would occur in an error-correction coding environment with sufficient decoding delay), a pure tone in the presence of noise would ultimately be produced (after sufficient iteration and low enough error probability) and thus could be tracked without any squaring loss. This article demonstrates that, with some modification, the same idea of iterative information reduction through decision feedback can be applied to quadrature phase-shift keyed (QPSK) modulation, something that was mentioned in the previous publication but never pursued.

Community oncology in an era of payment reform.

PubMed

Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

Should learners reason one step at a time? A randomised trial of two diagnostic scheme designs.

PubMed

Blissett, Sarah; Morrison, Deric; McCarty, David; Sibbald, Matthew

2017-04-01

Making a diagnosis can be difficult for learners as they must integrate multiple clinical variables. Diagnostic schemes can help learners with this complex task. A diagnostic scheme is an algorithm that organises possible diagnoses by assigning signs or symptoms (e.g. systolic murmur) to groups of similar diagnoses (e.g. aortic stenosis and aortic sclerosis) and provides distinguishing features to help discriminate between similar diagnoses (e.g. carotid pulse). The current literature does not identify whether scheme layouts should guide learners to reason one step at a time in a terminally branching scheme or weigh multiple variables simultaneously in a hybrid scheme. We compared diagnostic accuracy, perceptual errors and cognitive load using two scheme layouts for cardiac auscultation. Focused on the task of identifying murmurs on Harvey, a cardiopulmonary simulator, 86 internal medicine residents used two scheme layouts. The terminally branching scheme organised the information into single variable decisions. The hybrid scheme combined single variable decisions with a chart integrating multiple distinguishing features. Using a crossover design, participants completed one set of murmurs (diastolic or systolic) with either the terminally branching or the hybrid scheme. The second set of murmurs was completed with the other scheme. A repeated measures manova was performed to compare diagnostic accuracy, perceptual errors and cognitive load between the scheme layouts. There was a main effect of the scheme layout (Wilks' λ = 0.841, F 3,80 = 5.1, p = 0.003). Use of a terminally branching scheme was associated with increased diagnostic accuracy (65 versus 53%, p = 0.02), fewer perceptual errors (0.61 versus 0.98 errors, p = 0.001) and lower cognitive load (3.1 versus 3.5/7, p = 0.023). The terminally branching scheme was associated with improved diagnostic accuracy, fewer perceptual errors and lower cognitive load, suggesting that terminally branching schemes are effective for improving diagnostic accuracy. These findings can inform the design of schemes and other clinical decision aids. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

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

Wu, Qishi; Zhu, Mengxia; Rao, Nageswara S

We propose an intelligent decision support system based on sensor and computer networks that incorporates various component techniques for sensor deployment, data routing, distributed computing, and information fusion. The integrated system is deployed in a distributed environment composed of both wireless sensor networks for data collection and wired computer networks for data processing in support of homeland security defense. We present the system framework and formulate the analytical problems and develop approximate or exact solutions for the subtasks: (i) sensor deployment strategy based on a two-dimensional genetic algorithm to achieve maximum coverage with cost constraints; (ii) data routing scheme tomore » achieve maximum signal strength with minimum path loss, high energy efficiency, and effective fault tolerance; (iii) network mapping method to assign computing modules to network nodes for high-performance distributed data processing; and (iv) binary decision fusion rule that derive threshold bounds to improve system hit rate and false alarm rate. These component solutions are implemented and evaluated through either experiments or simulations in various application scenarios. The extensive results demonstrate that these component solutions imbue the integrated system with the desirable and useful quality of intelligence in decision making.« less

Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection.

PubMed

Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

2017-06-12

Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan-Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities.

Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection †

PubMed Central

Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

2017-01-01

Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan–Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities. PMID:28604628

Expert opinion on risks to the long-term viability of residential recycled water schemes: An Australian study.

PubMed

West, Camilla; Kenway, Steven; Hassall, Maureen; Yuan, Zhiguo

2017-09-01

The water sector needs to make efficient and prudent investment decisions by carefully considering the long-term viability of water infrastructure projects. To support the assessment and planning of residential recycled water schemes in Australia, we have sought to clarify scheme objectives and to further define the array of critical risks that can impact the long-term viability of schemes. Building on historical information, we conducted a national survey which elicited responses from 88 Australian expert practitioners, of which 64% have over 10 years of industry experience and 42% have experience with more than five residential recycled water schemes. On the basis of expert opinion, residential recycled water schemes are considered to be highly relevant for diversifying and improving water supply security, reducing wastewater effluent discharge and pollutant load to waterways and contributing to sustainable urban development. At present however, the inability to demonstrate an incontestable business case is posing a significant risk to the long-term viability of residential recycled water schemes. Political, regulatory, organisational and financial factors were also rated as critical risks, in addition to community risk perception and fall in demand. The survey results shed further light on the regulatory environment of residential recycled water schemes, with regulatory participants rating the level and impact of risk factors higher than other survey participants in most cases. The research outcomes provide a comprehensive understanding of the critical risks to the long-term viability of residential recycled water schemes, thereby enabling the specification of targeted risk management measures at the assessment and planning stage of a scheme. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enabling personalized cancer medicine decisions: The challenging pharmacological approach of PBPK models for nanomedicine and pharmacogenomics (Review).

PubMed

Vizirianakis, Ioannis S; Mystridis, George A; Avgoustakis, Konstantinos; Fatouros, Dimitrios G; Spanakis, Marios

2016-04-01

The existing tumor heterogeneity and the complexity of cancer cell biology critically demand powerful translational tools with which to support interdisciplinary efforts aiming to advance personalized cancer medicine decisions in drug development and clinical practice. The development of physiologically based pharmacokinetic (PBPK) models to predict the effects of drugs in the body facilitates the clinical translation of genomic knowledge and the implementation of in vivo pharmacology experience with pharmacogenomics. Such a direction unequivocally empowers our capacity to also make personalized drug dosage scheme decisions for drugs, including molecularly targeted agents and innovative nanoformulations, i.e. in establishing pharmacotyping in prescription. In this way, the applicability of PBPK models to guide individualized cancer therapeutic decisions of broad clinical utility in nanomedicine in real-time and in a cost-affordable manner will be discussed. The latter will be presented by emphasizing the need for combined efforts within the scientific borderlines of genomics with nanotechnology to ensure major benefits and productivity for nanomedicine and personalized medicine interventions.

Emerging Security Mechanisms for Medical Cyber Physical Systems.

PubMed

Kocabas, Ovunc; Soyata, Tolga; Aktas, Mehmet K

2016-01-01

The following decade will witness a surge in remote health-monitoring systems that are based on body-worn monitoring devices. These Medical Cyber Physical Systems (MCPS) will be capable of transmitting the acquired data to a private or public cloud for storage and processing. Machine learning algorithms running in the cloud and processing this data can provide decision support to healthcare professionals. There is no doubt that the security and privacy of the medical data is one of the most important concerns in designing an MCPS. In this paper, we depict the general architecture of an MCPS consisting of four layers: data acquisition, data aggregation, cloud processing, and action. Due to the differences in hardware and communication capabilities of each layer, different encryption schemes must be used to guarantee data privacy within that layer. We survey conventional and emerging encryption schemes based on their ability to provide secure storage, data sharing, and secure computation. Our detailed experimental evaluation of each scheme shows that while the emerging encryption schemes enable exciting new features such as secure sharing and secure computation, they introduce several orders-of-magnitude computational and storage overhead. We conclude our paper by outlining future research directions to improve the usability of the emerging encryption schemes in an MCPS.

One lens optical correlation: application to face recognition.

PubMed

Jridi, Maher; Napoléon, Thibault; Alfalou, Ayman

2018-03-20

Despite its extensive use, the traditional 4f Vander Lugt Correlator optical setup can be further simplified. We propose a lightweight correlation scheme where the decision is taken in the Fourier plane. For this purpose, the Fourier plane is adapted and used as a decision plane. Then, the offline phase and the decision metric are re-examined in order to keep a reasonable recognition rate. The benefits of the proposed approach are numerous: (1) it overcomes the constraints related to the use of a second lens; (2) the optical correlation setup is simplified; (3) the multiplication with the correlation filter can be done digitally, which offers a higher adaptability according to the application. Moreover, the digital counterpart of the correlation scheme is lightened since with the proposed scheme we get rid of the inverse Fourier transform (IFT) calculation (i.e., decision directly in the Fourier domain without resorting to IFT). To assess the performance of the proposed approach, an insight into digital hardware resources saving is provided. The proposed method involves nearly 100 times fewer arithmetic operators. Moreover, from experimental results in the context of face verification-based correlation, we demonstrate that the proposed scheme provides comparable or better accuracy than the traditional method. One interesting feature of the proposed scheme is that it could greatly outperform the traditional scheme for face identification application in terms of sensitivity to face orientation. The proposed method is found to be digital/optical implementation-friendly, which facilitates its integration on a very broad range of scenarios.

A new approach to implementing decentralized wastewater treatment concepts.

PubMed

van Afferden, Manfred; Cardona, Jaime A; Lee, Mi-Yong; Subah, Ali; Müller, Roland A

2015-01-01

Planners and decision-makers in the wastewater sector are often confronted with the problem of identifying adequate development strategies and most suitable finance schemes for decentralized wastewater infrastructure. This paper research has focused on providing an approach in support of such decision-making. It is based on basic principles that stand for an integrated perspective towards sustainable wastewater management. We operationalize these principles by means of a geographic information system (GIS)-based approach 'Assessment of Local Lowest-Cost Wastewater Solutions'--ALLOWS. The main product of ALLOWS is the identification of cost-effective local wastewater management solutions for any given demographic and physical context. By using universally available input data the tool allows decision-makers to compare different wastewater solutions for any given wastewater situation. This paper introduces the ALLOWS-GIS tool. Its application and functionality are illustrated by assessing different wastewater solutions for two neighboring communities in rural Jordan.

Analysis of a decision model in the context of equilibrium pricing and order book pricing

NASA Astrophysics Data System (ADS)

Wagner, D. C.; Schmitt, T. A.; Schäfer, R.; Guhr, T.; Wolf, D. E.

2014-12-01

An agent-based model for financial markets has to incorporate two aspects: decision making and price formation. We introduce a simple decision model and consider its implications in two different pricing schemes. First, we study its parameter dependence within a supply-demand balance setting. We find realistic behavior in a wide parameter range. Second, we embed our decision model in an order book setting. Here, we observe interesting features which are not present in the equilibrium pricing scheme. In particular, we find a nontrivial behavior of the order book volumes which reminds of a trend switching phenomenon. Thus, the decision making model alone does not realistically represent the trading and the stylized facts. The order book mechanism is crucial.

An Energy-Efficient Game-Theory-Based Spectrum Decision Scheme for Cognitive Radio Sensor Networks

PubMed Central

Salim, Shelly; Moh, Sangman

2016-01-01

A cognitive radio sensor network (CRSN) is a wireless sensor network in which sensor nodes are equipped with cognitive radio. In this paper, we propose an energy-efficient game-theory-based spectrum decision (EGSD) scheme for CRSNs to prolong the network lifetime. Note that energy efficiency is the most important design consideration in CRSNs because it determines the network lifetime. The central part of the EGSD scheme consists of two spectrum selection algorithms: random selection and game-theory-based selection. The EGSD scheme also includes a clustering algorithm, spectrum characterization with a Markov chain, and cluster member coordination. Our performance study shows that EGSD outperforms the existing popular framework in terms of network lifetime and coordination overhead. PMID:27376290

An Energy-Efficient Game-Theory-Based Spectrum Decision Scheme for Cognitive Radio Sensor Networks.

PubMed

Salim, Shelly; Moh, Sangman

2016-06-30

A cognitive radio sensor network (CRSN) is a wireless sensor network in which sensor nodes are equipped with cognitive radio. In this paper, we propose an energy-efficient game-theory-based spectrum decision (EGSD) scheme for CRSNs to prolong the network lifetime. Note that energy efficiency is the most important design consideration in CRSNs because it determines the network lifetime. The central part of the EGSD scheme consists of two spectrum selection algorithms: random selection and game-theory-based selection. The EGSD scheme also includes a clustering algorithm, spectrum characterization with a Markov chain, and cluster member coordination. Our performance study shows that EGSD outperforms the existing popular framework in terms of network lifetime and coordination overhead.

Sequential sampling: a novel method in farm animal welfare assessment.

PubMed

Heath, C A E; Main, D C J; Mullan, S; Haskell, M J; Browne, W J

2016-02-01

Lameness in dairy cows is an important welfare issue. As part of a welfare assessment, herd level lameness prevalence can be estimated from scoring a sample of animals, where higher levels of accuracy are associated with larger sample sizes. As the financial cost is related to the number of cows sampled, smaller samples are preferred. Sequential sampling schemes have been used for informing decision making in clinical trials. Sequential sampling involves taking samples in stages, where sampling can stop early depending on the estimated lameness prevalence. When welfare assessment is used for a pass/fail decision, a similar approach could be applied to reduce the overall sample size. The sampling schemes proposed here apply the principles of sequential sampling within a diagnostic testing framework. This study develops three sequential sampling schemes of increasing complexity to classify 80 fully assessed UK dairy farms, each with known lameness prevalence. Using the Welfare Quality herd-size-based sampling scheme, the first 'basic' scheme involves two sampling events. At the first sampling event half the Welfare Quality sample size is drawn, and then depending on the outcome, sampling either stops or is continued and the same number of animals is sampled again. In the second 'cautious' scheme, an adaptation is made to ensure that correctly classifying a farm as 'bad' is done with greater certainty. The third scheme is the only scheme to go beyond lameness as a binary measure and investigates the potential for increasing accuracy by incorporating the number of severely lame cows into the decision. The three schemes are evaluated with respect to accuracy and average sample size by running 100 000 simulations for each scheme, and a comparison is made with the fixed size Welfare Quality herd-size-based sampling scheme. All three schemes performed almost as well as the fixed size scheme but with much smaller average sample sizes. For the third scheme, an overall association between lameness prevalence and the proportion of lame cows that were severely lame on a farm was found. However, as this association was found to not be consistent across all farms, the sampling scheme did not prove to be as useful as expected. The preferred scheme was therefore the 'cautious' scheme for which a sampling protocol has also been developed.

Valuing breastfeeding: a qualitative study of women's experiences of a financial incentive scheme for breastfeeding.

PubMed

Johnson, Maxine; Whelan, Barbara; Relton, Clare; Thomas, Kate; Strong, Mark; Scott, Elaine; Renfrew, Mary J

2018-01-08

A cluster randomised controlled trial of a financial incentive for breastfeeding conducted in areas with low breastfeeding rates in the UK reported a statistically significant increase in breastfeeding at 6-8 weeks. In this paper we report an analysis of interviews with women eligible for the scheme, exploring their experiences and perceptions of the scheme and its impact on breastfeeding to support the interpretation of the results of the trial. Semi-structured interviews were carried out with 35 women eligible for the scheme during the feasibility and trial stages. All interviews were recorded and verbatim transcripts analysed using a Framework Analysis approach. Women reported that their decisions about infant feeding were influenced by the behaviours and beliefs of their family and friends, socio-cultural norms and by health and practical considerations. They were generally positive about the scheme, and felt valued for the effort involved in breastfeeding. The vouchers were frequently described as a reward, a bonus and something to look forward to, and helping women keep going with their breastfeeding. They were often perceived as compensation for the difficulties women encountered during breastfeeding. The scheme was not thought to make a difference to mothers who were strongly against breastfeeding. However, women did believe the scheme would help normalise breastfeeding, influence those who were undecided and help women to keep going with breastfeeding and reach key milestones e.g. 6 weeks or 3 months. The scheme was acceptable to women, who perceived it as rewarding and valuing them for breastfeeding. Women reported that the scheme could raise awareness of breastfeeding and encourage its normalisation. This provides a possible mechanism of action to explain the results of the trial. The trial is registered with the ISRCTN registry, number 44898617 , https://www.isrctn.com.

A Multi-layer Dynamic Model for Coordination Based Group Decision Making in Water Resource Allocation and Scheduling

NASA Astrophysics Data System (ADS)

Huang, Wei; Zhang, Xingnan; Li, Chenming; Wang, Jianying

Management of group decision-making is an important issue in water source management development. In order to overcome the defects in lacking of effective communication and cooperation in the existing decision-making models, this paper proposes a multi-layer dynamic model for coordination in water resource allocation and scheduling based group decision making. By introducing the scheme-recognized cooperative satisfaction index and scheme-adjusted rationality index, the proposed model can solve the problem of poor convergence of multi-round decision-making process in water resource allocation and scheduling. Furthermore, the problem about coordination of limited resources-based group decision-making process can be solved based on the effectiveness of distance-based group of conflict resolution. The simulation results show that the proposed model has better convergence than the existing models.

Technological innovations in the development of cardiovascular clinical information systems.

PubMed

Hsieh, Nan-Chen; Chang, Chung-Yi; Lee, Kuo-Chen; Chen, Jeen-Chen; Chan, Chien-Hui

2012-04-01

Recent studies have shown that computerized clinical case management and decision support systems can be used to assist surgeons in the diagnosis of disease, optimize surgical operation, aid in drug therapy and decrease the cost of medical treatment. Therefore, medical informatics has become an extensive field of research and many of these approaches have demonstrated potential value for improving medical quality. The aim of this study was to develop a web-based cardiovascular clinical information system (CIS) based on innovative techniques, such as electronic medical records, electronic registries and automatic feature surveillance schemes, to provide effective tools and support for clinical care, decision-making, biomedical research and training activities. The CIS developed for this study contained monitoring, surveillance and model construction functions. The monitoring layer function provided a visual user interface. At the surveillance and model construction layers, we explored the application of model construction and intelligent prognosis to aid in making preoperative and postoperative predictions. With the use of the CIS, surgeons can provide reasonable conclusions and explanations in uncertain environments.

Revolution then evolution: the advance of health economic evaluation in Australia.

PubMed

Lopert, Ruth; Viney, Rosalie

2014-01-01

All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health. Copyright © 2014. Published by Elsevier GmbH.

An Adaptive Handover Prediction Scheme for Seamless Mobility Based Wireless Networks

PubMed Central

Safa Sadiq, Ali; Fisal, Norsheila Binti; Ghafoor, Kayhan Zrar; Lloret, Jaime

2014-01-01

We propose an adaptive handover prediction (AHP) scheme for seamless mobility based wireless networks. That is, the AHP scheme incorporates fuzzy logic with AP prediction process in order to lend cognitive capability to handover decision making. Selection metrics, including received signal strength, mobile node relative direction towards the access points in the vicinity, and access point load, are collected and considered inputs of the fuzzy decision making system in order to select the best preferable AP around WLANs. The obtained handover decision which is based on the calculated quality cost using fuzzy inference system is also based on adaptable coefficients instead of fixed coefficients. In other words, the mean and the standard deviation of the normalized network prediction metrics of fuzzy inference system, which are collected from available WLANs are obtained adaptively. Accordingly, they are applied as statistical information to adjust or adapt the coefficients of membership functions. In addition, we propose an adjustable weight vector concept for input metrics in order to cope with the continuous, unpredictable variation in their membership degrees. Furthermore, handover decisions are performed in each MN independently after knowing RSS, direction toward APs, and AP load. Finally, performance evaluation of the proposed scheme shows its superiority compared with representatives of the prediction approaches. PMID:25574490

An adaptive handover prediction scheme for seamless mobility based wireless networks.

PubMed

Sadiq, Ali Safa; Fisal, Norsheila Binti; Ghafoor, Kayhan Zrar; Lloret, Jaime

2014-01-01

We propose an adaptive handover prediction (AHP) scheme for seamless mobility based wireless networks. That is, the AHP scheme incorporates fuzzy logic with AP prediction process in order to lend cognitive capability to handover decision making. Selection metrics, including received signal strength, mobile node relative direction towards the access points in the vicinity, and access point load, are collected and considered inputs of the fuzzy decision making system in order to select the best preferable AP around WLANs. The obtained handover decision which is based on the calculated quality cost using fuzzy inference system is also based on adaptable coefficients instead of fixed coefficients. In other words, the mean and the standard deviation of the normalized network prediction metrics of fuzzy inference system, which are collected from available WLANs are obtained adaptively. Accordingly, they are applied as statistical information to adjust or adapt the coefficients of membership functions. In addition, we propose an adjustable weight vector concept for input metrics in order to cope with the continuous, unpredictable variation in their membership degrees. Furthermore, handover decisions are performed in each MN independently after knowing RSS, direction toward APs, and AP load. Finally, performance evaluation of the proposed scheme shows its superiority compared with representatives of the prediction approaches.

Integrated Workforce Planning Model: A Proof of Concept

NASA Technical Reports Server (NTRS)

Guruvadoo, Eranna K.

2001-01-01

Recently, the Workforce and Diversity Management Office at KSC have launched a major initiative to develop and implement a competency/skill approach to Human Resource management. As the competency/skill dictionary is being elaborated, the need for a competency-based workforce-planning model is recognized. A proof of concept for such a model is presented using a multidimensional data model that can provide the data infrastructure necessary to drive intelligent decision support systems for workforce planing. The components of competency-driven workforce planning model are explained. The data model is presented and several schemes that would support the workforce-planning model are presented. Some directions and recommendations for future work are given.

Evaluation of decision making and negotiation processes under uncertainties regarding the water management of Peiros-Parapeiros Dam, in Achaia Region (Greece).

NASA Astrophysics Data System (ADS)

Podimata, Marianthi V.; Yannopoulos, Panayotis C.

2015-04-01

Water managers, decision-makers, water practitioners and others involved in Integrated Water Resources Management often encounter the problem of finding a joint agreement among stakeholders concerning the management of a common water body. Handling conflict situations/disputes over water issues and finding an acceptable joint solution remain a thorny issue in water negotiation processes, since finding a formula for wise, fair and sustainable management of a water resource is a complex process that includes environmental, economic, technical, socio-political criteria and their uncertainties. Decision Support Systems and Adaptive Management are increasingly used in that direction. To assist decision makers in handling water disputes and execute negotiations, a conceptual tool is required. The Graph Model for Conflict Resolution is a Decision Support flexible tool for negotiation support regarding water conflicts. It includes efficient algorithms for estimating strategic moves of water stakeholders, even though there is a lack of detail concerning their real motives and prospects. It calculates the stability of their states and encourages what-if analyses. This paper presents a case study of water decision makers' evaluations concerning the management of up-coming technical infrastructure Peiros-Parapeiros Dam, in Achaia Region (Greece). The continuous consultations between institutions and representatives revealed that the formation of a joint agreement between stakeholders is not easy, due to arising conflicts and contradictions regarding the jurisdiction and legal status of the dam operator and the cost undertaking of the dam operation. This paper analyzes the positions of the parties involved in the consultation process and examines possible conflict resolution states, using GMCR II. This methodology tries to minimize uncertainty to a certain extent concerning the possible moves/decisions of involved parties regarding the operation and management of the dam by developing and simulating potential strategic interactions and multilateral negotiations and finding confidence-building cooperation schemes (cooperative arrangements) over water use and management.

A cascaded coding scheme for error control

NASA Technical Reports Server (NTRS)

Shu, L.; Kasami, T.

1985-01-01

A cascade coding scheme for error control is investigated. The scheme employs a combination of hard and soft decisions in decoding. Error performance is analyzed. If the inner and outer codes are chosen properly, extremely high reliability can be attained even for a high channel bit-error-rate. Some example schemes are evaluated. They seem to be quite suitable for satellite down-link error control.

A cascaded coding scheme for error control

NASA Technical Reports Server (NTRS)

Kasami, T.; Lin, S.

1985-01-01

A cascaded coding scheme for error control was investigated. The scheme employs a combination of hard and soft decisions in decoding. Error performance is analyzed. If the inner and outer codes are chosen properly, extremely high reliability can be attained even for a high channel bit-error-rate. Some example schemes are studied which seem to be quite suitable for satellite down-link error control.

A multiple kernel support vector machine scheme for feature selection and rule extraction from gene expression data of cancer tissue.

PubMed

Chen, Zhenyu; Li, Jianping; Wei, Liwei

2007-10-01

Recently, gene expression profiling using microarray techniques has been shown as a promising tool to improve the diagnosis and treatment of cancer. Gene expression data contain high level of noise and the overwhelming number of genes relative to the number of available samples. It brings out a great challenge for machine learning and statistic techniques. Support vector machine (SVM) has been successfully used to classify gene expression data of cancer tissue. In the medical field, it is crucial to deliver the user a transparent decision process. How to explain the computed solutions and present the extracted knowledge becomes a main obstacle for SVM. A multiple kernel support vector machine (MK-SVM) scheme, consisting of feature selection, rule extraction and prediction modeling is proposed to improve the explanation capacity of SVM. In this scheme, we show that the feature selection problem can be translated into an ordinary multiple parameters learning problem. And a shrinkage approach: 1-norm based linear programming is proposed to obtain the sparse parameters and the corresponding selected features. We propose a novel rule extraction approach using the information provided by the separating hyperplane and support vectors to improve the generalization capacity and comprehensibility of rules and reduce the computational complexity. Two public gene expression datasets: leukemia dataset and colon tumor dataset are used to demonstrate the performance of this approach. Using the small number of selected genes, MK-SVM achieves encouraging classification accuracy: more than 90% for both two datasets. Moreover, very simple rules with linguist labels are extracted. The rule sets have high diagnostic power because of their good classification performance.

The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

PubMed

Bern-Klug, Mercedes

2008-01-01

Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

Improved CDMA Performance Using Parallel Interference Cancellation

NASA Technical Reports Server (NTRS)

Simon, Marvin; Divsalar, Dariush

1995-01-01

This report considers a general parallel interference cancellation scheme that significantly reduces the degradation effect of user interference but with a lesser implementation complexity than the maximum-likelihood technique. The scheme operates on the fact that parallel processing simultaneously removes from each user the interference produced by the remaining users accessing the channel in an amount proportional to their reliability. The parallel processing can be done in multiple stages. The proposed scheme uses tentative decision devices with different optimum thresholds at the multiple stages to produce the most reliably received data for generation and cancellation of user interference. The 1-stage interference cancellation is analyzed for three types of tentative decision devices, namely, hard, null zone, and soft decision, and two types of user power distribution, namely, equal and unequal powers. Simulation results are given for a multitude of different situations, in particular, those cases for which the analysis is too complex.

Effective crisis decision-making.

PubMed

Kaschner, Holger

2017-01-01

When an organisation's reputation is at stake, crisis decision-making (CDM) is challenging and prone to failure. Most CDM schemes are strong at certain aspects of the overall CDM process, but almost none are strong at all of them. This paper defines criteria for good CDM schemes, analyses common approaches and introduces an alternative, stakeholder-driven scheme. Focusing on the most important stakeholders and directing any actions to preserve the relationships with them is crucial. When doing so, the interdependencies between the stakeholders must be identified and considered. Without knowledge of the sometimes less than obvious links, wellmeaning actions can cause adverse effects, so a cross-check for the impacts of potential options is recommended before making the final decision. The paper also gives recommendations on how to implement these steps at any organisation in order to enhance the quality of CDM and thus protect the organisation's reputation.

Development and Exploration of a Regional Stormwater BMP Performance Database to Parameterize an Integrated Decision Support Tool (i-DST)

NASA Astrophysics Data System (ADS)

Bell, C.; Li, Y.; Lopez, E.; Hogue, T. S.

2017-12-01

Decision support tools that quantitatively estimate the cost and performance of infrastructure alternatives are valuable for urban planners. Such a tool is needed to aid in planning stormwater projects to meet diverse goals such as the regulation of stormwater runoff and its pollutants, minimization of economic costs, and maximization of environmental and social benefits in the communities served by the infrastructure. This work gives a brief overview of an integrated decision support tool, called i-DST, that is currently being developed to serve this need. This presentation focuses on the development of a default database for the i-DST that parameterizes water quality treatment efficiency of stormwater best management practices (BMPs) by region. Parameterizing the i-DST by region will allow the tool to perform accurate simulations in all parts of the United States. A national dataset of BMP performance is analyzed to determine which of a series of candidate regionalizations explains the most variance in the national dataset. The data used in the regionalization analysis comes from the International Stormwater BMP Database and data gleaned from an ongoing systematic review of peer-reviewed and gray literature. In addition to identifying a regionalization scheme for water quality performance parameters in the i-DST, our review process will also provide example methods and protocols for systematic reviews in the field of Earth Science.

Study on the key technology of grain logistics tracking system

NASA Astrophysics Data System (ADS)

Zhen, Tong; Ge, Hongyi; Jiang, Yuying; Che, Yi

2010-07-01

In recent year, with the rapid development of GIS technology, more and more programming problems depend on the GIS technology and professional model system. The solution of auxiliary programming problem by using GIS technology, which has become very popular. GIS is an important tool and technology, that captures, stores, analyzes, manages, and presents data that are linked to location. A grain logistics distribution system based on GIS is established, which provides a visualization scheme during the process of grain circulation and supports users making decision and analyzing for grain logistics enterprise.

Probabilistic Amplitude Shaping With Hard Decision Decoding and Staircase Codes

NASA Astrophysics Data System (ADS)

Sheikh, Alireza; Amat, Alexandre Graell i.; Liva, Gianluigi; Steiner, Fabian

2018-05-01

We consider probabilistic amplitude shaping (PAS) as a means of increasing the spectral efficiency of fiber-optic communication systems. In contrast to previous works in the literature, we consider probabilistic shaping with hard decision decoding (HDD). In particular, we apply the PAS recently introduced by B\\"ocherer \\emph{et al.} to a coded modulation (CM) scheme with bit-wise HDD that uses a staircase code as the forward error correction code. We show that the CM scheme with PAS and staircase codes yields significant gains in spectral efficiency with respect to the baseline scheme using a staircase code and a standard constellation with uniformly distributed signal points. Using a single staircase code, the proposed scheme achieves performance within $0.57$--$1.44$ dB of the corresponding achievable information rate for a wide range of spectral efficiencies.

R&D incentives for neglected diseases.

PubMed

Dimitri, Nicola

2012-01-01

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as 'push' or 'pull' programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency.

An Integrated H-G Scheme Identifying Areas for Soil Remediation and Primary Heavy Metal Contributors: A Risk Perspective.

PubMed

Zou, Bin; Jiang, Xiaolu; Duan, Xiaoli; Zhao, Xiuge; Zhang, Jing; Tang, Jingwen; Sun, Guoqing

2017-03-23

Traditional sampling for soil pollution evaluation is cost intensive and has limited representativeness. Therefore, developing methods that can accurately and rapidly identify at-risk areas and the contributing pollutants is imperative for soil remediation. In this study, we propose an innovative integrated H-G scheme combining human health risk assessment and geographical detector methods that was based on geographical information system technology and validated its feasibility in a renewable resource industrial park in mainland China. With a discrete site investigation of cadmium (Cd), arsenic (As), copper (Cu), mercury (Hg) and zinc (Zn) concentrations, the continuous surfaces of carcinogenic risk and non-carcinogenic risk caused by these heavy metals were estimated and mapped. Source apportionment analysis using geographical detector methods further revealed that these risks were primarily attributed to As, according to the power of the determinant and its associated synergic actions with other heavy metals. Concentrations of critical As and Cd, and the associated exposed CRs are closed to the safe thresholds after remediating the risk areas identified by the integrated H-G scheme. Therefore, the integrated H-G scheme provides an effective approach to support decision-making for regional contaminated soil remediation at fine spatial resolution with limited sampling data over a large geographical extent.

Diagnostic classification scheme in Iranian breast cancer patients using a decision tree.

PubMed

Malehi, Amal Saki

2014-01-01

The objective of this study was to determine a diagnostic classification scheme using a decision tree based model. The study was conducted as a retrospective case-control study in Imam Khomeini hospital in Tehran during 2001 to 2009. Data, including demographic and clinical-pathological characteristics, were uniformly collected from 624 females, 312 of them were referred with positive diagnosis of breast cancer (cases) and 312 healthy women (controls). The decision tree was implemented to develop a diagnostic classification scheme using CART 6.0 Software. The AUC (area under curve), was measured as the overall performance of diagnostic classification of the decision tree. Five variables as main risk factors of breast cancer and six subgroups as high risk were identified. The results indicated that increasing age, low age at menarche, single and divorced statues, irregular menarche pattern and family history of breast cancer are the important diagnostic factors in Iranian breast cancer patients. The sensitivity and specificity of the analysis were 66% and 86.9% respectively. The high AUC (0.82) also showed an excellent classification and diagnostic performance of the model. Decision tree based model appears to be suitable for identifying risk factors and high or low risk subgroups. It can also assists clinicians in making a decision, since it can identify underlying prognostic relationships and understanding the model is very explicit.

IMPROVEMENT OF BUSINESS EFFICIENCY USING A MULTI-AGENT SIMULATION FOR HIGHWAY PATROL ON URBAN EXPRESSWAY

NASA Astrophysics Data System (ADS)

Okamoto, Taro; Taniguchi, Eiichi; Yamada, Tadashi

In Japan, the network of urban expressway has been expanding with the development of urban areas. However, the patrol systems in the urban expressway has not been operated on the basis of scientific evidence, but of conformity and experience. It is therefore crucial to efficiently operate such systems, not only to facilitate the rapid recovery of decreased expressway functionality, but also to acquire the income that supports the operation of privatized expressway companies. Therefore, we develop a multiagent simulation model consisting of the decision-making of four agents, including expressway company, highway patol company, road network users and road authority. These agents determines their schemes depending on their profit obtained. Results of the simulation identyfies the schemes that could offer the profits to the expressway companies in terms of the convenience of the users and the improvement of their operation.

DISSECT: a new mnemonic-based approach to the categorization of aortic dissection.

PubMed

Dake, M D; Thompson, M; van Sambeek, M; Vermassen, F; Morales, J P

2013-08-01

Classification systems for aortic dissection provide important guides to clinical decision-making, but the relevance of traditional categorization schemes is being questioned in an era when endovascular techniques are assuming a growing role in the management of this frequently complex and catastrophic entity. In recognition of the expanding range of interventional therapies now used as alternatives to conventional treatment approaches, the Working Group on Aortic Diseases of the DEFINE Project developed a categorization system that features the specific anatomic and clinical manifestations of the disease process that are most relevant to contemporary decision-making. The DISSECT classification system is a mnemonic-based approach to the evaluation of aortic dissection. It guides clinicians through an assessment of six critical characteristics that facilitate optimal communication of the most salient details that currently influence the selection of a therapeutic option, including those findings that are key when considering an endovascular procedure, but are not taken into account by the DeBakey or Stanford categorization schemes. The six features of aortic dissection include: duration of disease; intimal tear location; size of the dissected aorta; segmental extent of aortic involvement; clinical complications of the dissection, and thrombus within the aortic false lumen. In current clinical practice, endovascular therapy is increasingly considered as an alternative to medical management or open surgical repair in select cases of type B aortic dissection. Currently, endovascular aortic repair is not used for patients with type A aortic dissection, but catheter-based techniques directed at peripheral branch vessel ischemia that may complicate type A dissection are considered valuable adjunctive interventions, when indicated. The use of a new system for categorization of aortic dissection, DISSECT, addresses the shortcomings of well-known established schemes devised more than 40 years ago, before the introduction of endovascular techniques. It will serve as a guide to support a critical analysis of contemporary therapeutic options and inform management decisions based on specific features of the disease process. Copyright © 2013 European Society for Vascular Surgery. All rights reserved.

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

Hale, M.A.; Craig, J.I.

Integrated Product and Process Development (IPPD) embodies the simultaneous application to both system and quality engineering methods throughout an iterative design process. The use of IPPD results in the time-conscious, cost-saving development of engineering systems. To implement IPPD, a Decision-Based Design perspective is encapsulated in an approach that focuses on the role of the human designer in product development. The approach has two parts and is outlined in this paper. First, an architecture, called DREAMS, is being developed that facilitates design from a decision-based perspective. Second, a supporting computing infrastructure, called IMAGE, is being designed. Agents are used to implementmore » the overall infrastructure on the computer. Successful agent utilization requires that they be made of three components: the resource, the model, and the wrap. Current work is focused on the development of generalized agent schemes and associated demonstration projects. When in place, the technology independent computing infrastructure will aid the designer in systematically generating knowledge used to facilitate decision-making.« less

Use of agents to implement an integrated computing environment

NASA Technical Reports Server (NTRS)

Hale, Mark A.; Craig, James I.

1995-01-01

Integrated Product and Process Development (IPPD) embodies the simultaneous application to both system and quality engineering methods throughout an iterative design process. The use of IPPD results in the time-conscious, cost-saving development of engineering systems. To implement IPPD, a Decision-Based Design perspective is encapsulated in an approach that focuses on the role of the human designer in product development. The approach has two parts and is outlined in this paper. First, an architecture, called DREAMS, is being developed that facilitates design from a decision-based perspective. Second, a supporting computing infrastructure, called IMAGE, is being designed. Agents are used to implement the overall infrastructure on the computer. Successful agent utilization requires that they be made of three components: the resource, the model, and the wrap. Current work is focused on the development of generalized agent schemes and associated demonstration projects. When in place, the technology independent computing infrastructure will aid the designer in systematically generating knowledge used to facilitate decision-making.

Biological competition: Decision rules, pattern formation, and oscillations

PubMed Central

Grossberg, Stephen

1980-01-01

Competition solves a universal problem about pattern processing by cellular systems. Competition allows cells to automatically retune their sensitivity to avoid noise and saturation effects. All competitive systems induce decision schemes that permit them to be classified. Systems are identified that achieve global pattern formation, or decision-making, no matter how their parameters are chosen. Oscillations can occur due to contradictions in a system's decision scheme. The pattern formation and oscillation results are extreme examples of a complementarity principle that seems to hold for competitive systems. Nonlinear competitive systems can sometimes appear, to a macroscopic observer, to have linear and cooperative properties, although the two types of systems are not equivalent. This observation is relevant to theories about the evolutionary transition from competitive to cooperative behavior. PMID:16592807

Hydropower Optimization Using Artificial Neural Network Surrogate Models of a High-Fidelity Hydrodynamics and Water Quality Model

NASA Astrophysics Data System (ADS)

Shaw, Amelia R.; Smith Sawyer, Heather; LeBoeuf, Eugene J.; McDonald, Mark P.; Hadjerioua, Boualem

2017-11-01

Hydropower operations optimization subject to environmental constraints is limited by challenges associated with dimensionality and spatial and temporal resolution. The need for high-fidelity hydrodynamic and water quality models within optimization schemes is driven by improved computational capabilities, increased requirements to meet specific points of compliance with greater resolution, and the need to optimize operations of not just single reservoirs but systems of reservoirs. This study describes an important advancement for computing hourly power generation schemes for a hydropower reservoir using high-fidelity models, surrogate modeling techniques, and optimization methods. The predictive power of the high-fidelity hydrodynamic and water quality model CE-QUAL-W2 is successfully emulated by an artificial neural network, then integrated into a genetic algorithm optimization approach to maximize hydropower generation subject to constraints on dam operations and water quality. This methodology is applied to a multipurpose reservoir near Nashville, Tennessee, USA. The model successfully reproduced high-fidelity reservoir information while enabling 6.8% and 6.6% increases in hydropower production value relative to actual operations for dissolved oxygen (DO) limits of 5 and 6 mg/L, respectively, while witnessing an expected decrease in power generation at more restrictive DO constraints. Exploration of simultaneous temperature and DO constraints revealed capability to address multiple water quality constraints at specified locations. The reduced computational requirements of the new modeling approach demonstrated an ability to provide decision support for reservoir operations scheduling while maintaining high-fidelity hydrodynamic and water quality information as part of the optimization decision support routines.

Hydropower Optimization Using Artificial Neural Network Surrogate Models of a High-Fidelity Hydrodynamics and Water Quality Model

DOE PAGES

Shaw, Amelia R.; Sawyer, Heather Smith; LeBoeuf, Eugene J.; ...

2017-10-24

Hydropower operations optimization subject to environmental constraints is limited by challenges associated with dimensionality and spatial and temporal resolution. The need for high-fidelity hydrodynamic and water quality models within optimization schemes is driven by improved computational capabilities, increased requirements to meet specific points of compliance with greater resolution, and the need to optimize operations of not just single reservoirs but systems of reservoirs. This study describes an important advancement for computing hourly power generation schemes for a hydropower reservoir using high-fidelity models, surrogate modeling techniques, and optimization methods. The predictive power of the high-fidelity hydrodynamic and water quality model CE-QUAL-W2more » is successfully emulated by an artificial neural network, then integrated into a genetic algorithm optimization approach to maximize hydropower generation subject to constraints on dam operations and water quality. This methodology is applied to a multipurpose reservoir near Nashville, Tennessee, USA. The model successfully reproduced high-fidelity reservoir information while enabling 6.8% and 6.6% increases in hydropower production value relative to actual operations for dissolved oxygen (DO) limits of 5 and 6 mg/L, respectively, while witnessing an expected decrease in power generation at more restrictive DO constraints. Exploration of simultaneous temperature and DO constraints revealed capability to address multiple water quality constraints at specified locations. Here, the reduced computational requirements of the new modeling approach demonstrated an ability to provide decision support for reservoir operations scheduling while maintaining high-fidelity hydrodynamic and water quality information as part of the optimization decision support routines.« less

Hydropower Optimization Using Artificial Neural Network Surrogate Models of a High-Fidelity Hydrodynamics and Water Quality Model

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

Shaw, Amelia R.; Sawyer, Heather Smith; LeBoeuf, Eugene J.

Hydropower operations optimization subject to environmental constraints is limited by challenges associated with dimensionality and spatial and temporal resolution. The need for high-fidelity hydrodynamic and water quality models within optimization schemes is driven by improved computational capabilities, increased requirements to meet specific points of compliance with greater resolution, and the need to optimize operations of not just single reservoirs but systems of reservoirs. This study describes an important advancement for computing hourly power generation schemes for a hydropower reservoir using high-fidelity models, surrogate modeling techniques, and optimization methods. The predictive power of the high-fidelity hydrodynamic and water quality model CE-QUAL-W2more » is successfully emulated by an artificial neural network, then integrated into a genetic algorithm optimization approach to maximize hydropower generation subject to constraints on dam operations and water quality. This methodology is applied to a multipurpose reservoir near Nashville, Tennessee, USA. The model successfully reproduced high-fidelity reservoir information while enabling 6.8% and 6.6% increases in hydropower production value relative to actual operations for dissolved oxygen (DO) limits of 5 and 6 mg/L, respectively, while witnessing an expected decrease in power generation at more restrictive DO constraints. Exploration of simultaneous temperature and DO constraints revealed capability to address multiple water quality constraints at specified locations. Here, the reduced computational requirements of the new modeling approach demonstrated an ability to provide decision support for reservoir operations scheduling while maintaining high-fidelity hydrodynamic and water quality information as part of the optimization decision support routines.« less

Using patient self-reports to study heterogeneity of treatment effects in major depressive disorder

PubMed Central

Kessler, R.C.; van Loo, H.M.; Wardenaar, K.J.; Bossarte, R.M.; Brenner, L.A.; Ebert, D.D; de Jonge, P.; Nierenberg, A.A.; Rosellini, A.J.; Sampson, N.A.; Schoevers, R.A.; Wilcox, M.A.; Zaslavsky, A.M.

2016-01-01

Aims Clinicians need guidance to address the heterogeneity of treatment responses of patients with major depressive disorder (MDD). While prediction schemes based on symptom clustering and biomarkers have so far not yielded results of sufficient strength to inform clinical decision-making, prediction schemes based on big data predictive analytic models might be more practically useful. Methods We review evidence suggesting that prediction equations based on symptoms and other easily-assessed clinical features found in previous research to predict MDD treatment outcomes might provide a foundation for developing predictive analytic clinical decision support models that could help clinicians select optimal (personalized) MDD treatments. These methods could also be useful in targeting patient subsamples for more expensive biomarker assessments. Results Approximately two dozen baseline variables obtained from medical records or patient reports have been found repeatedly in MDD treatment trials to predict overall treatment outcomes (i.e., intervention versus control) or differential treatment outcomes (i.e., intervention A versus intervention B). Similar evidence has been found in observational studies of MDD persistence-severity. However, no treatment studies have yet attempted to develop treatment outcome equations using the full set of these predictors. Promising preliminary empirical results coupled with recent developments in statistical methodology suggest that models could be developed to provide useful clinical decision support in personalized treatment selection. These tools could also provide a strong foundation to increase statistical power in focused studies of biomarkers and MDD heterogeneity of treatment response in subsequent controlled trials. Conclusions Coordinated efforts are needed to develop a protocol for systematically collecting information about established predictors of heterogeneity of MDD treatment response in large observational treatment studies, applying and refining these models in subsequent pragmatic trials, carrying out pooled secondary analyses to extract the maximum amount of information from these coordinated studies, and using this information to focus future discovery efforts in the segment of the patient population in which continued uncertainty about treatment response exists. PMID:26810628

Using patient self-reports to study heterogeneity of treatment effects in major depressive disorder.

PubMed

Kessler, R C; van Loo, H M; Wardenaar, K J; Bossarte, R M; Brenner, L A; Ebert, D D; de Jonge, P; Nierenberg, A A; Rosellini, A J; Sampson, N A; Schoevers, R A; Wilcox, M A; Zaslavsky, A M

2017-02-01

Clinicians need guidance to address the heterogeneity of treatment responses of patients with major depressive disorder (MDD). While prediction schemes based on symptom clustering and biomarkers have so far not yielded results of sufficient strength to inform clinical decision-making, prediction schemes based on big data predictive analytic models might be more practically useful. We review evidence suggesting that prediction equations based on symptoms and other easily-assessed clinical features found in previous research to predict MDD treatment outcomes might provide a foundation for developing predictive analytic clinical decision support models that could help clinicians select optimal (personalised) MDD treatments. These methods could also be useful in targeting patient subsamples for more expensive biomarker assessments. Approximately two dozen baseline variables obtained from medical records or patient reports have been found repeatedly in MDD treatment trials to predict overall treatment outcomes (i.e., intervention v. control) or differential treatment outcomes (i.e., intervention A v. intervention B). Similar evidence has been found in observational studies of MDD persistence-severity. However, no treatment studies have yet attempted to develop treatment outcome equations using the full set of these predictors. Promising preliminary empirical results coupled with recent developments in statistical methodology suggest that models could be developed to provide useful clinical decision support in personalised treatment selection. These tools could also provide a strong foundation to increase statistical power in focused studies of biomarkers and MDD heterogeneity of treatment response in subsequent controlled trials. Coordinated efforts are needed to develop a protocol for systematically collecting information about established predictors of heterogeneity of MDD treatment response in large observational treatment studies, applying and refining these models in subsequent pragmatic trials, carrying out pooled secondary analyses to extract the maximum amount of information from these coordinated studies, and using this information to focus future discovery efforts in the segment of the patient population in which continued uncertainty about treatment response exists.

A secure and robust password-based remote user authentication scheme using smart cards for the integrated EPR information system.

PubMed

Das, Ashok Kumar

2015-03-01

An integrated EPR (Electronic Patient Record) information system of all the patients provides the medical institutions and the academia with most of the patients' information in details for them to make corrective decisions and clinical decisions in order to maintain and analyze patients' health. In such system, the illegal access must be restricted and the information from theft during transmission over the insecure Internet must be prevented. Lee et al. proposed an efficient password-based remote user authentication scheme using smart card for the integrated EPR information system. Their scheme is very efficient due to usage of one-way hash function and bitwise exclusive-or (XOR) operations. However, in this paper, we show that though their scheme is very efficient, their scheme has three security weaknesses such as (1) it has design flaws in password change phase, (2) it fails to protect privileged insider attack and (3) it lacks the formal security verification. We also find that another recently proposed Wen's scheme has the same security drawbacks as in Lee at al.'s scheme. In order to remedy these security weaknesses found in Lee et al.'s scheme and Wen's scheme, we propose a secure and efficient password-based remote user authentication scheme using smart cards for the integrated EPR information system. We show that our scheme is also efficient as compared to Lee et al.'s scheme and Wen's scheme as our scheme only uses one-way hash function and bitwise exclusive-or (XOR) operations. Through the security analysis, we show that our scheme is secure against possible known attacks. Furthermore, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications) tool and show that our scheme is secure against passive and active attacks.

Introducing high-cost health care to patients: dentists' accounts of offering dental implant treatment.

PubMed

Vernazza, Christopher R; Rousseau, Nikki; Steele, Jimmy G; Ellis, Janice S; Thomason, John Mark; Eastham, Jane; Exley, Catherine

2015-02-01

The decision-making process within health care has been widely researched, with shared decision-making, where both patients and clinicians share technical and personal information, often being cited as the ideal model. To date, much of this research has focused on systems where patients receive their care and treatment free at the point of contact (either in government-funded schemes or in insurance-based schemes). Oral health care often involves patients making direct payments for their care and treatment, and less is known about how this payment affects the decision-making process. It is clear that patient characteristics influence decision-making, but previous evidence suggests that clinicians may assume characteristics rather than eliciting them directly. The aim was to explore the influences on how dentists' engaged in the decision-making process surrounding a high-cost item of health care, dental implant treatments (DITs). A qualitative study using semi-structured interviews was undertaken using a purposive sample of primary care dentists (n = 25). Thematic analysis was undertaken to reveal emerging key themes. There were differences in how dentists discussed and offered implants. Dentists made decisions about whether to offer implants based on business factors, professional and legal obligations and whether they perceived the patient to be motivated to have treatment and their ability to pay. There was evidence that assessment of these characteristics was often based on assumptions derived from elements such as the appearance of the patient, the state of the patient's mouth and demographic details. The data suggest that there is a conflict between three elements of acting as a healthcare professional: minimizing provision of unneeded treatment, trying to fully involve patients in shared decisions and acting as a business person with the potential for financial gain. It might be expected that in the context of a high-cost healthcare intervention for which patients pay the bill themselves, that decision-making would be closer to an informed than a paternalistic model. Our research suggests that paternalistic decision-making is still practised and is influenced by assumptions about patient characteristics. Better tools and training may be required to support clinicians in this area of practice. © 2014 The Authors. Community Dentistry and Oral Epidemiology Published by John Wiley & Sons Ltd.

Ocean Variability Effects on Underwater Acoustic Communications

DTIC Science & Technology

2011-09-01

schemes for accessing wide frequency bands. Compared with OFDM schemes, the multiband MIMO transmission combined with time reversal processing...systems, or multiple- input/multiple-output ( MIMO ) systems, decision feedback equalization and interference cancellation schemes have been integrated...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 2 MIMO receiver also iterates channel estimation and symbol demodulation with

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

EPA Science Inventory

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

Public policy and risk financing strategies for global catastrophe risk management - the role of global risk initiatives

NASA Astrophysics Data System (ADS)

McSharry, Patrick; Mitchell, Andrew; Anderson, Rebecca

2010-05-01

Decision-makers in both public and private organisations depend on accurate data and scientific understanding to adequately address climate change and the impact of extreme events. The financial impacts of catastrophes on populations and infrastructure can be offset through effective risk transfer mechanisms, structured to reflect the specific perils and levels of exposure to be covered. Optimal strategies depend on the likely socio-econonomic impact, the institutional framework, the overall objectives of the covers placed and the level of both the frequency and severity of loss potential expected. The diversity of approaches across different countries has been documented by the Spanish "Consorcio de Compensación de Seguros". We discuss why international public/private partnerships are necessary for addressing the risk of natural catastrophes. International initiatives such as the Global Earthquake Model (GEM) and the World Forum of Catastrophe Programmes (WFCP) can provide effective guidelines for constructing natural catastrophe schemes. The World Bank has been instrumental in the creation of many of the existing schemes such as the Turkish Catastrophe Insurance Pool, the Caribbean Catastrophe Risk Insurance Facility and the Mongolian Index-Based Livestock Insurance Program. We review existing schemes and report on best practice in relation to providing protection against natural catastrophe perils. The suitability of catastrophe modelling approaches to support schemes across the world are discussed and we identify opportunities to improve risk assessment for such schemes through transparent frameworks for quantifying, pricing, sharing and financing catastrophe risk on a local and global basis.

Markup of temporal information in electronic health records.

PubMed

Hyun, Sookyung; Bakken, Suzanne; Johnson, Stephen B

2006-01-01

Temporal information plays a critical role in the understanding of clinical narrative (i.e., free text). We developed a representation for marking up temporal information in a narrative, consisting of five elements: 1) reference point, 2) direction, 3) number, 4) time unit, and 5) pattern. We identified 254 temporal expressions from 50 discharge summaries and represented them using our scheme. The overall inter-rater reliability among raters applying the representation model was 75 percent agreement. The model can contribute to temporal reasoning in computer systems for decision support, data mining, and process and outcomes analyses by providing structured temporal information.

Seven Measures of the Ways That Deciders Frame Their Career Decisions.

ERIC Educational Resources Information Center

Cochran, Larry

1983-01-01

Illustrates seven different measures of the ways people structure a career decision. Given sets of occupational alternatives and considerations, the career grid is a decisional balance sheet that indicates the way each occupation is judged on each consideration. It can be used to correct faulty decision schemes. (JAC)

Efficiently approximating the Pareto frontier: Hydropower dam placement in the Amazon basin

USGS Publications Warehouse

Wu, Xiaojian; Gomes-Selman, Jonathan; Shi, Qinru; Xue, Yexiang; Garcia-Villacorta, Roosevelt; Anderson, Elizabeth; Sethi, Suresh; Steinschneider, Scott; Flecker, Alexander; Gomes, Carla P.

2018-01-01

Real–world problems are often not fully characterized by a single optimal solution, as they frequently involve multiple competing objectives; it is therefore important to identify the so-called Pareto frontier, which captures solution trade-offs. We propose a fully polynomial-time approximation scheme based on Dynamic Programming (DP) for computing a polynomially succinct curve that approximates the Pareto frontier to within an arbitrarily small > 0 on treestructured networks. Given a set of objectives, our approximation scheme runs in time polynomial in the size of the instance and 1/. We also propose a Mixed Integer Programming (MIP) scheme to approximate the Pareto frontier. The DP and MIP Pareto frontier approaches have complementary strengths and are surprisingly effective. We provide empirical results showing that our methods outperform other approaches in efficiency and accuracy. Our work is motivated by a problem in computational sustainability concerning the proliferation of hydropower dams throughout the Amazon basin. Our goal is to support decision-makers in evaluating impacted ecosystem services on the full scale of the Amazon basin. Our work is general and can be applied to approximate the Pareto frontier of a variety of multiobjective problems on tree-structured networks.

Score level fusion scheme based on adaptive local Gabor features for face-iris-fingerprint multimodal biometric

NASA Astrophysics Data System (ADS)

He, Fei; Liu, Yuanning; Zhu, Xiaodong; Huang, Chun; Han, Ye; Chen, Ying

2014-05-01

A multimodal biometric system has been considered a promising technique to overcome the defects of unimodal biometric systems. We have introduced a fusion scheme to gain a better understanding and fusion method for a face-iris-fingerprint multimodal biometric system. In our case, we use particle swarm optimization to train a set of adaptive Gabor filters in order to achieve the proper Gabor basic functions for each modality. For a closer analysis of texture information, two different local Gabor features for each modality are produced by the corresponding Gabor coefficients. Next, all matching scores of the two Gabor features for each modality are projected to a single-scalar score via a trained, supported, vector regression model for a final decision. A large-scale dataset is formed to validate the proposed scheme using the Facial Recognition Technology database-fafb and CASIA-V3-Interval together with FVC2004-DB2a datasets. The experimental results demonstrate that as well as achieving further powerful local Gabor features of multimodalities and obtaining better recognition performance by their fusion strategy, our architecture also outperforms some state-of-the-art individual methods and other fusion approaches for face-iris-fingerprint multimodal biometric systems.

A risk explicit interval linear programming model for uncertainty-based environmental economic optimization in the Lake Fuxian watershed, China.

PubMed

Zhang, Xiaoling; Huang, Kai; Zou, Rui; Liu, Yong; Yu, Yajuan

2013-01-01

The conflict of water environment protection and economic development has brought severe water pollution and restricted the sustainable development in the watershed. A risk explicit interval linear programming (REILP) method was used to solve integrated watershed environmental-economic optimization problem. Interval linear programming (ILP) and REILP models for uncertainty-based environmental economic optimization at the watershed scale were developed for the management of Lake Fuxian watershed, China. Scenario analysis was introduced into model solution process to ensure the practicality and operability of optimization schemes. Decision makers' preferences for risk levels can be expressed through inputting different discrete aspiration level values into the REILP model in three periods under two scenarios. Through balancing the optimal system returns and corresponding system risks, decision makers can develop an efficient industrial restructuring scheme based directly on the window of "low risk and high return efficiency" in the trade-off curve. The representative schemes at the turning points of two scenarios were interpreted and compared to identify a preferable planning alternative, which has the relatively low risks and nearly maximum benefits. This study provides new insights and proposes a tool, which was REILP, for decision makers to develop an effectively environmental economic optimization scheme in integrated watershed management.

A Risk Explicit Interval Linear Programming Model for Uncertainty-Based Environmental Economic Optimization in the Lake Fuxian Watershed, China

PubMed Central

Zou, Rui; Liu, Yong; Yu, Yajuan

2013-01-01

The conflict of water environment protection and economic development has brought severe water pollution and restricted the sustainable development in the watershed. A risk explicit interval linear programming (REILP) method was used to solve integrated watershed environmental-economic optimization problem. Interval linear programming (ILP) and REILP models for uncertainty-based environmental economic optimization at the watershed scale were developed for the management of Lake Fuxian watershed, China. Scenario analysis was introduced into model solution process to ensure the practicality and operability of optimization schemes. Decision makers' preferences for risk levels can be expressed through inputting different discrete aspiration level values into the REILP model in three periods under two scenarios. Through balancing the optimal system returns and corresponding system risks, decision makers can develop an efficient industrial restructuring scheme based directly on the window of “low risk and high return efficiency” in the trade-off curve. The representative schemes at the turning points of two scenarios were interpreted and compared to identify a preferable planning alternative, which has the relatively low risks and nearly maximum benefits. This study provides new insights and proposes a tool, which was REILP, for decision makers to develop an effectively environmental economic optimization scheme in integrated watershed management. PMID:24191144

Cynefin as Reference Framework to Facilitate Insight and Decision-Making in Complex Contexts of Biomedical Research.

PubMed

Kempermann, Gerd

2017-01-01

The Cynefin scheme is a concept of knowledge management, originally devised to support decision making in management, but more generally applicable to situations, in which complexity challenges the quality of insight, prediction, and decision. Despite the fact that life itself, and especially the brain and its diseases, are complex to the extent that complexity could be considered their cardinal feature, complex problems in biomedicine are often treated as if they were actually not more than the complicated sum of solvable sub-problems. Because of the emergent properties of complex contexts this is not correct. With a set of clear criteria Cynefin helps to set apart complex problems from "simple/obvious," "complicated," "chaotic," and "disordered" contexts in order to avoid misinterpreting the relevant causality structures. The distinction comes with the insight, which specific kind of knowledge is possible in each of these categories and what are the consequences for resulting decisions and actions. From student's theses over the publication and grant writing process to research politics, misinterpretation of complexity can have problematic or even dangerous consequences, especially in clinical contexts. Conceptualization of problems within a straightforward reference language like Cynefin improves clarity and stringency within projects and facilitates communication and decision-making about them.

R&D Incentives for Neglected Diseases

PubMed Central

Dimitri, Nicola

2012-01-01

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as ‘push’ or ‘pull’ programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency. PMID:23284648

Data acquisition and path selection decision making for an autonomous roving vehicle. [laser pointing control system for vehicle guidance

NASA Technical Reports Server (NTRS)

Shen, C. N.; YERAZUNIS

1979-01-01

The feasibility of using range/pointing angle data such as might be obtained by a laser rangefinder for the purpose of terrain evaluation in the 10-40 meter range on which to base the guidance of an autonomous rover was investigated. The decision procedure of the rapid estimation scheme for the detection of discrete obstacles has been modified to reinforce the detection ability. With the introduction of the logarithmic scanning scheme and obstacle identification scheme, previously developed algorithms are combined to demonstrate the overall performance of the intergrated route designation system using laser rangefinder. In an attempt to cover a greater range, 30 m to 100 mm, the problem estimating gradients in the presence of positioning angle noise at middle range is investigated.

Information-reduced Carrier Synchronization of Iterative Decoded BPSK and QPSK using Soft Decision (Extrinsic) Feedback

NASA Technical Reports Server (NTRS)

Simon, Marvin; Valles, Esteban; Jones, Christopher

2008-01-01

This paper addresses the carrier-phase estimation problem under low SNR conditions as are typical of turbo- and LDPC-coded applications. In previous publications by the first author, closed-loop carrier synchronization schemes for error-correction coded BPSK and QPSK modulation were proposed that were based on feeding back hard data decisions at the input of the loop, the purpose being to remove the modulation prior to attempting to track the carrier phase as opposed to the more conventional decision-feedback schemes that incorporate such feedback inside the loop. In this paper, we consider an alternative approach wherein the extrinsic soft information from the iterative decoder of turbo or LDPC codes is instead used as the feedback.

The effects of nutrition labeling on consumer food choice: a psychological experiment and computational model.

PubMed

Helfer, Peter; Shultz, Thomas R

2014-12-01

The widespread availability of calorie-dense food is believed to be a contributing cause of an epidemic of obesity and associated diseases throughout the world. One possible countermeasure is to empower consumers to make healthier food choices with useful nutrition labeling. An important part of this endeavor is to determine the usability of existing and proposed labeling schemes. Here, we report an experiment on how four different labeling schemes affect the speed and nutritional value of food choices. We then apply decision field theory, a leading computational model of human decision making, to simulate the experimental results. The psychology experiment shows that quantitative, single-attribute labeling schemes have greater usability than multiattribute and binary ones, and that they remain effective under moderate time pressure. The computational model simulates these psychological results and provides explanatory insights into them. This work shows how experimental psychology and computational modeling can contribute to the evaluation and improvement of nutrition-labeling schemes. © 2014 New York Academy of Sciences.

Research on comprehensive decision-making of PV power station connecting system

NASA Astrophysics Data System (ADS)

Zhou, Erxiong; Xin, Chaoshan; Ma, Botao; Cheng, Kai

2018-04-01

In allusion to the incomplete indexes system and not making decision on the subjectivity and objectivity of PV power station connecting system, based on the combination of improved Analytic Hierarchy Process (AHP), Criteria Importance Through Intercriteria Correlation (CRITIC) as well as grey correlation degree analysis (GCDA) is comprehensively proposed to select the appropriate system connecting scheme of PV power station. Firstly, indexes of PV power station connecting system are divided the recursion order hierarchy and calculated subjective weight by the improved AHP. Then, CRITIC is adopted to determine the objective weight of each index through the comparison intensity and conflict between indexes. The last the improved GCDA is applied to screen the optimal scheme, so as to, from the subjective and objective angle, select the connecting system. Comprehensive decision of Xinjiang PV power station is conducted and reasonable analysis results are attained. The research results might provide scientific basis for investment decision.

Integrated Hydrographical Basin Management. Study Case - Crasna River Basin

NASA Astrophysics Data System (ADS)

Visescu, Mircea; Beilicci, Erika; Beilicci, Robert

2017-10-01

Hydrographical basins are important from hydrological, economic and ecological points of view. They receive and channel the runoff from rainfall and snowmelt which, when adequate managed, can provide fresh water necessary for water supply, irrigation, food industry, animal husbandry, hydrotechnical arrangements and recreation. Hydrographical basin planning and management follows the efficient use of available water resources in order to satisfy environmental, economic and social necessities and constraints. This can be facilitated by a decision support system that links hydrological, meteorological, engineering, water quality, agriculture, environmental, and other information in an integrated framework. In the last few decades different modelling tools for resolving problems regarding water quantity and quality were developed, respectively water resources management. Watershed models have been developed to the understanding of water cycle and pollution dynamics, and used to evaluate the impacts of hydrotechnical arrangements and land use management options on water quantity, quality, mitigation measures and possible global changes. Models have been used for planning monitoring network and to develop plans for intervention in case of hydrological disasters: floods, flash floods, drought and pollution. MIKE HYDRO Basin is a multi-purpose, map-centric decision support tool for integrated hydrographical basin analysis, planning and management. MIKE HYDRO Basin is designed for analyzing water sharing issues at international, national and local hydrographical basin level. MIKE HYDRO Basin uses a simplified mathematical representation of the hydrographical basin including the configuration of river and reservoir systems, catchment hydrology and existing and potential water user schemes with their various demands including a rigorous irrigation scheme module. This paper analyzes the importance and principles of integrated hydrographical basin management and develop a case study for Crasna river basin, with the use of MIKE HYDRO Basin advanced hydroinformatic tool for integrated hydrographical basin analysis, planning and management.

Irrigation water policy analysis using a business simulation game

NASA Astrophysics Data System (ADS)

Buchholz, M.; Holst, G.; Musshoff, O.

2016-10-01

Despite numerous studies on farmers' responses to changing irrigation water policies, uncertainties remain about the potential of water pricing schemes and water quotas to reduce irrigation. Thus far, policy impact analysis is predominantly based upon rational choice models that assume behavioral assumptions, such as a perfectly rational profit-maximizing decision maker. Also, econometric techniques are applied which could lack internal validity due to uncontrolled field data. Furthermore, such techniques are not capable of identifying ill-designed policies prior to their implementation. With this in mind, we apply a business simulation game for ex ante policy impact analysis of irrigation water policies at the farm level. Our approach has the potential to reveal the policy-induced behavioral change of the participants in a controlled environment. To do so, we investigate how real farmers from Germany, in an economic experiment, respond to a water pricing scheme and a water quota intending to reduce irrigation. In the business simulation game, the participants manage a "virtual" cash-crop farm for which they make crop allocation and irrigation decisions during several production periods, while facing uncertain product prices and weather conditions. The results reveal that a water quota is able to reduce mean irrigation applications, while a water pricing scheme does not have an impact, even though both policies exhibit equal income effects for the farmers. However, both policies appear to increase the variation of irrigation applications. Compared to a perfectly rational profit-maximizing decision maker, the participants apply less irrigation on average, both when irrigation is not restricted and when a water pricing scheme applies. Moreover, the participants' risk attitude affects the irrigation decisions.

Energy efficiency in cognitive radio network: Study of cooperative sensing using different channel sensing methods

NASA Astrophysics Data System (ADS)

Cui, Chenxuan

When cognitive radio (CR) operates, it starts by sensing spectrum and looking for idle bandwidth. There are several methods for CR to make a decision on either the channel is occupied or idle, for example, energy detection scheme, cyclostationary detection scheme and matching filtering detection scheme [1]. Among them, the most common method is energy detection scheme because of its algorithm and implementation simplicities [2]. There are two major methods for sensing, the first one is to sense single channel slot with varying bandwidth, whereas the second one is to sense multiple channels and each with same bandwidth. After sensing periods, samples are compared with a preset detection threshold and a decision is made on either the primary user (PU) is transmitting or not. Sometimes the sensing and decision results can be erroneous, for example, false alarm error and misdetection error may occur. In order to better control error probabilities and improve CR network performance (i.e. energy efficiency), we introduce cooperative sensing; in which several CR within a certain range detect and make decisions on channel availability together. The decisions are transmitted to and analyzed by a data fusion center (DFC) to make a final decision on channel availability. After the final decision is been made, DFC sends back the decision to the CRs in order to tell them to stay idle or start to transmit data to secondary receiver (SR) within a preset transmission time. After the transmission, a new cycle starts again with sensing. This thesis report is organized as followed: Chapter II review some of the papers on optimizing CR energy efficiency. In Chapter III, we study how to achieve maximal energy efficiency when CR senses single channel with changing bandwidth and with constrain on misdetection threshold in order to protect PU; furthermore, a case study is given and we calculate the energy efficiency. In Chapter IV, we study how to achieve maximal energy efficiency when CR senses multiple channels and each channel with same bandwidth, also, we preset a misdetection threshold and calculate the energy efficiency. A comparison will be shown between two sensing methods at the end of the chapter. Finally, Chapter V concludes this thesis.

77 FR 46713 - Circular Welded Carbon Steel Pipes and Tubes From Turkey: Final Results of Countervailing Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... Support. L. IEP: Land Allocation. M. National Restructuring Program. N. Regional Incentive Scheme: Reduced Corporate Tax Rates. O. Regional Incentive Scheme: Social Security Premium Contribution for Employees. P. Regional Incentive Scheme: Allocation of State Land. Q. Regional Incentive Scheme: Interest Support. R. OIZ...

An evaluation of supervised classifiers for indirectly detecting salt-affected areas at irrigation scheme level

NASA Astrophysics Data System (ADS)

Muller, Sybrand Jacobus; van Niekerk, Adriaan

2016-07-01

Soil salinity often leads to reduced crop yield and quality and can render soils barren. Irrigated areas are particularly at risk due to intensive cultivation and secondary salinization caused by waterlogging. Regular monitoring of salt accumulation in irrigation schemes is needed to keep its negative effects under control. The dynamic spatial and temporal characteristics of remote sensing can provide a cost-effective solution for monitoring salt accumulation at irrigation scheme level. This study evaluated a range of pan-fused SPOT-5 derived features (spectral bands, vegetation indices, image textures and image transformations) for classifying salt-affected areas in two distinctly different irrigation schemes in South Africa, namely Vaalharts and Breede River. The relationship between the input features and electro conductivity measurements were investigated using regression modelling (stepwise linear regression, partial least squares regression, curve fit regression modelling) and supervised classification (maximum likelihood, nearest neighbour, decision tree analysis, support vector machine and random forests). Classification and regression trees and random forest were used to select the most important features for differentiating salt-affected and unaffected areas. The results showed that the regression analyses produced weak models (<0.4 R squared). Better results were achieved using the supervised classifiers, but the algorithms tend to over-estimate salt-affected areas. A key finding was that none of the feature sets or classification algorithms stood out as being superior for monitoring salt accumulation at irrigation scheme level. This was attributed to the large variations in the spectral responses of different crops types at different growing stages, coupled with their individual tolerances to saline conditions.

Robust watermarking scheme for binary images using a slice-based large-cluster algorithm with a Hamming Code

NASA Astrophysics Data System (ADS)

Chen, Wen-Yuan; Liu, Chen-Chung

2006-01-01

The problems with binary watermarking schemes are that they have only a small amount of embeddable space and are not robust enough. We develop a slice-based large-cluster algorithm (SBLCA) to construct a robust watermarking scheme for binary images. In SBLCA, a small-amount cluster selection (SACS) strategy is used to search for a feasible slice in a large-cluster flappable-pixel decision (LCFPD) method, which is used to search for the best location for concealing a secret bit from a selected slice. This method has four major advantages over the others: (a) SBLCA has a simple and effective decision function to select appropriate concealment locations, (b) SBLCA utilizes a blind watermarking scheme without the original image in the watermark extracting process, (c) SBLCA uses slice-based shuffling capability to transfer the regular image into a hash state without remembering the state before shuffling, and finally, (d) SBLCA has enough embeddable space that every 64 pixels could accommodate a secret bit of the binary image. Furthermore, empirical results on test images reveal that our approach is a robust watermarking scheme for binary images.

Adaptive adjustment of reference constellation for demodulating 16QAM signal with intrinsic distortion due to imperfect modulation.

PubMed

Inoue, Takashi; Namiki, Shu

2013-12-02

We find that an adaptive equalizer and a phase-locked loop operating with decision-directed mode exhibit degraded performances when they are used in a digital coherent receiver to demodulate a 16QAM signal with intrinsically distorted constellation, and that the degradation is more significant for the dual-polarization case. We then propose a scheme to correctly demodulate such a distorted 16QAM signal, where the reference constellation and the threshold for the decision are adaptively adjusted such that they fit to the distorted ones. We experimentally confirm the improved performance of the proposed scheme over the conventional one for single-and dual-polarization 16QAM signals with distortion. We also investigate the applicable range of the proposed scheme for the degree of distortion of the signal.

A study of malware detection on smart mobile devices

NASA Astrophysics Data System (ADS)

Yu, Wei; Zhang, Hanlin; Xu, Guobin

2013-05-01

The growing in use of smart mobile devices for everyday applications has stimulated the spread of mobile malware, especially on popular mobile platforms. As a consequence, malware detection becomes ever more critical in sustaining the mobile market and providing a better user experience. In this paper, we review the existing malware and detection schemes. Using real-world malware samples with known signatures, we evaluate four popular commercial anti-virus tools and our data shows that these tools can achieve high detection accuracy. To deal with the new malware with unknown signatures, we study the anomaly based detection using decision tree algorithm. We evaluate the effectiveness of our detection scheme using malware and legitimate software samples. Our data shows that the detection scheme using decision tree can achieve a detection rate up to 90% and a false positive rate as low as 10%.

Organization of functional interaction of corporate information systems

NASA Astrophysics Data System (ADS)

Safronov, V. V.; Barabanov, V. F.; Podvalniy, S. L.; Nuzhnyy, A. M.

2018-03-01

In this article the methods of specialized software systems integration are analyzed and the concept of seamless integration of production decisions is offered. In view of this concept developed structural and functional schemes of the specialized software are shown. The proposed schemes and models are improved for a machine-building enterprise.

Low-latency optical parallel adder based on a binary decision diagram with wavelength division multiplexing scheme

NASA Astrophysics Data System (ADS)

Shinya, A.; Ishihara, T.; Inoue, K.; Nozaki, K.; Kita, S.; Notomi, M.

2018-02-01

We propose an optical parallel adder based on a binary decision diagram that can calculate simply by propagating light through electrically controlled optical pass gates. The CARRY and CARRY operations are multiplexed in one circuit by a wavelength division multiplexing scheme to reduce the number of optical elements, and only a single gate constitutes the critical path for one digit calculation. The processing time reaches picoseconds per digit when we use a 100-μm-long optical path gates, which is ten times faster than a CMOS circuit.

A Multimetric Approach for Handoff Decision in Heterogeneous Wireless Networks

NASA Astrophysics Data System (ADS)

Kustiawan, I.; Purnama, W.

2018-02-01

Seamless mobility and service continuity anywhere at any time are an important issue in the wireless Internet. This research proposes a scheme to make handoff decisions effectively in heterogeneous wireless networks using a fuzzy system. Our design lies in an inference engine which takes RSS (received signal strength), data rate, network latency, and user preference as strategic determinants. The logic of our engine is realized on a UE (user equipment) side in faster reaction to network dynamics while roaming across different radio access technologies. The fuzzy system handles four metrics jointly to deduce a moderate decision about when to initiate handoff. The performance of our design is evaluated by simulating move-out mobility scenarios. Simulation results show that our scheme outperforms other approaches in terms of reducing unnecessary handoff.

Patient-tailored prioritization for a pediatric care decision support system through machine learning.

PubMed

Klann, Jeffrey G; Anand, Vibha; Downs, Stephen M

2013-12-01

Over 8 years, we have developed an innovative computer decision support system that improves appropriate delivery of pediatric screening and care. This system employs a guidelines evaluation engine using data from the electronic health record (EHR) and input from patients and caregivers. Because guideline recommendations typically exceed the scope of one visit, the engine uses a static prioritization scheme to select recommendations. Here we extend an earlier idea to create patient-tailored prioritization. We used Bayesian structure learning to build networks of association among previously collected data from our decision support system. Using area under the receiver-operating characteristic curve (AUC) as a measure of discriminability (a sine qua non for expected value calculations needed for prioritization), we performed a structural analysis of variables with high AUC on a test set. Our source data included 177 variables for 29 402 patients. The method produced a network model containing 78 screening questions and anticipatory guidance (107 variables total). Average AUC was 0.65, which is sufficient for prioritization depending on factors such as population prevalence. Structure analysis of seven highly predictive variables reveals both face-validity (related nodes are connected) and non-intuitive relationships. We demonstrate the ability of a Bayesian structure learning method to 'phenotype the population' seen in our primary care pediatric clinics. The resulting network can be used to produce patient-tailored posterior probabilities that can be used to prioritize content based on the patient's current circumstances. This study demonstrates the feasibility of EHR-driven population phenotyping for patient-tailored prioritization of pediatric preventive care services.

Intelligent Support System of Steel Technical Preparation in an Arc Furnace: Functional Scheme of Interactive Builder of the Multi Objective Optimization Problem

NASA Astrophysics Data System (ADS)

Logunova, O. S.; Sibileva, N. S.

2017-12-01

The purpose of the study is to increase the efficiency of the steelmaking process in large capacity arc furnace on the basis of implementation a new decision-making system about the composition of charge materials. The authors proposed an interactive builder for the formation of the optimization problem, taking into account the requirements of the customer, normative documents and stocks of charge materials in the warehouse. To implement the interactive builder, the sets of deterministic and stochastic model components are developed, as well as a list of preferences of criteria and constraints.

New User Support in the University Network with DACS Scheme

ERIC Educational Resources Information Center

Odagiri, Kazuya; Yaegashi, Rihito; Tadauchi, Masaharu; Ishii, Naohiro

2007-01-01

Purpose: The purpose of this paper is to propose and examine the new user support in university network. Design/methodology/approach: The new user support is realized by use of DACS (Destination Addressing Control System) Scheme which manages a whole network system through communication control on a client computer. This DACS Scheme has been…

Secure Distributed Detection under Energy Constraint in IoT-Oriented Sensor Networks.

PubMed

Zhang, Guomei; Sun, Hao

2016-12-16

We study the secure distributed detection problems under energy constraint for IoT-oriented sensor networks. The conventional channel-aware encryption (CAE) is an efficient physical-layer secure distributed detection scheme in light of its energy efficiency, good scalability and robustness over diverse eavesdropping scenarios. However, in the CAE scheme, it remains an open problem of how to optimize the key thresholds for the estimated channel gain, which are used to determine the sensor's reporting action. Moreover, the CAE scheme does not jointly consider the accuracy of local detection results in determining whether to stay dormant for a sensor. To solve these problems, we first analyze the error probability and derive the optimal thresholds in the CAE scheme under a specified energy constraint. These results build a convenient mathematic framework for our further innovative design. Under this framework, we propose a hybrid secure distributed detection scheme. Our proposal can satisfy the energy constraint by keeping some sensors inactive according to the local detection confidence level, which is characterized by likelihood ratio. In the meanwhile, the security is guaranteed through randomly flipping the local decisions forwarded to the fusion center based on the channel amplitude. We further optimize the key parameters of our hybrid scheme, including two local decision thresholds and one channel comparison threshold. Performance evaluation results demonstrate that our hybrid scheme outperforms the CAE under stringent energy constraints, especially in the high signal-to-noise ratio scenario, while the security is still assured.

Secure Distributed Detection under Energy Constraint in IoT-Oriented Sensor Networks

PubMed Central

Zhang, Guomei; Sun, Hao

2016-01-01

We study the secure distributed detection problems under energy constraint for IoT-oriented sensor networks. The conventional channel-aware encryption (CAE) is an efficient physical-layer secure distributed detection scheme in light of its energy efficiency, good scalability and robustness over diverse eavesdropping scenarios. However, in the CAE scheme, it remains an open problem of how to optimize the key thresholds for the estimated channel gain, which are used to determine the sensor’s reporting action. Moreover, the CAE scheme does not jointly consider the accuracy of local detection results in determining whether to stay dormant for a sensor. To solve these problems, we first analyze the error probability and derive the optimal thresholds in the CAE scheme under a specified energy constraint. These results build a convenient mathematic framework for our further innovative design. Under this framework, we propose a hybrid secure distributed detection scheme. Our proposal can satisfy the energy constraint by keeping some sensors inactive according to the local detection confidence level, which is characterized by likelihood ratio. In the meanwhile, the security is guaranteed through randomly flipping the local decisions forwarded to the fusion center based on the channel amplitude. We further optimize the key parameters of our hybrid scheme, including two local decision thresholds and one channel comparison threshold. Performance evaluation results demonstrate that our hybrid scheme outperforms the CAE under stringent energy constraints, especially in the high signal-to-noise ratio scenario, while the security is still assured. PMID:27999282

A methodology for comprehensive strategic planning and program prioritization

NASA Astrophysics Data System (ADS)

Raczynski, Christopher Michael

2008-10-01

This process developed in this work, Strategy Optimization for the Allocation of Resources (SOAR), is a strategic planning methodology based off Integrated Product and Process Development and systems engineering techniques. Utilizing a top down approach, the process starts with the creation of the organization vision and its measures of effectiveness. These measures are prioritized based on their application to external world scenarios which will frame the future. The programs which will be used to accomplish this vision are identified by decomposing the problem. Information is gathered on the programs as to the application, cost, schedule, risk, and other pertinent information. The relationships between the levels of the hierarchy are mapped utilizing subject matter experts. These connections are then utilized to determine the overall benefit of the programs to the vision of the organization. Through a Multi-Objective Genetic Algorithm a tradespace of potential program portfolios can be created amongst which the decision maker can allocate resources. The information and portfolios are presented to the decision maker through the use of a Decision Support System which collects and visualizes all the data in a single location. This methodology was tested utilizing a science and technology planning exercise conducted by the United States Navy. A thorough decomposition was defined and technology programs identified which had the potential to provide benefit to the vision. The prioritization of the top level capabilities was performed through the use of a rank ordering scheme and a previous naval application was used to demonstrate a cumulative voting scheme. Voting was performed utilizing the Nominal Group Technique to capture the relationships between the levels of the hierarchy. Interrelationships between the technologies were identified and a MOGA was utilized to optimize portfolios with respect to these constraints and information was placed in a DSS. This formulation allowed the decision makers to assess which portfolio could provide the greatest benefit to the Navy while still fitting within the funding profile.

GIS coupled Multiple Criteria based Decision Support for Classification of Urban Coastal Areas in India

NASA Astrophysics Data System (ADS)

Dhiman, R.; Kalbar, P.; Inamdar, A. B.

2017-12-01

Coastal area classification in India is a challenge for federal and state government agencies due to fragile institutional framework, unclear directions in implementation of costal regulations and violations happening at private and government level. This work is an attempt to improvise the objectivity of existing classification methods to synergies the ecological systems and socioeconomic development in coastal cities. We developed a Geographic information system coupled Multi-criteria Decision Making (GIS-MCDM) approach to classify urban coastal areas where utility functions are used to transform the costal features into quantitative membership values after assessing the sensitivity of urban coastal ecosystem. Furthermore, these membership values for costal features are applied in different weighting schemes to derive Coastal Area Index (CAI) which classifies the coastal areas in four distinct categories viz. 1) No Development Zone, 2) Highly Sensitive Zone, 3) Moderately Sensitive Zone and 4) Low Sensitive Zone based on the sensitivity of urban coastal ecosystem. Mumbai, a coastal megacity in India is used as case study for demonstration of proposed method. Finally, uncertainty analysis using Monte Carlo approach to validate the sensitivity of CAI under specific multiple scenarios is carried out. Results of CAI method shows the clear demarcation of coastal areas in GIS environment based on the ecological sensitivity. CAI provides better decision support for federal and state level agencies to classify urban coastal areas according to the regional requirement of coastal resources considering resilience and sustainable development. CAI method will strengthen the existing institutional framework for decision making in classification of urban coastal areas where most effective coastal management options can be proposed.

Multi-stakeholder perspectives of locally commissioned enhanced optometric services

PubMed Central

Baker, H; Harper, R A; Edgar, D F; Lawrenson, J G

2016-01-01

Objectives To explore views of all stakeholders (patients, optometrists, general practitioners (GPs), commissioners and ophthalmologists) regarding the operation of community-based enhanced optometric services. Design Qualitative study using mixed methods (patient satisfaction surveys, semi-structured telephone interviews and optometrist focus groups). Setting A minor eye conditions scheme (MECS) and glaucoma referral refinement scheme (GRRS) provided by accredited community optometrists. Participants 189 patients, 25 community optometrists, 4 glaucoma specialist hospital optometrists (GRRS), 5 ophthalmologists, 6 GPs (MECS), 4 commissioners. Results Overall, 99% (GRRS) and 100% (MECS) patients were satisfied with their optometrists’ examination. The vast majority rated the following as ‘very good’; examination duration, optometrists’ listening skills, explanations of tests and management, patient involvement in decision-making, treating the patient with care and concern. 99% of MECS patients would recommend the service. Manchester optometrists were enthusiastic about GRRS, feeling fortunate to practise in a ‘pro-optometry’ area. No major negatives were reported, although both schemes were limited to patients resident within certain postcode areas, and some inappropriate GP referrals occurred (MECS). Communication with hospitals was praised in GRRS but was variable, depending on hospital (MECS). Training for both schemes was valuable and appropriate but should be ongoing. MECS GPs were very supportive, reporting the scheme would reduce secondary care referral numbers, although some MECS patients were referred back to GPs for medication. Ophthalmologists (MECS and GRRS) expressed very positive views and widely acknowledged that these new care pathways would reduce unnecessary referrals and shorten patient waiting times. Commissioners felt both schemes met or exceeded expectations in terms of quality of care, allowing patients to be seen quicker and more efficiently. Conclusions Locally commissioned schemes can be a positive experience for all involved. With appropriate training, clear referral pathways and good communication, community optometrists can offer high-quality services that are highly acceptable to patients, health professionals and commissioners. PMID:27798000

Coordination games, anti-coordination games, and imitative learning.

PubMed

McCain, Roger A; Hamilton, Richard

2014-02-01

Bentley et al.'s scheme generates distributions characteristic of situations of high and low social influence on decisions and of high and low salience ("transparency") of rewards. Another element of decisions that may influence the placement of a decision process in their map is the way in which individual decisions interact to determine the payoffs. This commentary discusses the role of Nash equilibria in game theory, focusing especially on coordination and anti-coordination games.

Evaluation of the MindMatters Buddy Support Scheme in Southwest Sydney: Strategies, Achievements and Challenges

ERIC Educational Resources Information Center

Khan, Raquiba J.; Bedford, Karen; Williams, Mandy

2012-01-01

Objective: Assessing the strategies, achievements and challenges of implementing MindMatters and the views of partner schools towards the buddy support scheme. Design: The MindMatters buddy support scheme (2007-2008) was designed to increase the capacity of secondary schools to adopt a whole-school approach to improving health and well-being of…

Perceptions of financial incentives for smoking cessation: a survey of smokers in a country with an endgame goal.

PubMed

Robertson, Lindsay; Gendall, Philip; Hoek, Janet; Marsh, Louise; McGee, Rob

2017-12-15

Financial incentives can support smoking cessation, yet low acceptability may limit the wider implementation of such schemes. Few studies have examined how smokers view financial-incentive interventions aimed at reducing smoking prevalence. We recruited a sample of 623 smokers from an internet panel to a survey assessing support for, and perceived effectiveness of, financial incentives for smoking cessation. We used descriptive statistics, plus logistic regression, to test associations between demographics and smoking, and support. We used qualitative content analysis to analyse open-ended responses to a question that invited respondents to comment on financial incentives. 38.4% of smokers supported financial incentives; 42.2% did not (19.4% had no opinion). Support was higher among heavy (OR 3.96, CI 2.39 - 6.58) and moderate smokers (OR 1.68, CI 1.13 - 2.49), and those with a recent quit attempt (OR 1.47, 1.04 - 2.07). Support was strongly associated with perceived effectiveness. A Government-funded reward-only scheme was seen as the most acceptable option (preferred by 26.6% of participants), followed by a Government-funded deposit-based scheme (20.6%); few respondents supported employer-funded schemes. Open-ended responses (n=301) indicated three overarching themes expressing opposition to financial incentives: smokers' individual responsibility for quitting, concerns about abuse of an incentive scheme, and concerns about unfairness. Even amongst those who would benefit from schemes designed to reward smokers for quitting, support for such schemes is muted, despite evidence of their effectiveness. Media advocacy and health education could be used to increase understanding of, and support for, financial incentives for smoking cessation. Given the absolute effectiveness and cost-effectiveness of financial-incentive schemes for smoking cessation amongst pregnant smokers and in workplaces, implementing such schemes at a national-level could help reduce overall smoking prevalence and contribute to endgame goals. Our study found that similar proportions of smokers supported and opposed financial-incentive schemes, and suggests much of the opposition was underpinned by information gaps, which could be addressed using education and media advocacy. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Time as a Tool for Policy Analysis in Aging.

ERIC Educational Resources Information Center

Pastorello, Thomas

National policy makers have put forth different life cycle planning proposals for the more satisfying integration of education, work and leisure over the life course. This speech describes a decision making scheme, the Time Paradigm, for researched-based choice among various proposals. The scheme is defined in terms of a typology of time-related…

Multi-stage robust scheme for citrus identification from high resolution airborne images

NASA Astrophysics Data System (ADS)

Amorós-López, Julia; Izquierdo Verdiguier, Emma; Gómez-Chova, Luis; Muñoz-Marí, Jordi; Zoilo Rodríguez-Barreiro, Jorge; Camps-Valls, Gustavo; Calpe-Maravilla, Javier

2008-10-01

Identification of land cover types is one of the most critical activities in remote sensing. Nowadays, managing land resources by using remote sensing techniques is becoming a common procedure to speed up the process while reducing costs. However, data analysis procedures should satisfy the accuracy figures demanded by institutions and governments for further administrative actions. This paper presents a methodological scheme to update the citrus Geographical Information Systems (GIS) of the Comunidad Valenciana autonomous region, Spain). The proposed approach introduces a multi-stage automatic scheme to reduce visual photointerpretation and ground validation tasks. First, an object-oriented feature extraction process is carried out for each cadastral parcel from very high spatial resolution (VHR) images (0.5m) acquired in the visible and near infrared. Next, several automatic classifiers (decision trees, multilayer perceptron, and support vector machines) are trained and combined to improve the final accuracy of the results. The proposed strategy fulfills the high accuracy demanded by policy makers by means of combining automatic classification methods with visual photointerpretation available resources. A level of confidence based on the agreement between classifiers allows us an effective management by fixing the quantity of parcels to be reviewed. The proposed methodology can be applied to similar problems and applications.

A critical review on sustainability assessment of recycled water schemes.

PubMed

Chen, Zhuo; Ngo, Huu Hao; Guo, Wenshan

2012-06-01

Recycled water provides a viable opportunity to supplement water supplies as well as alleviate environmental loads. To further expand current schemes and explore new recycled water end uses, this study reviews several environmental assessment tools, including Life Cycle Assessment (LCA), Material Flow Analysis (MFA) and Environmental Risk Assessment (ERA) in terms of their types, characteristics and weaknesses in evaluating the sustainability of recycled water schemes. Due to the limitations in individual models, the integrated approaches are recommended in most cases, of which the outputs could be further combined with additional economic and social assessments in multi-criteria decision making framework. The study also proposes several management strategies in improving the environmental scores. The discussion and suggestions could help decision makers in making a sound judgement as well as recognising the challenges and tasks in the future. Copyright © 2012 Elsevier B.V. All rights reserved.

A novel evaluation method for building construction project based on integrated information entropy with reliability theory.

PubMed

Bai, Xiao-ping; Zhang, Xi-wei

2013-01-01

Selecting construction schemes of the building engineering project is a complex multiobjective optimization decision process, in which many indexes need to be selected to find the optimum scheme. Aiming at this problem, this paper selects cost, progress, quality, and safety as the four first-order evaluation indexes, uses the quantitative method for the cost index, uses integrated qualitative and quantitative methodologies for progress, quality, and safety indexes, and integrates engineering economics, reliability theories, and information entropy theory to present a new evaluation method for building construction project. Combined with a practical case, this paper also presents detailed computing processes and steps, including selecting all order indexes, establishing the index matrix, computing score values of all order indexes, computing the synthesis score, sorting all selected schemes, and making analysis and decision. Presented method can offer valuable references for risk computing of building construction projects.

On-Line Modal State Monitoring of Slowly Time-Varying Structures

NASA Technical Reports Server (NTRS)

Johnson, Erik A.; Bergman, Lawrence A.; Voulgaris, Petros G.

1997-01-01

Monitoring the dynamic response of structures is often performed for a variety of reasons. These reasons include condition-based maintenance, health monitoring, performance improvements, and control. In many cases the data analysis that is performed is part of a repetitive decision-making process, and in these cases the development of effective on-line monitoring schemes help to speed the decision-making process and reduce the risk of erroneous decisions. This report investigates the use of spatial modal filters for tracking the dynamics of slowly time-varying linear structures. The report includes an overview of modal filter theory followed by an overview of several structural system identification methods. Included in this discussion and comparison are H-infinity, eigensystem realization, and several time-domain least squares approaches. Finally, a two-stage adaptive on-line monitoring scheme is developed and evaluated.

Prehospital Trauma Triage Decision-making: A Model of What Happens between the 9-1-1 Call and the Hospital.

PubMed

Jones, Courtney Marie Cora; Cushman, Jeremy T; Lerner, E Brooke; Fisher, Susan G; Seplaki, Christopher L; Veazie, Peter J; Wasserman, Erin B; Dozier, Ann; Shah, Manish N

2016-01-01

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated in the prehospital setting; 2) field triage criteria are applied in-practice; and 3) selection of a destination hospital is determined. We conducted separate focus groups with advanced and basic life support providers from rural and urban/suburban regions. Four exploratory focus groups were conducted to identify overarching themes and five additional confirmatory focus groups were conducted to verify initial focus group findings and provide additional detail regarding trauma triage decision-making and application of field triage criteria. All focus groups were conducted by a public health researcher with formal training in qualitative research. A standardized question guide was used to facilitate discussion at all focus groups. All focus groups were audio-recorded and transcribed. Responses were coded and categorized into larger domains to describe how EMS providers approach trauma triage and apply the Field Triage Decision Scheme. We conducted 9 focus groups with 50 EMS providers. Participants highlighted that trauma triage is complex and there is often limited time to make destination decisions. Four overarching domains were identified within the context of trauma triage decision-making: 1) initial assessment; 2) importance of speed versus accuracy; 3) usability of current field triage criteria; and 4) consideration of patient and emergency care system-level factors. Field triage is a complex decision-making process which involves consideration of many patient and system-level factors. The decision model presented in this study suggests that EMS providers place significant emphasis on speed of decisions, relying on initial impressions and immediately observable information, rather than precise measurement of vital signs or systematic application of field triage criteria.

Personalization, Self-Advocacy and Inclusion: An Evaluation of Parent-Initiated Supported Living Schemes for People with Intellectual and Developmental Disabilities in the Netherlands

ERIC Educational Resources Information Center

Reindl, Marie-Sol; Waltz, Mitzi; Schippers, Alice

2016-01-01

This study focused on parent-initiated supported living schemes in the South of the Netherlands and the ability of these living schemes to enhance participation, choice, autonomy and self-advocacy for people with intellectual or developmental disabilities through personalized planning, support and care. Based on in-depth interviews with tenants,…

Understanding latent structures of clinical information logistics: A bottom-up approach for model building and validating the workflow composite score.

PubMed

Esdar, Moritz; Hübner, Ursula; Liebe, Jan-David; Hüsers, Jens; Thye, Johannes

2017-01-01

Clinical information logistics is a construct that aims to describe and explain various phenomena of information provision to drive clinical processes. It can be measured by the workflow composite score, an aggregated indicator of the degree of IT support in clinical processes. This study primarily aimed to investigate the yet unknown empirical patterns constituting this construct. The second goal was to derive a data-driven weighting scheme for the constituents of the workflow composite score and to contrast this scheme with a literature based, top-down procedure. This approach should finally test the validity and robustness of the workflow composite score. Based on secondary data from 183 German hospitals, a tiered factor analytic approach (confirmatory and subsequent exploratory factor analysis) was pursued. A weighting scheme, which was based on factor loadings obtained in the analyses, was put into practice. We were able to identify five statistically significant factors of clinical information logistics that accounted for 63% of the overall variance. These factors were "flow of data and information", "mobility", "clinical decision support and patient safety", "electronic patient record" and "integration and distribution". The system of weights derived from the factor loadings resulted in values for the workflow composite score that differed only slightly from the score values that had been previously published based on a top-down approach. Our findings give insight into the internal composition of clinical information logistics both in terms of factors and weights. They also allowed us to propose a coherent model of clinical information logistics from a technical perspective that joins empirical findings with theoretical knowledge. Despite the new scheme of weights applied to the calculation of the workflow composite score, the score behaved robustly, which is yet another hint of its validity and therefore its usefulness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[GIS and scenario analysis aid to water pollution control planning of river basin].

PubMed

Wang, Shao-ping; Cheng, Sheng-tong; Jia, Hai-feng; Ou, Zhi-dan; Tan, Bin

2004-07-01

The forward and backward algorithms for watershed water pollution control planning were summarized in this paper as well as their advantages and shortages. The spatial databases of water environmental function region, pollution sources, monitoring sections and sewer outlets were built with ARCGIS8.1 as the platform in the case study of Ganjiang valley, Jiangxi province. Based on the principles of the forward algorithm, four scenarios were designed for the watershed pollution control. Under these scenarios, ten sets of planning schemes were generated to implement cascade pollution source control. The investment costs of sewage treatment for these schemes were estimated by means of a series of cost-effective functions; with pollution source prediction, the water quality was modeled with CSTR model for each planning scheme. The modeled results of different planning schemes were visualized through GIS to aid decision-making. With the results of investment cost and water quality attainment as decision-making accords and based on the analysis of the economic endurable capacity for water pollution control in Ganjiang river basin, two optimized schemes were proposed. The research shows that GIS technology and scenario analysis can provide a good guidance to the synthesis, integrity and sustainability aspects for river basin water quality planning.

Promoting universal financial protection: how the Thai universal coverage scheme was designed to ensure equity.

PubMed

Tangcharoensathien, Viroj; Pitayarangsarit, Siriwan; Patcharanarumol, Walaiporn; Prakongsai, Phusit; Sumalee, Hathaichanok; Tosanguan, Jiraboon; Mills, Anne

2013-08-06

Empirical evidence demonstrates that the Thai Universal Coverage Scheme (UCS) has improved equity of health financing and provided a relatively high level of financial risk protection. Several UCS design features contribute to these outcomes: a tax-financed scheme, a comprehensive benefit package and gradual extension of coverage to illnesses that can lead to catastrophic household costs, and capacity of the National Health Security Office (NHSO) to mobilise adequate resources. This study assesses the policy processes related to making decisions on these features. The study employs qualitative methods including reviews of relevant documents, in-depth interviews of 25 key informants, and triangulation amongst information sources. Continued political and financial commitments to the UCS, despite political rivalry, played a key role. The Thai Rak Thai (TRT)-led coalition government introduced UCS; staying in power 8 of the 11 years between 2001 and 2011 was long enough to nurture and strengthen the UCS and overcome resistance from various opponents. Prime Minister Surayud's government, replacing the ousted TRT government, introduced universal renal replacement therapy, which deepened financial risk protection.Commitment to their manifesto and fiscal capacity pushed the TRT to adopt a general tax-financed universal scheme; collecting premiums from people engaged in the informal sector was neither politically palatable nor technically feasible. The relatively stable tenure of NHSO Secretary Generals and the chairs of the Financing and the Benefit Package subcommittees provided a platform for continued deepening of financial risk protection. NHSO exerted monopsonistic purchasing power to control prices, resulting in greater patient access and better systems efficiency than might have been the case with a different design.The approach of proposing an annual per capita budget changed the conventional line-item programme budgeting system by basing negotiations between the Bureau of Budget, the NHSO and other stakeholders on evidence of service utilization and unit costs. Future success of Thai UCS requires coverage of effective interventions that address primary and secondary prevention of non-communicable diseases and long-term care policies in view of epidemiologic and demographic transitions. Lessons for other countries include the importance of continued political support, evidence informed decisions, and a capable purchaser organization.

An ex-ante economic evaluation of the Maternal and Child Health Voucher Scheme as a decision-making tool in Myanmar

PubMed Central

Kingkaew, Pritaporn; Werayingyong, Pitsaphun; Aye, San San; Tin, Nilar; Singh, Alaka; Myint, Phone; Teerawattananon, Yot

2016-01-01

Reducing child and maternal mortality in order to meet the health-related Millennium Development Goals (MDGs) 4 and 5 remains a major challenge in Myanmar. Inadequate care during pregnancy and labour plays an important role in the maternal mortality rate in Myanmar. A Maternal and Child Health (MCH) Voucher Scheme comprising a subsidization for pregnant women to receive four antenatal care (ANC), delivery and postnatal care (PNC) free-of-charge was planned to help women overcome financial barriers in addition to raising awareness of ANC and delivery with skilled birth attendants (SBA), which can reduce the rate of maternal and neonatal death. This study is part of an ex-ante evaluation of a feasibility study of the MCH Voucher Scheme. A cost-utility analysis was conducted using a decision tree model to assess the cost per disability-adjusted life years (DALYs) averted from the MCH Voucher Scheme compared with the current situation. Most input parameters were obtained from Myanmar context. From the base-case analysis, where the financial burden on households was fully subsidized, the MCH Voucher Scheme increased utilization for ANC from 73% up to 93% and for delivery from SBAs from 51% up to and 71%, respectively; hence, it is considered to be very cost-effective with an incremental cost-effectiveness ratio of 381 027 kyats per DALY averted (2010, price year). From the probabilistic sensitivity analysis, the MCH Voucher Scheme had a 52% chance of being a cost-effective option at 1 GDP per capita threshold compared to the current situation. Given that the Voucher Scheme is currently being implemented in one township in Myanmar as a result of this study, ongoing evaluation of the effectiveness and cost-effectiveness of this scheme is warranted. PMID:26412858

MIMO transmit scheme based on morphological perceptron with competitive learning.

PubMed

Valente, Raul Ambrozio; Abrão, Taufik

2016-08-01

This paper proposes a new multi-input multi-output (MIMO) transmit scheme aided by artificial neural network (ANN). The morphological perceptron with competitive learning (MP/CL) concept is deployed as a decision rule in the MIMO detection stage. The proposed MIMO transmission scheme is able to achieve double spectral efficiency; hence, in each time-slot the receiver decodes two symbols at a time instead one as Alamouti scheme. Other advantage of the proposed transmit scheme with MP/CL-aided detector is its polynomial complexity according to modulation order, while it becomes linear when the data stream length is greater than modulation order. The performance of the proposed scheme is compared to the traditional MIMO schemes, namely Alamouti scheme and maximum-likelihood MIMO (ML-MIMO) detector. Also, the proposed scheme is evaluated in a scenario with variable channel information along the frame. Numerical results have shown that the diversity gain under space-time coding Alamouti scheme is partially lost, which slightly reduces the bit-error rate (BER) performance of the proposed MP/CL-NN MIMO scheme. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automatic Scoring of Multiple Semantic Attributes With Multi-Task Feature Leverage: A Study on Pulmonary Nodules in CT Images.

PubMed

Sihong Chen; Jing Qin; Xing Ji; Baiying Lei; Tianfu Wang; Dong Ni; Jie-Zhi Cheng

2017-03-01

The gap between the computational and semantic features is the one of major factors that bottlenecks the computer-aided diagnosis (CAD) performance from clinical usage. To bridge this gap, we exploit three multi-task learning (MTL) schemes to leverage heterogeneous computational features derived from deep learning models of stacked denoising autoencoder (SDAE) and convolutional neural network (CNN), as well as hand-crafted Haar-like and HoG features, for the description of 9 semantic features for lung nodules in CT images. We regard that there may exist relations among the semantic features of "spiculation", "texture", "margin", etc., that can be explored with the MTL. The Lung Image Database Consortium (LIDC) data is adopted in this study for the rich annotation resources. The LIDC nodules were quantitatively scored w.r.t. 9 semantic features from 12 radiologists of several institutes in U.S.A. By treating each semantic feature as an individual task, the MTL schemes select and map the heterogeneous computational features toward the radiologists' ratings with cross validation evaluation schemes on the randomly selected 2400 nodules from the LIDC dataset. The experimental results suggest that the predicted semantic scores from the three MTL schemes are closer to the radiologists' ratings than the scores from single-task LASSO and elastic net regression methods. The proposed semantic attribute scoring scheme may provide richer quantitative assessments of nodules for better support of diagnostic decision and management. Meanwhile, the capability of the automatic association of medical image contents with the clinical semantic terms by our method may also assist the development of medical search engine.

A decision support system for automatic sleep staging from EEG signals using tunable Q-factor wavelet transform and spectral features.

PubMed

Hassan, Ahnaf Rashik; Bhuiyan, Mohammed Imamul Hassan

2016-09-15

Automatic sleep scoring is essential owing to the fact that conventionally a large volume of data have to be analyzed visually by the physicians which is onerous, time-consuming and error-prone. Therefore, there is a dire need of an automated sleep staging scheme. In this work, we decompose sleep-EEG signal segments using tunable-Q factor wavelet transform (TQWT). Various spectral features are then computed from TQWT sub-bands. The performance of spectral features in the TQWT domain has been determined by intuitive and graphical analyses, statistical validation, and Fisher criteria. Random forest is used to perform classification. Optimal choices and the effects of TQWT and random forest parameters have been determined and expounded. Experimental outcomes manifest the efficacy of our feature generation scheme in terms of p-values of ANOVA analysis and Fisher criteria. The proposed scheme yields 90.38%, 91.50%, 92.11%, 94.80%, 97.50% for 6-stage to 2-stage classification of sleep states on the benchmark Sleep-EDF data-set. In addition, its performance on DREAMS Subjects Data-set is also promising. The performance of the proposed method is significantly better than the existing ones in terms of accuracy and Cohen's kappa coefficient. Additionally, the proposed scheme gives high detection accuracy for sleep stages non-REM 1 and REM. Spectral features in the TQWT domain can discriminate sleep-EEG signals corresponding to various sleep states efficaciously. The proposed scheme will alleviate the burden of the physicians, speed-up sleep disorder diagnosis, and expedite sleep research. Copyright © 2016 Elsevier B.V. All rights reserved.

Stroke prevention with oral anticoagulation in older people with atrial fibrillation - a pragmatic approach.

PubMed

Ali, Ali; Bailey, Claire; Abdelhafiz, Ahmed H

2012-08-01

With advancing age, the prevalence of both stroke and non valvular atrial fibrillation (NVAF) is increasing. NVAF in old age has a high embolic potential if not anticoagulated. Oral anticoagulation therapy is cost effective in older people with NVAF due to their high base line stroke risk. The current stroke and bleeding risk scoring schemes have been based on complex scoring systems that are difficult to apply in clinical practice. Both scoring schemes include similar risk factors for ischemic and bleeding events which may lead to confusion in clinical decision making to balance the risks of bleeding against the risks of stroke, thereby limiting the applicability of such schemes. The difficulty in application of such schemes combined with physicians' fear of inducing bleeding complications has resulted in under use of anticoagulation therapy in older people. As older people (≥75 years) with NVAF are all at high risk of stroke, we are suggesting a pragmatic approach based on a yes/no decision rather than a risk scoring stratification which involves an opt out rather an opt in approach unless there is a contraindication for oral anticoagulation. Antiplatelet agents should not be an alternative option for antithrombotic treatment in older people with NVAF due to lack of efficacy and the potential of being used as an excuse of not prescribing anticoagulation. Bleeding risk should be assessed on individual basis and the decision to anticoagulate should include patients' views.

Stroke Prevention with Oral Anticoagulation in Older People with Atrial Fibrillation - A Pragmatic Approach

PubMed Central

Ali, Ali; Bailey, Claire; Abdelhafiz, Ahmed H

2012-01-01

With advancing age, the prevalence of both stroke and non valvular atrial fibrillation (NVAF) is increasing. NVAF in old age has a high embolic potential if not anticoagulated. Oral anticoagulation therapy is cost effective in older people with NVAF due to their high base line stroke risk. The current stroke and bleeding risk scoring schemes have been based on complex scoring systems that are difficult to apply in clinical practice. Both scoring schemes include similar risk factors for ischemic and bleeding events which may lead to confusion in clinical decision making to balance the risks of bleeding against the risks of stroke, thereby limiting the applicability of such schemes. The difficulty in application of such schemes combined with physicians’ fear of inducing bleeding complications has resulted in under use of anticoagulation therapy in older people. As older people (≥75 years) with NVAF are all at high risk of stroke, we are suggesting a pragmatic approach based on a yes/no decision rather than a risk scoring stratification which involves an opt out rather an opt in approach unless there is a contraindication for oral anticoagulation. Antiplatelet agents should not be an alternative option for antithrombotic treatment in older people with NVAF due to lack of efficacy and the potential of being used as an excuse of not prescribing anticoagulation. Bleeding risk should be assessed on individual basis and the decision to anticoagulate should include patients’ views. PMID:23185715

Decision-Related Activity in Macaque V2 for Fine Disparity Discrimination Is Not Compatible with Optimal Linear Readout

PubMed Central

Clery, Stephane; Cumming, Bruce G.

2017-01-01

Fine judgments of stereoscopic depth rely mainly on relative judgments of depth (relative binocular disparity) between objects, rather than judgments of the distance to where the eyes are fixating (absolute disparity). In macaques, visual area V2 is the earliest site in the visual processing hierarchy for which neurons selective for relative disparity have been observed (Thomas et al., 2002). Here, we found that, in macaques trained to perform a fine disparity discrimination task, disparity-selective neurons in V2 were highly selective for the task, and their activity correlated with the animals' perceptual decisions (unexplained by the stimulus). This may partially explain similar correlations reported in downstream areas. Although compatible with a perceptual role of these neurons for the task, the interpretation of such decision-related activity is complicated by the effects of interneuronal “noise” correlations between sensory neurons. Recent work has developed simple predictions to differentiate decoding schemes (Pitkow et al., 2015) without needing measures of noise correlations, and found that data from early sensory areas were compatible with optimal linear readout of populations with information-limiting correlations. In contrast, our data here deviated significantly from these predictions. We additionally tested this prediction for previously reported results of decision-related activity in V2 for a related task, coarse disparity discrimination (Nienborg and Cumming, 2006), thought to rely on absolute disparity. Although these data followed the predicted pattern, they violated the prediction quantitatively. This suggests that optimal linear decoding of sensory signals is not generally a good predictor of behavior in simple perceptual tasks. SIGNIFICANCE STATEMENT Activity in sensory neurons that correlates with an animal's decision is widely believed to provide insights into how the brain uses information from sensory neurons. Recent theoretical work developed simple predictions to differentiate decoding schemes, and found support for optimal linear readout of early sensory populations with information-limiting correlations. Here, we observed decision-related activity for neurons in visual area V2 of macaques performing fine disparity discrimination, as yet the earliest site for this task. These findings, and previously reported results from V2 in a different task, deviated from the predictions for optimal linear readout of a population with information-limiting correlations. Our results suggest that optimal linear decoding of early sensory information is not a general decoding strategy used by the brain. PMID:28100751

Priority setting for government investment in forestry conservation schemes-an example from New Zealand

Treesearch

Colin L. O' Loughlin

1991-01-01

In New Zealand responsibility for funding flood protection and erosion prevention and control projects rests largely with local regional authorities. However, in 1988 Central Government decided to provide direct funding for a major forestry conservation scheme in the erosion-susceptible East Coast region. Government's investment decision was influenced by a number...

Peer counsellors' views on the collegial support scheme for doctors.

PubMed

Rø, Karin Isaksson; Aasland, Olaf Gjerløw

2016-02-23

The health condition and health-related behaviour of doctors are important to the doctors themselves as well as for their treatment of patients. The collegial support scheme is a county-based and easily accessible health and care service for doctors. We therefore wanted to describe the framework and functions of this scheme and examine its utility. Fourteen focus-group interviews with a total of 61 peer counsellors from all the counties were conducted. The interviews were recorded, transcribed and analysed with the aid of systematic text condensation. The framework--easy accessibility, a readily available offer of up to three sessions, a high degree of confidentiality and informal contact--was emphasised as crucial for doctors to make use of the scheme. The peer counsellors described their role as that of a listener and supportive helper. They helped bring clarity and discuss possible needs for further follow-up or treatment of numerous different and frequently complex issues. The peer counsellors highlighted three benefits in particular: the scheme helps raise awareness by legitimising help-seeking behaviour among doctors, it is a contingency scheme, and it eases the burden by lowering the threshold to seeking out further advice and treatment. A systematic evaluation of the collegial support scheme is important for an understanding of the totality of the collegial health and care services. The collegial support scheme may lower the threshold to seeking help, and encourage some doctors to seek necessary treatment.

Personalization, self-advocacy and inclusion: An evaluation of parent-initiated supported living schemes for people with intellectual and developmental disabilities in the Netherlands.

PubMed

Reindl, Marie-Sol; Waltz, Mitzi; Schippers, Alice

2016-06-01

This study focused on parent-initiated supported living schemes in the South of the Netherlands and the ability of these living schemes to enhance participation, choice, autonomy and self-advocacy for people with intellectual or developmental disabilities through personalized planning, support and care. Based on in-depth interviews with tenants, parents and caregivers, findings included that parent-initiated supported housing schemes made steps towards stimulating self-advocacy and autonomy for tenants. However, overprotective and paternalistic attitudes expressed by a significant number of parents, as well as structural constraints affecting the living schemes, created obstacles to tenants' personal development. The study calls for consideration of interdependence as a model for the relationship of parents and adult offspring with disabilities. The benefits and tensions inherent within this relationship must be taken into consideration during inclusive community building. © The Author(s) 2016.

Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

PubMed Central

Xiong, Linping; Zhang, Lulu; Tang, Weidong; Ma, Yuqin

2012-01-01

China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China's medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme. PMID:22481973

Is the Door in the Invisible Wall Closing?

ERIC Educational Resources Information Center

Windsor, Duane; Greanias, George

Several Supreme Court decisions in the 1970s have rejected constitutional arguments aimed at eliminating exclusionary zoning and growth management schemes which allegedly maintain existing problems of racial and income segregation in major metropolitan areas. These decisions have led observers to conclude that the Supreme Court has greatly…

Scenario analysis of carbon emissions' anti-driving effect on Qingdao's energy structure adjustment with an optimization model, Part II: Energy system planning and management.

PubMed

Wu, C B; Huang, G H; Liu, Z P; Zhen, J L; Yin, J G

2017-03-01

In this study, an inexact multistage stochastic mixed-integer programming (IMSMP) method was developed for supporting regional-scale energy system planning (EPS) associated with multiple uncertainties presented as discrete intervals, probability distributions and their combinations. An IMSMP-based energy system planning (IMSMP-ESP) model was formulated for Qingdao to demonstrate its applicability. Solutions which can provide optimal patterns of energy resources generation, conversion, transmission, allocation and facility capacity expansion schemes have been obtained. The results can help local decision makers generate cost-effective energy system management schemes and gain a comprehensive tradeoff between economic objectives and environmental requirements. Moreover, taking the CO 2 emissions scenarios mentioned in Part I into consideration, the anti-driving effect of carbon emissions on energy structure adjustment was studied based on the developed model and scenario analysis. Several suggestions can be concluded from the results: (a) to ensure the smooth realization of low-carbon and sustainable development, appropriate price control and fiscal subsidy on high-cost energy resources should be considered by the decision-makers; (b) compared with coal, natural gas utilization should be strongly encouraged in order to insure that Qingdao could reach the carbon discharges peak value in 2020; (c) to guarantee Qingdao's power supply security in the future, the construction of new power plants should be emphasised instead of enhancing the transmission capacity of grid infrastructure. Copyright © 2016 Elsevier Ltd. All rights reserved.

TAXONOMY OF MEDICAL DEVICES IN THE LOGIC OF HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Henschke, Cornelia; Panteli, Dimitra; Perleth, Matthias; Busse, Reinhard

2015-01-01

The suitability of general HTA methodology for medical devices is gaining interest as a topic of scientific discourse. Given the broad range of medical devices, there might be differences between groups of devices that impact both the necessity and the methods of their assessment. Our aim is to develop a taxonomy that provides researchers and policy makers with an orientation tool on how to approach the assessment of different types of medical devices. Several classifications for medical devices based on varying rationales for different regulatory and reporting purposes were analyzed in detail to develop a comprehensive taxonomic model. The taxonomy is based on relevant aspects of existing classification schemes incorporating elements of risk and functionality. Its 9 × 6 matrix distinguishes between the diagnostic or therapeutic nature of devices and considers whether the medical device is directly used by patients, constitutes part of a specific procedure, or can be used for a variety of procedures. We considered the relevance of different device categories in regard to HTA to be considerably variable, ranging from high to low. Existing medical device classifications cannot be used for HTA as they are based on different underlying logics. The developed taxonomy combines different device classification schemes used for different purposes. It aims at providing decision makers with a tool enabling them to consider device characteristics in detail across more than one dimension. The placement of device groups in the matrix can provide decision support on the necessity of conducting a full HTA.

Double dissociation of value computations in orbitofrontal and anterior cingulate neurons

PubMed Central

Kennerley, Steven W.; Behrens, Timothy E. J.; Wallis, Jonathan D.

2011-01-01

Damage to prefrontal cortex (PFC) impairs decision-making, but the underlying value computations that might cause such impairments remain unclear. Here we report that value computations are doubly dissociable within PFC neurons. While many PFC neurons encoded chosen value, they used opponent encoding schemes such that averaging the neuronal population eliminated value coding. However, a special population of neurons in anterior cingulate cortex (ACC) - but not orbitofrontal cortex (OFC) - multiplex chosen value across decision parameters using a unified encoding scheme, and encoded reward prediction errors. In contrast, neurons in OFC - but not ACC - encoded chosen value relative to the recent history of choice values. Together, these results suggest complementary valuation processes across PFC areas: OFC neurons dynamically evaluate current choices relative to recent choice values, while ACC neurons encode choice predictions and prediction errors using a common valuation currency reflecting the integration of multiple decision parameters. PMID:22037498

Data Mining and Complex Problems: Case Study in Composite Materials

NASA Technical Reports Server (NTRS)

Rabelo, Luis; Marin, Mario

2009-01-01

Data mining is defined as the discovery of useful, possibly unexpected, patterns and relationships in data using statistical and non-statistical techniques in order to develop schemes for decision and policy making. Data mining can be used to discover the sources and causes of problems in complex systems. In addition, data mining can support simulation strategies by finding the different constants and parameters to be used in the development of simulation models. This paper introduces a framework for data mining and its application to complex problems. To further explain some of the concepts outlined in this paper, the potential application to the NASA Shuttle Reinforced Carbon-Carbon structures and genetic programming is used as an illustration.

Giving advice on cost effective measures for a cleaner Baltic Sea: a challenge for science.

PubMed

Wulff, F; Bonsdorff, E; Gren, I M; Johansson, S; Stigebrandt, A

2001-08-01

The Baltic Sea is one of the world's seas that is most severely affected by human activities. Although there is an international agreement that nutrient input to the Baltic should be reduced, the measures taken so far have not resulted in major reductions in nutrient inputs nor in environmental improvements. The reasons for this are partly due to lack of knowledge on large-scale relationships and couplings between physics, biogeochemistry and ecological properties. But there is also a lack of overall drainage basin-wide analyses on cost-effective measures. There is a danger in making the wrong decisions, e.g. implement reduction schemes that are at worst ineffective or at best, far from cost effective. Researchers from many disciplines are faced with a common challenge: To develop a decision-support system, which can be used as the scientific base for cost-effective measures for the entire Baltic Sea. Such an effort is now being made within the research program MARE (http://www.mare.su.se).

Formal and informal decision making on water management at the village level: A case study from the Office du Niger irrigation scheme (Mali)

NASA Astrophysics Data System (ADS)

Vandersypen, Klaartje; Keita, Abdoulaye C. T.; Coulibaly, Y.; Raes, D.; Jamin, J.-Y.

2007-06-01

Water Users Associations (WUAs) are all too often considered a panacea for improving water management in irrigation schemes. Where grassroots movements are absent, they are usually imposed on farmers by national governments, NGOs, and international donors, without fully considering existing forms of organization. This also happened in the Office du Niger irrigation scheme in Mali, where after a partial irrigation management transfer, WUAs were created to fill the resulting power vacuum. This paper demonstrates that, despite active efforts to organize farmers in WUAs, informal patterns of decision making remain dominant. Given the shortcomings of these informal patterns, WUAs could provide a much-needed platform for institutionalizing collective action, on the condition that farmers accept them. Therefore WUAs should adopt some crucial characteristics of informal patterns of decision making while avoiding their weaknesses. First, making use of the existing authority of village leadership and the central management can improve the credibility of WUAs. Second, allowing flexibility in procedures and rules can make them more appropriate for dealing with collective action problems that are typically temporary and specific. Last, formalizing the current pattern of conflict management and sanctioning might enhance its sphere of action and tackle the current absence of firm engagement with respect to some informal management decisions. In addition, WUAs should represent and be accountable to all farmers, including those residing outside the village community.

Fast Track Teacher Education: A Review of the Research Literature on "Teach For All" Schemes

ERIC Educational Resources Information Center

McConney, Andrew; Price, Anne; Woods-McConney, Amanda

2012-01-01

This review of the research literature was commissioned by the New Zealand Post-Primary Teachers Association (PPTA) Te Wehengarua as a means of informing the decision-making of the Association and its members about the Teach For All (TFA) scheme seeking to prepare teachers for New Zealand's schools. The systematic review is about fast track…

An Effective and Robust Decentralized Target Tracking Scheme in Wireless Camera Sensor Networks.

PubMed

Fu, Pengcheng; Cheng, Yongbo; Tang, Hongying; Li, Baoqing; Pei, Jun; Yuan, Xiaobing

2017-03-20

In this paper, we propose an effective and robust decentralized tracking scheme based on the square root cubature information filter (SRCIF) to balance the energy consumption and tracking accuracy in wireless camera sensor networks (WCNs). More specifically, regarding the characteristics and constraints of camera nodes in WCNs, some special mechanisms are put forward and integrated in this tracking scheme. First, a decentralized tracking approach is adopted so that the tracking can be implemented energy-efficiently and steadily. Subsequently, task cluster nodes are dynamically selected by adopting a greedy on-line decision approach based on the defined contribution decision (CD) considering the limited energy of camera nodes. Additionally, we design an efficient cluster head (CH) selection mechanism that casts such selection problem as an optimization problem based on the remaining energy and distance-to-target. Finally, we also perform analysis on the target detection probability when selecting the task cluster nodes and their CH, owing to the directional sensing and observation limitations in field of view (FOV) of camera nodes in WCNs. From simulation results, the proposed tracking scheme shows an obvious improvement in balancing the energy consumption and tracking accuracy over the existing methods.

An Effective and Robust Decentralized Target Tracking Scheme in Wireless Camera Sensor Networks

PubMed Central

Fu, Pengcheng; Cheng, Yongbo; Tang, Hongying; Li, Baoqing; Pei, Jun; Yuan, Xiaobing

2017-01-01

In this paper, we propose an effective and robust decentralized tracking scheme based on the square root cubature information filter (SRCIF) to balance the energy consumption and tracking accuracy in wireless camera sensor networks (WCNs). More specifically, regarding the characteristics and constraints of camera nodes in WCNs, some special mechanisms are put forward and integrated in this tracking scheme. First, a decentralized tracking approach is adopted so that the tracking can be implemented energy-efficiently and steadily. Subsequently, task cluster nodes are dynamically selected by adopting a greedy on-line decision approach based on the defined contribution decision (CD) considering the limited energy of camera nodes. Additionally, we design an efficient cluster head (CH) selection mechanism that casts such selection problem as an optimization problem based on the remaining energy and distance-to-target. Finally, we also perform analysis on the target detection probability when selecting the task cluster nodes and their CH, owing to the directional sensing and observation limitations in field of view (FOV) of camera nodes in WCNs. From simulation results, the proposed tracking scheme shows an obvious improvement in balancing the energy consumption and tracking accuracy over the existing methods. PMID:28335537

A soft-hard combination-based cooperative spectrum sensing scheme for cognitive radio networks.

PubMed

Do, Nhu Tri; An, Beongku

2015-02-13

In this paper we propose a soft-hard combination scheme, called SHC scheme, for cooperative spectrum sensing in cognitive radio networks. The SHC scheme deploys a cluster based network in which Likelihood Ratio Test (LRT)-based soft combination is applied at each cluster, and weighted decision fusion rule-based hard combination is utilized at the fusion center. The novelties of the SHC scheme are as follows: the structure of the SHC scheme reduces the complexity of cooperative detection which is an inherent limitation of soft combination schemes. By using the LRT, we can detect primary signals in a low signal-to-noise ratio regime (around an average of -15 dB). In addition, the computational complexity of the LRT is reduced since we derive the closed-form expression of the probability density function of LRT value. The SHC scheme also takes into account the different effects of large scale fading on different users in the wide area network. The simulation results show that the SHC scheme not only provides the better sensing performance compared to the conventional hard combination schemes, but also reduces sensing overhead in terms of reporting time compared to the conventional soft combination scheme using the LRT.

Sensor data monitoring and decision level fusion scheme for early fire detection

NASA Astrophysics Data System (ADS)

Rizogiannis, Constantinos; Thanos, Konstantinos Georgios; Astyakopoulos, Alkiviadis; Kyriazanos, Dimitris M.; Thomopoulos, Stelios C. A.

2017-05-01

The aim of this paper is to present the sensor monitoring and decision level fusion scheme for early fire detection which has been developed in the context of the AF3 Advanced Forest Fire Fighting European FP7 research project, adopted specifically in the OCULUS-Fire control and command system and tested during a firefighting field test in Greece with prescribed real fire, generating early-warning detection alerts and notifications. For this purpose and in order to improve the reliability of the fire detection system, a two-level fusion scheme is developed exploiting a variety of observation solutions from air e.g. UAV infrared cameras, ground e.g. meteorological and atmospheric sensors and ancillary sources e.g. public information channels, citizens smartphone applications and social media. In the first level, a change point detection technique is applied to detect changes in the mean value of each measured parameter by the ground sensors such as temperature, humidity and CO2 and then the Rate-of-Rise of each changed parameter is calculated. In the second level the fire event Basic Probability Assignment (BPA) function is determined for each ground sensor using Fuzzy-logic theory and then the corresponding mass values are combined in a decision level fusion process using Evidential Reasoning theory to estimate the final fire event probability.

An Optimized Handover Scheme with Movement Trend Awareness for Body Sensor Networks

PubMed Central

Sun, Wen; Zhang, Zhiqiang; Ji, Lianying; Wong, Wai-Choong

2013-01-01

When a body sensor network (BSN) that is linked to the backbone via a wireless network interface moves from one coverage zone to another, a handover is required to maintain network connectivity. This paper presents an optimized handover scheme with movement trend awareness for BSNs. The proposed scheme predicts the future position of a BSN user using the movement trend extracted from the historical position, and adjusts the handover decision accordingly. Handover initiation time is optimized when the unnecessary handover rate is estimated to meet the requirement and the outage probability is minimized. The proposed handover scheme is simulated in a BSN deployment area in a hospital environment in UK. Simulation results show that the proposed scheme reduces the outage probability by 22% as compared with the existing hysteresis-based handover scheme under the constraint of acceptable handover rate. PMID:23736852

Learning from peer support schemes--can prison listeners support offenders who self-injure in custody?

PubMed

Griffiths, Louise; Bailey, Di

2015-01-01

The purpose of this paper is to critically evaluate the current evidence for peer support in prisons, in particular its contribution to working with prisoners who self-injure and the extent to which the success of peer support schemes such as the prison listeners, hinges upon staff's willingness to engage with the initiative. The review was constructed by using primary and secondary terms to search the literature. The studies focused on peer support in custody with reference to mental health and self-injury. Searches identified papers on the prison listener scheme and staff perspectives on prison peer support, as these formed a central focus of the review. Studies were excluded from the review if the participants' behaviours was explicitly linked to suicidal intent, as the review focused on self-injury as a coping strategy. A total of 24 studies were selected according to specific inclusion criteria (six were grey literature, 18 academic literature). Of the 24 studies ten studies focused on peer support and self-injury. Of the 24 studies the listener scheme was the focus of 16 studies, of these 16 studies self-injury and the listener scheme was a focus of eight studies. Evidence from the review suggests that prison peer support could be considered on a continuum depending on the different degrees of peer involvement.

Determining the Impact of Personal Mobility Carbon Allowance Schemes in Transportation Networks

DOE PAGES

Aziz, H. M. Abdul; Ukkusuri, Satish V.; Zhan, Xianyuan

2016-10-17

We know that personal mobility carbon allowance (PMCA) schemes are designed to reduce carbon consumption from transportation networks. PMCA schemes influence the travel decision process of users and accordingly impact the system metrics including travel time and greenhouse gas (GHG) emissions. Here, we develop a multi-user class dynamic user equilibrium model to evaluate the transportation system performance when PMCA scheme is implemented. The results using Sioux-Falls test network indicate that PMCA schemes can achieve the emissions reduction goals for transportation networks. Further, users characterized by high value of travel time are found to be less sensitive to carbon budget inmore » the context of work trips. Results also show that PMCA scheme can lead to higher emissions for a path compared with the case without PMCA because of flow redistribution. The developed network equilibrium model allows us to examine the change in system states at different carbon allocation levels and to design parameters of PMCA schemes accounting for population heterogeneity.« less

Determining the Impact of Personal Mobility Carbon Allowance Schemes in Transportation Networks

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

Aziz, H. M. Abdul; Ukkusuri, Satish V.; Zhan, Xianyuan

We know that personal mobility carbon allowance (PMCA) schemes are designed to reduce carbon consumption from transportation networks. PMCA schemes influence the travel decision process of users and accordingly impact the system metrics including travel time and greenhouse gas (GHG) emissions. Here, we develop a multi-user class dynamic user equilibrium model to evaluate the transportation system performance when PMCA scheme is implemented. The results using Sioux-Falls test network indicate that PMCA schemes can achieve the emissions reduction goals for transportation networks. Further, users characterized by high value of travel time are found to be less sensitive to carbon budget inmore » the context of work trips. Results also show that PMCA scheme can lead to higher emissions for a path compared with the case without PMCA because of flow redistribution. The developed network equilibrium model allows us to examine the change in system states at different carbon allocation levels and to design parameters of PMCA schemes accounting for population heterogeneity.« less

Updating beliefs and combining evidence in adaptive forest management under climate change: a case study of Norway spruce (Picea abies L. Karst) in the Black Forest, Germany.

PubMed

Yousefpour, Rasoul; Temperli, Christian; Bugmann, Harald; Elkin, Che; Hanewinkel, Marc; Meilby, Henrik; Jacobsen, Jette Bredahl; Thorsen, Bo Jellesmark

2013-06-15

We study climate uncertainty and how managers' beliefs about climate change develop and influence their decisions. We develop an approach for updating knowledge and beliefs based on the observation of forest and climate variables and illustrate its application for the adaptive management of an even-aged Norway spruce (Picea abies L. Karst) forest in the Black Forest, Germany. We simulated forest development under a range of climate change scenarios and forest management alternatives. Our analysis used Bayesian updating and Dempster's rule of combination to simulate how observations of climate and forest variables may influence a decision maker's beliefs about climate development and thereby management decisions. While forest managers may be inclined to rely on observed forest variables to infer climate change and impacts, we found that observation of climate state, e.g. temperature or precipitation is superior for updating beliefs and supporting decision-making. However, with little conflict among information sources, the strongest evidence would be offered by a combination of at least two informative variables, e.g., temperature and precipitation. The success of adaptive forest management depends on when managers switch to forward-looking management schemes. Thus, robust climate adaptation policies may depend crucially on a better understanding of what factors influence managers' belief in climate change. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factors affecting sustainability of rural water schemes in Swaziland

NASA Astrophysics Data System (ADS)

Peter, Graciana; Nkambule, Sizwe E.

The Millennium Development Goal (MDG) target to reduce the proportion of people without sustainable access to safe drinking water by the year 2015 has been met as of 2010, but huge disparities exist. Some regions, particularly Sub-Saharan Africa are lagging behind it is also in this region where up to 30% of the rural schemes are not functional at any given time. There is need for more studies on factors affecting sustainability and necessary measures which when implemented will improve the sustainability of rural water schemes. The main objective of this study was to assess the main factors affecting the sustainability of rural water schemes in Swaziland using a Multi-Criteria Analysis Approach. The main factors considered were: financial, social, technical, environmental and institutional. The study was done in Lubombo region. Fifteen functional water schemes in 11 communities were studied. Data was collected using questionnaires, checklist and focused group discussion guide. A total of 174 heads of households were interviewed. Statistical Package for Social Sciences (SPSS) was used to analyse the data and to calculate sustainability scores for water schemes. SPSS was also used to classify sustainability scores according to sustainability categories: sustainable, partially sustainable and non-sustainable. The averages of the ratings for the different sub-factors studied and the results on the sustainability scores for the sustainable, partially sustainable and non-sustainable schemes were then computed and compared to establish the main factors influencing sustainability of the water schemes. The results indicated technical and social factors as most critical while financial and institutional, although important, played a lesser role. Factors which contributed to the sustainability of water schemes were: functionality; design flow; water fetching time; ability to meet additional demand; use by population; equity; participation in decision making on operation and maintenance; existence of fund for operation and maintenance; willingness to contribute money; existence of a user’s committee; participation in the initial planning and design of the water scheme; and coordination between the local leaders and user’s committee. The main factors which made the schemes unsustainable were: long fetching time; non-involvement in decision making; lack of willingness to contribute funds; absence of users committee; and lack of cooperation between local leaders and the users committee. Water service providers should address the technical, social, financial and institutional factors identified affecting sustainability in their planning and implementation of rural water schemes.

Optimal operating rules definition in complex water resource systems combining fuzzy logic, expert criteria and stochastic programming

NASA Astrophysics Data System (ADS)

Macian-Sorribes, Hector; Pulido-Velazquez, Manuel

2016-04-01

This contribution presents a methodology for defining optimal seasonal operating rules in multireservoir systems coupling expert criteria and stochastic optimization. Both sources of information are combined using fuzzy logic. The structure of the operating rules is defined based on expert criteria, via a joint expert-technician framework consisting in a series of meetings, workshops and surveys carried out between reservoir managers and modelers. As a result, the decision-making process used by managers can be assessed and expressed using fuzzy logic: fuzzy rule-based systems are employed to represent the operating rules and fuzzy regression procedures are used for forecasting future inflows. Once done that, a stochastic optimization algorithm can be used to define optimal decisions and transform them into fuzzy rules. Finally, the optimal fuzzy rules and the inflow prediction scheme are combined into a Decision Support System for making seasonal forecasts and simulate the effect of different alternatives in response to the initial system state and the foreseen inflows. The approach presented has been applied to the Jucar River Basin (Spain). Reservoir managers explained how the system is operated, taking into account the reservoirs' states at the beginning of the irrigation season and the inflows previewed during that season. According to the information given by them, the Jucar River Basin operating policies were expressed via two fuzzy rule-based (FRB) systems that estimate the amount of water to be allocated to the users and how the reservoir storages should be balanced to guarantee those deliveries. A stochastic optimization model using Stochastic Dual Dynamic Programming (SDDP) was developed to define optimal decisions, which are transformed into optimal operating rules embedding them into the two FRBs previously created. As a benchmark, historical records are used to develop alternative operating rules. A fuzzy linear regression procedure was employed to foresee future inflows depending on present and past hydrological and meteorological variables actually used by the reservoir managers to define likely inflow scenarios. A Decision Support System (DSS) was created coupling the FRB systems and the inflow prediction scheme in order to give the user a set of possible optimal releases in response to the reservoir states at the beginning of the irrigation season and the fuzzy inflow projections made using hydrological and meteorological information. The results show that the optimal DSS created using the FRB operating policies are able to increase the amount of water allocated to the users in 20 to 50 Mm3 per irrigation season with respect to the current policies. Consequently, the mechanism used to define optimal operating rules and transform them into a DSS is able to increase the water deliveries in the Jucar River Basin, combining expert criteria and optimization algorithms in an efficient way. This study has been partially supported by the IMPADAPT project (CGL2013-48424-C2-1-R) with Spanish MINECO (Ministerio de Economía y Competitividad) and FEDER funds. It also has received funding from the European Union's Horizon 2020 research and innovation programme under the IMPREX project (grant agreement no: 641.811).

The cost-effectiveness of supported employment for adults with autism in the United Kingdom

PubMed Central

Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

2014-01-01

Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings. PMID:24126866

An ex-ante economic evaluation of the Maternal and Child Health Voucher Scheme as a decision-making tool in Myanmar.

PubMed

Kingkaew, Pritaporn; Werayingyong, Pitsaphun; Aye, San San; Tin, Nilar; Singh, Alaka; Myint, Phone; Teerawattananon, Yot

2016-05-01

Reducing child and maternal mortality in order to meet the health-related Millennium Development Goals (MDGs) 4 and 5 remains a major challenge in Myanmar. Inadequate care during pregnancy and labour plays an important role in the maternal mortality rate in Myanmar. A Maternal and Child Health (MCH) Voucher Scheme comprising a subsidization for pregnant women to receive four antenatal care (ANC), delivery and postnatal care (PNC) free-of-charge was planned to help women overcome financial barriers in addition to raising awareness of ANC and delivery with skilled birth attendants (SBA), which can reduce the rate of maternal and neonatal death. This study is part of an ex-ante evaluation of a feasibility study of the MCH Voucher Scheme. A cost-utility analysis was conducted using a decision tree model to assess the cost per disability-adjusted life years (DALYs) averted from the MCH Voucher Scheme compared with the current situation. Most input parameters were obtained from Myanmar context. From the base-case analysis, where the financial burden on households was fully subsidized, the MCH Voucher Scheme increased utilization for ANC from 73% up to 93% and for delivery from SBAs from 51% up to and 71%, respectively; hence, it is considered to be very cost-effective with an incremental cost-effectiveness ratio of 381 027 kyats per DALY averted (2010, price year). From the probabilistic sensitivity analysis, the MCH Voucher Scheme had a 52% chance of being a cost-effective option at 1 GDP per capita threshold compared to the current situation. Given that the Voucher Scheme is currently being implemented in one township in Myanmar as a result of this study, ongoing evaluation of the effectiveness and cost-effectiveness of this scheme is warranted. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Design scheme for optical manufacturing support system of TMT M3 prototype

NASA Astrophysics Data System (ADS)

Hu, Haifei; Luo, Xiao

2014-09-01

Thirty Meter Telescope's Tertiary Mirror Cell Assembly (TMTM3-CA) will be manufactured in Changchun Institute of Optics, Fine Mechanics and Physics (CIOMP). To reduce the risk of fabricating TMTM3, a prototype made of Zerodur with a d/t ratio of 72 is planned to be polished. Here the focus is on the design scheme of the prototype's optical manufacturing support system. Firstly the number of support points was estimated, then structural design scheme for equal-force polishing support system are drawn, and finally layout optimization of support points was carried out. As its high performance and efficiency, the work will be beneficial to manufacturing large thin mirrors.

The Hawke's Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms.

PubMed

Ryder, Hollie; Aspden, Trudi; Sheridan, Janie

2015-12-01

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke's Bay District Health Board, New Zealand, set up a pilot condom card scheme ('the Scheme') to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme. Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013. Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme's criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme. The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people's suggestions for improving the Scheme is also essential. © 2015 Royal Pharmaceutical Society.

University Choice: What Influences the Decisions of Academically Successful Post-16 Students?

ERIC Educational Resources Information Center

Whitehead, Joan M.; Raffan, John; Deaney, Rosemary

2006-01-01

The questionnaire survey reported in this paper is part of an ongoing evaluation of the effect of a bursary scheme on recruitment to Cambridge University. It sought to identify factors that encouraged or discouraged highly successful A Level students from applying to Cambridge. Findings reveal three main dimensions associated with the decision to…

An evaluation of several different classification schemes - Their parameters and performance. [maximum likelihood decision for crop identification

NASA Technical Reports Server (NTRS)

Scholz, D.; Fuhs, N.; Hixson, M.

1979-01-01

The overall objective of this study was to apply and evaluate several of the currently available classification schemes for crop identification. The approaches examined were: (1) a per point Gaussian maximum likelihood classifier, (2) a per point sum of normal densities classifier, (3) a per point linear classifier, (4) a per point Gaussian maximum likelihood decision tree classifier, and (5) a texture sensitive per field Gaussian maximum likelihood classifier. Three agricultural data sets were used in the study: areas from Fayette County, Illinois, and Pottawattamie and Shelby Counties in Iowa. The segments were located in two distinct regions of the Corn Belt to sample variability in soils, climate, and agricultural practices.

Supporting local diversity of habitats and species on farmland: a comparison of three wildlife-friendly schemes.

PubMed

Hardman, Chloe J; Harrison, Dominic P G; Shaw, Pete J; Nevard, Tim D; Hughes, Brin; Potts, Simon G; Norris, Ken

2016-02-01

Restoration and maintenance of habitat diversity have been suggested as conservation priorities in farmed landscapes, but how this should be achieved and at what scale are unclear. This study makes a novel comparison of the effectiveness of three wildlife-friendly farming schemes for supporting local habitat diversity and species richness on 12 farms in England.The schemes were: (i) Conservation Grade (Conservation Grade: a prescriptive, non-organic, biodiversity-focused scheme), (ii) organic agriculture and (iii) a baseline of Entry Level Stewardship (Entry Level Stewardship: a flexible widespread government scheme). Conservation Grade farms supported a quarter higher habitat diversity at the 100-m radius scale compared to Entry Level Stewardship farms. Conservation Grade and organic farms both supported a fifth higher habitat diversity at the 250-m radius scale compared to Entry Level Stewardship farms. Habitat diversity at the 100-m and 250-m scales significantly predicted species richness of butterflies and plants. Habitat diversity at the 100-m scale also significantly predicted species richness of birds in winter and solitary bees. There were no significant relationships between habitat diversity and species richness for bumblebees or birds in summer.Butterfly species richness was significantly higher on organic farms (50% higher) and marginally higher on Conservation Grade farms (20% higher), compared with farms in Entry Level Stewardship. Organic farms supported significantly more plant species than Entry Level Stewardship farms (70% higher) but Conservation Grade farms did not (10% higher). There were no significant differences between the three schemes for species richness of bumblebees, solitary bees or birds. Policy implications . The wildlife-friendly farming schemes which included compulsory changes in management, Conservation Grade and organic, were more effective at increasing local habitat diversity and species richness compared with the less prescriptive Entry Level Stewardship scheme. We recommend that wildlife-friendly farming schemes should aim to enhance and maintain high local habitat diversity, through mechanisms such as option packages, where farmers are required to deliver a combination of several habitats.

Delivery of a national home safety equipment scheme in England: a survey of local scheme leaders.

PubMed

Mulvaney, C A; Watson, M C; Hamilton, T; Errington, G

2013-11-01

Unintentional home injuries sustained by preschool children are a major cause of morbidity in the UK. Home safety equipment schemes may reduce home injury rates. In 2009, the Royal Society for the Prevention of Accidents was appointed as central coordinator of a two-year, £18m national home safety equipment scheme in England. This paper reports the findings from a national survey of all scheme leaders responsible for local scheme delivery. A questionnaire mailed to all local scheme leaders sought details of how the schemes were operated locally; barriers and facilitators to scheme implementation; evaluation of the local scheme and its sustainability. A response rate of 73% was achieved. Health visitors and family support workers played a key role in both the identification of eligible families and performing home safety checks. The majority of local scheme leaders (94.6%) reported that they thought their local scheme had been successful in including those families considered 'harder to engage'. Many scheme leaders (72.4%) reported that they had evaluated the provision of safety equipment in their scheme and over half (56.6%) stated that they would not be able to continue the scheme once funding ceased. Local schemes need support to effectively evaluate their scheme and to seek sustainability funding to ensure the future of the scheme. There remains a lack of evidence of whether the provision of home safety equipment reduces injuries in preschool children.

A work-centered cognitively based architecture for decision support: the work-centered infomediary layer (WIL) model

NASA Astrophysics Data System (ADS)

Zachary, Wayne; Eggleston, Robert; Donmoyer, Jason; Schremmer, Serge

2003-09-01

Decision-making is strongly shaped and influenced by the work context in which decisions are embedded. This suggests that decision support needs to be anchored by a model (implicit or explicit) of the work process, in contrast to traditional approaches that anchor decision support to either context free decision models (e.g., utility theory) or to detailed models of the external (e.g., battlespace) environment. An architecture for cognitively-based, work centered decision support called the Work-centered Informediary Layer (WIL) is presented. WIL separates decision support into three overall processes that build and dynamically maintain an explicit context model, use the context model to identify opportunities for decision support and tailor generic decision-support strategies to the current context and offer them to the system-user/decision-maker. The generic decision support strategies include such things as activity/attention aiding, decision process structuring, work performance support (selective, contextual automation), explanation/ elaboration, infosphere data retrieval, and what if/action-projection and visualization. A WIL-based application is a work-centered decision support layer that provides active support without intent inferencing, and that is cognitively based without requiring classical cognitive task analyses. Example WIL applications are detailed and discussed.

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

PubMed Central

2013-01-01

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

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

PubMed

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

2013-09-22

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

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

Optimal throughput for cognitive radio with energy harvesting in fading wireless channel.

PubMed

Vu-Van, Hiep; Koo, Insoo

2014-01-01

Energy resource management is a crucial problem of a device with a finite capacity battery. In this paper, cognitive radio is considered to be a device with an energy harvester that can harvest energy from a non-RF energy resource while performing other actions of cognitive radio. Harvested energy will be stored in a finite capacity battery. At the start of the time slot of cognitive radio, the radio needs to determine if it should remain silent or carry out spectrum sensing based on the idle probability of the primary user and the remaining energy in order to maximize the throughput of the cognitive radio system. In addition, optimal sensing energy and adaptive transmission power control are also investigated in this paper to effectively utilize the limited energy of cognitive radio. Finding an optimal approach is formulated as a partially observable Markov decision process. The simulation results show that the proposed optimal decision scheme outperforms the myopic scheme in which current throughput is only considered when making a decision.

Game-Theoretic Models for Usage-based Maintenance Contract

NASA Astrophysics Data System (ADS)

Husniah, H.; Wangsaputra, R.; Cakravastia, A.; Iskandar, B. P.

2018-03-01

A usage-based maintenance contracts with coordination and non coordination between two parties is studied in this paper. The contract is applied to a dump truck operated in a mining industry. The situation under study is that an agent offers service contract to the owner of the truck after warranty ends. This contract has only a time limit but no usage limit. If the total usage per period exceeds the maximum usage allowed in the contract, then the owner will be charged an additional cost. In general, the agent (Original Equipment Manufacturer/OEM) provides a full coverage of maintenance, which includes PM and CM under the lease contract. The decision problem for the owner is to select the best option offered that fits to its requirement, and the decision problem for the agent is to find the optimal maintenance efforts for a given price of the service option offered. We first find the optimal decisions using coordination scheme and then with non coordination scheme for both parties.

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.

Decision-Related Activity in Macaque V2 for Fine Disparity Discrimination Is Not Compatible with Optimal Linear Readout.

PubMed

Clery, Stephane; Cumming, Bruce G; Nienborg, Hendrikje

2017-01-18

Fine judgments of stereoscopic depth rely mainly on relative judgments of depth (relative binocular disparity) between objects, rather than judgments of the distance to where the eyes are fixating (absolute disparity). In macaques, visual area V2 is the earliest site in the visual processing hierarchy for which neurons selective for relative disparity have been observed (Thomas et al., 2002). Here, we found that, in macaques trained to perform a fine disparity discrimination task, disparity-selective neurons in V2 were highly selective for the task, and their activity correlated with the animals' perceptual decisions (unexplained by the stimulus). This may partially explain similar correlations reported in downstream areas. Although compatible with a perceptual role of these neurons for the task, the interpretation of such decision-related activity is complicated by the effects of interneuronal "noise" correlations between sensory neurons. Recent work has developed simple predictions to differentiate decoding schemes (Pitkow et al., 2015) without needing measures of noise correlations, and found that data from early sensory areas were compatible with optimal linear readout of populations with information-limiting correlations. In contrast, our data here deviated significantly from these predictions. We additionally tested this prediction for previously reported results of decision-related activity in V2 for a related task, coarse disparity discrimination (Nienborg and Cumming, 2006), thought to rely on absolute disparity. Although these data followed the predicted pattern, they violated the prediction quantitatively. This suggests that optimal linear decoding of sensory signals is not generally a good predictor of behavior in simple perceptual tasks. Activity in sensory neurons that correlates with an animal's decision is widely believed to provide insights into how the brain uses information from sensory neurons. Recent theoretical work developed simple predictions to differentiate decoding schemes, and found support for optimal linear readout of early sensory populations with information-limiting correlations. Here, we observed decision-related activity for neurons in visual area V2 of macaques performing fine disparity discrimination, as yet the earliest site for this task. These findings, and previously reported results from V2 in a different task, deviated from the predictions for optimal linear readout of a population with information-limiting correlations. Our results suggest that optimal linear decoding of early sensory information is not a general decoding strategy used by the brain. Copyright © 2017 the authors 0270-6474/17/370715-11$15.00/0.

Triple Scheme of Learning Support Design for Scientific Discovery Learning Based on Computer Simulation: Experimental Research

ERIC Educational Resources Information Center

Zhang, Jianwei; Chen, Qi; Sun, Yanquing; Reid, David J.

2004-01-01

Learning support studies involving simulation-based scientific discovery learning have tended to adopt an ad hoc strategies-oriented approach in which the support strategies are typically pre-specified according to learners' difficulties in particular activities. This article proposes a more integrated approach, a triple scheme for learning…

Classmate Peer-Coaching: "A Study Buddy Support Scheme"

ERIC Educational Resources Information Center

Thalluri, Jyothi; O'Flaherty, Jackie A.; Shepherd, Paul L.

2014-01-01

This study had two aims: firstly, to determine whether participation in a peer support scheme called Study Buddy Support (SBS) improves pass rates of "at risk" students, and secondly, to examine the advantages of this model over hierarchical models where senior students tutor junior years. Bachelor of Nursing and Midwifery students in a…

Measuring Shared Decision Making in Psychiatric Care

PubMed Central

Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.

2014-01-01

Objective Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. Methods A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. Results Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. Conclusions The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. PMID:22854725

FPGA implementation of concatenated non-binary QC-LDPC codes for high-speed optical transport.

PubMed

Zou, Ding; Djordjevic, Ivan B

2015-06-01

In this paper, we propose a soft-decision-based FEC scheme that is the concatenation of a non-binary LDPC code and hard-decision FEC code. The proposed NB-LDPC + RS with overhead of 27.06% provides a superior NCG of 11.9dB at a post-FEC BER of 10^-15. As a result, the proposed NB-LDPC codes represent the strong FEC candidate of soft-decision FEC for beyond 100Gb/s optical transmission systems.

Development of Decision-Making Automated System for Optimal Placement of Physical Access Control System’s Elements

NASA Astrophysics Data System (ADS)

Danilova, Olga; Semenova, Zinaida

2018-04-01

The objective of this study is a detailed analysis of physical protection systems development for information resources. The optimization theory and decision-making mathematical apparatus is used to formulate correctly and create an algorithm of selection procedure for security systems optimal configuration considering the location of the secured object’s access point and zones. The result of this study is a software implementation scheme of decision-making system for optimal placement of the physical access control system’s elements.

Meeting stroke survivors' perceived needs: a qualitative study of a community-based exercise and education scheme.

PubMed

Reed, Mary; Harrington, Rachel; Duggan, Aine; Wood, Victorine A

2010-01-01

A qualitative study using a phenomenological approach, to explore stroke survivors' needs and their perceptions of whether a community stroke scheme met these needs. Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence and sense of purpose to 'create their social self', and external resources of 'responsive services' and an 'informal support network', to provide direction and encouragement. Participants felt the community stroke scheme met some of these needs through exercise, goal setting and peer group interaction, which included social support and knowledge acquisition. Stroke survivors need a variety of internal and external resources so that they can rebuild their lives positively post stroke. A stroke-specific community scheme, based on exercise, life-centred goal setting, peer support and knowledge acquisition, is an external resource that can help with meeting some of the stroke survivor's needs.

Effect of noise in intelligent cellular decision making.

PubMed

Bates, Russell; Blyuss, Oleg; Alsaedi, Ahmed; Zaikin, Alexey

2015-01-01

Similar to intelligent multicellular neural networks controlling human brains, even single cells, surprisingly, are able to make intelligent decisions to classify several external stimuli or to associate them. This happens because of the fact that gene regulatory networks can perform as perceptrons, simple intelligent schemes known from studies on Artificial Intelligence. We study the role of genetic noise in intelligent decision making at the genetic level and show that noise can play a constructive role helping cells to make a proper decision. We show this using the example of a simple genetic classifier able to classify two external stimuli.

Opinion Dynamics and Decision of Vote in Bipolar Political Systems

NASA Astrophysics Data System (ADS)

Caruso, Filippo; Castorina, Paolo

A model of the opinion dynamics underlying the political decision is proposed. The analysis is restricted to a bipolar scheme with a possible third political area. The interaction among voters is local but the final decision strongly depends on global effects such as the rating of the governments. As in the realistic case, the individual decision making process is determined by the most relevant personal interests and problems. The phenomenological analysis of the national vote in Italy and Germany has been carried out and a prediction of the next Italian vote as a function of the government rating is presented.

Hospital drug and therapeutics committees in Australia: is there a role for economic evaluation at the institutional level?

PubMed

Gallego, Gisselle

2011-12-01

Decisions about spending on medicines occur at different levels in the Australian health care system. This commentary describes the role of economic evaluation at the institutional (public hospital) level. In contrast to the decisions taken at the level of Federal subsidy (listing on the Pharmaceutical Benefits Scheme) formal pharmacoeonomic data analyses are usually not available, and arguably often not relevant to decision making within the public hospital setting. Future research is needed to develop and explore models of best practice and how to incorporate pharmacoeconomic evidence into local decisions.

The anatomy of choice: dopamine and decision-making

PubMed Central

Friston, Karl; Schwartenbeck, Philipp; FitzGerald, Thomas; Moutoussis, Michael; Behrens, Timothy; Dolan, Raymond J.

2014-01-01

This paper considers goal-directed decision-making in terms of embodied or active inference. We associate bounded rationality with approximate Bayesian inference that optimizes a free energy bound on model evidence. Several constructs such as expected utility, exploration or novelty bonuses, softmax choice rules and optimism bias emerge as natural consequences of free energy minimization. Previous accounts of active inference have focused on predictive coding. In this paper, we consider variational Bayes as a scheme that the brain might use for approximate Bayesian inference. This scheme provides formal constraints on the computational anatomy of inference and action, which appear to be remarkably consistent with neuroanatomy. Active inference contextualizes optimal decision theory within embodied inference, where goals become prior beliefs. For example, expected utility theory emerges as a special case of free energy minimization, where the sensitivity or inverse temperature (associated with softmax functions and quantal response equilibria) has a unique and Bayes-optimal solution. Crucially, this sensitivity corresponds to the precision of beliefs about behaviour. The changes in precision during variational updates are remarkably reminiscent of empirical dopaminergic responses—and they may provide a new perspective on the role of dopamine in assimilating reward prediction errors to optimize decision-making. PMID:25267823

The anatomy of choice: dopamine and decision-making.

PubMed

Friston, Karl; Schwartenbeck, Philipp; FitzGerald, Thomas; Moutoussis, Michael; Behrens, Timothy; Dolan, Raymond J

2014-11-05

This paper considers goal-directed decision-making in terms of embodied or active inference. We associate bounded rationality with approximate Bayesian inference that optimizes a free energy bound on model evidence. Several constructs such as expected utility, exploration or novelty bonuses, softmax choice rules and optimism bias emerge as natural consequences of free energy minimization. Previous accounts of active inference have focused on predictive coding. In this paper, we consider variational Bayes as a scheme that the brain might use for approximate Bayesian inference. This scheme provides formal constraints on the computational anatomy of inference and action, which appear to be remarkably consistent with neuroanatomy. Active inference contextualizes optimal decision theory within embodied inference, where goals become prior beliefs. For example, expected utility theory emerges as a special case of free energy minimization, where the sensitivity or inverse temperature (associated with softmax functions and quantal response equilibria) has a unique and Bayes-optimal solution. Crucially, this sensitivity corresponds to the precision of beliefs about behaviour. The changes in precision during variational updates are remarkably reminiscent of empirical dopaminergic responses-and they may provide a new perspective on the role of dopamine in assimilating reward prediction errors to optimize decision-making.

Value based pricing, research and development, and patient access schemes. Will the United Kingdom get it right or wrong?

PubMed Central

Towse, Adrian

2010-01-01

The National Health Service (NHS) should reward innovation it values. This will enable the NHS and the United Kingdom (UK) economy to benefit and impact positively on the Research and Development (R&D) decision making of companies. The National Institute for Health and Clinical Excellence (NICE) currently seeks to do this on behalf of the NHS. Yet the Office of Fair Trading proposals for Value Based Pricing add price setting powers – initially for the Department of Health (DH) and then for NICE. This introduces an additional substantial uncertainty that will impact on R&D and, conditional on R&D proceeding, on launch (or not) in the UK. Instead of adding to uncertainty the institutional arrangements for assessing value should seek to be predictable and science based, building on NICE's current arrangements. The real challenge is to increase understanding of the underlying cost-effectiveness of the technology itself by collecting evidence alongside use. The 2009 Pharmaceutical Price Regulation Scheme sought to help do this with Flexible Pricing (FP) and Patient Access Schemes (PASs). The PASs to date have increased access to medicines, but no schemes proposed to date have yet helped to tackle outcomes uncertainty. The 2010 Innovation Pass can also be seen as a form of ‘coverage with evidence development.’ The NHS is understandably concerned about the costs of running such evidence collection schemes. Enabling the NHS to deliver on such schemes will impact favourably on R&D decisions. Increasing the uncertainty in the UK NHS market through government price setting will reduce incentives for R&D and for early UK launch. PMID:20716236

Value based pricing, research and development, and patient access schemes. Will the United Kingdom get it right or wrong?

PubMed

Towse, Adrian

2010-09-01

The National Health Service (NHS) should reward innovation it values. This will enable the NHS and the United Kingdom (UK) economy to benefit and impact positively on the Research and Development (R&D) decision making of companies. The National Institute for Health and Clinical Excellence (NICE) currently seeks to do this on behalf of the NHS. Yet the Office of Fair Trading proposals for Value Based Pricing add price setting powers--initially for the Department of Health (DH) and then for NICE. This introduces an additional substantial uncertainty that will impact on R&D and, conditional on R&D proceeding, on launch (or not) in the UK. Instead of adding to uncertainty the institutional arrangements for assessing value should seek to be predictable and science based, building on NICE's current arrangements. The real challenge is to increase understanding of the underlying cost-effectiveness of the technology itself by collecting evidence alongside use. The 2009 Pharmaceutical Price Regulation Scheme sought to help do this with Flexible Pricing (FP) and Patient Access Schemes (PASs). The PASs to date have increased access to medicines, but no schemes proposed to date have yet helped to tackle outcomes uncertainty. The 2010 Innovation Pass can also be seen as a form of 'coverage with evidence development.' The NHS is understandably concerned about the costs of running such evidence collection schemes. Enabling the NHS to deliver on such schemes will impact favourably on R&D decisions. Increasing the uncertainty in the UK NHS market through government price setting will reduce incentives for R&D and for early UK launch.

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

PubMed

Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight

2007-01-01

Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

The Pharmaceutical Benefits Scheme 2003–2004

PubMed Central

Harvey, Ken J

2005-01-01

The Pharmaceutical Benefits Scheme (PBS) grew by 8% in 2003–04; a slower rate than the 12.0% pa average growth over the last decade. Nevertheless, the sustainability of the Scheme remained an ongoing concern given an aging population and the continued introduction of useful (but increasingly expensive) new medicines. There was also concern that the Australia-United States Free Trade Agreement could place further pressure on the Scheme. In 2003, as in 2002, the government proposed a 27% increase in PBS patient co-payments and safety-net thresholds in order to transfer more of the cost of the PBS from the government to consumers. While this measure was initially blocked by the Senate, the forthcoming election resulted in the Labor Party eventually supporting this policy. Recommendations of the Pharmaceutical Benefits Advisory Committee to list, not list or defer a decision to list a medicine on the PBS were made publicly available for the first time and the full cost of PBS medicines appeared on medicine labels if the price was greater than the co-payment. Pharmaceutical reform in Victorian public hospitals designed to minimise PBS cost-shifting was evaluated and extended to other States and Territories. Programs promoting the quality use of medicines were further developed coordinated by the National Prescribing Service, Australian Divisions of General Practice and the Pharmacy Guild of Australia. The extensive uptake of computerised prescribing software by GPs produced benefits but also problems. The latter included pharmaceutical promotion occurring at the time of prescribing, failure to incorporate key sources of objective therapeutic information in the software and gross variation in the ability of various programs to detect important drug-drug interactions. These issues remain to be tackled. PMID:15679896

From development to success: the European surveillance scheme for travel associated Legionnaires' disease.

PubMed

Joseph, Carol A; Ricketts, Katherine D

2007-12-01

EWGLINET, the European surveillance scheme for travel associated Legionnaires' disease, was established in 1987 following the identification of the disease in 1976. In 1998, the European Commission's Decision 2119/98/EC provided a legal framework for EWGLINET's operation, and its aims and objectives were formalised. Since its inception, the scheme has encountered a number of challenges which have influenced its development as a Disease Specific Network. The solutions to these challenges, and their successes, may be of interest to similar schemes. This article traces the development of the scheme and its responses to the challenges it has encountered. One especially significant document developed by the scheme is the European Guidelines for Control and Prevention of Travel Associated Legionnaires' Disease;(1) its history is explored. In addition, EWGLINET's relationship with collaborating centres and other groups such as tour operators is highlighted. Despite changing over time, the collaborations and partnerships have been maintained and continue to ensure a close cooperation, maximizing public health effects.

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

Nonlinear BCJR equalizer for suppression of intrachannel nonlinearities in 40 Gb/s optical communications systems.

PubMed

Djordjevic, Ivan B; Vasic, Bane

2006-05-29

A maximum a posteriori probability (MAP) symbol decoding supplemented with iterative decoding is proposed as an effective mean for suppression of intrachannel nonlinearities. The MAP detector, based on Bahl-Cocke-Jelinek-Raviv algorithm, operates on the channel trellis, a dynamical model of intersymbol interference, and provides soft-decision outputs processed further in an iterative decoder. A dramatic performance improvement is demonstrated. The main reason is that the conventional maximum-likelihood sequence detector based on Viterbi algorithm provides hard-decision outputs only, hence preventing the soft iterative decoding. The proposed scheme operates very well in the presence of strong intrachannel intersymbol interference, when other advanced forward error correction schemes fail, and it is also suitable for 40 Gb/s upgrade over existing 10 Gb/s infrastructure.

Optimization of the scheme for natural ecology planning of urban rivers based on ANP (analytic network process) model.

PubMed

Zhang, Yichuan; Wang, Jiangping

2015-07-01

Rivers serve as a highly valued component in ecosystem and urban infrastructures. River planning should follow basic principles of maintaining or reconstructing the natural landscape and ecological functions of rivers. Optimization of planning scheme is a prerequisite for successful construction of urban rivers. Therefore, relevant studies on optimization of scheme for natural ecology planning of rivers is crucial. In the present study, four planning schemes for Zhaodingpal River in Xinxiang City, Henan Province were included as the objects for optimization. Fourteen factors that influenced the natural ecology planning of urban rivers were selected from five aspects so as to establish the ANP model. The data processing was done using Super Decisions software. The results showed that important degree of scheme 3 was highest. A scientific, reasonable and accurate evaluation of schemes could be made by ANP method on natural ecology planning of urban rivers. This method could be used to provide references for sustainable development and construction of urban rivers. ANP method is also suitable for optimization of schemes for urban green space planning and design.

A genetic fuzzy analytical hierarchy process based projection pursuit method for selecting schemes of water transportation projects

NASA Astrophysics Data System (ADS)

Jin, Juliang; Li, Lei; Wang, Wensheng; Zhang, Ming

2006-10-01

The optimal selection of schemes of water transportation projects is a process of choosing a relatively optimal scheme from a number of schemes of water transportation programming and management projects, which is of importance in both theory and practice in water resource systems engineering. In order to achieve consistency and eliminate the dimensions of fuzzy qualitative and fuzzy quantitative evaluation indexes, to determine the weights of the indexes objectively, and to increase the differences among the comprehensive evaluation index values of water transportation project schemes, a projection pursuit method, named FPRM-PP for short, was developed in this work for selecting the optimal water transportation project scheme based on the fuzzy preference relation matrix. The research results show that FPRM-PP is intuitive and practical, the correction range of the fuzzy preference relation matrix A it produces is relatively small, and the result obtained is both stable and accurate; therefore FPRM-PP can be widely used in the optimal selection of different multi-factor decision-making schemes.

A low-complexity and high performance concatenated coding scheme for high-speed satellite communications

NASA Technical Reports Server (NTRS)

Lin, Shu; Rhee, Dojun; Rajpal, Sandeep

1993-01-01

This report presents a low-complexity and high performance concatenated coding scheme for high-speed satellite communications. In this proposed scheme, the NASA Standard Reed-Solomon (RS) code over GF(2(exp 8) is used as the outer code and the second-order Reed-Muller (RM) code of Hamming distance 8 is used as the inner code. The RM inner code has a very simple trellis structure and is decoded with the soft-decision Viterbi decoding algorithm. It is shown that the proposed concatenated coding scheme achieves an error performance which is comparable to that of the NASA TDRS concatenated coding scheme in which the NASA Standard rate-1/2 convolutional code of constraint length 7 and d sub free = 10 is used as the inner code. However, the proposed RM inner code has much smaller decoding complexity, less decoding delay, and much higher decoding speed. Consequently, the proposed concatenated coding scheme is suitable for reliable high-speed satellite communications, and it may be considered as an alternate coding scheme for the NASA TDRS system.

78 FR 64916 - Circular Welded Carbon Steel Pipes and Tubes From Turkey: Final Results of Countervailing Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

...: Land Allocation National Restructuring Program Regional Incentive Scheme: Reduced Corporate Tax Rates Regional Incentive Scheme: Social Security Premium Contribution for Employees Regional Incentive Scheme: Allocation of State Land Regional Incentive Scheme: Interest Support OIZ: Waste Water Charges OIZ: Exemptions...

Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use.

PubMed

Nikles, Jane; Mitchell, Geoffrey K; Clavarino, Alexandra; Yelland, Michael J; Del Mar, Christopher B

2010-03-01

N-of-1 trials are empirical formal tests using a within-patient randomised, double-blind, cross-over comparison of drug and placebo (or another drug), which we adapted to study individual patients' responses as a clinical tool to guide clinical management. We administered semi-structured interviews to gauge stakeholder perspectives on the possibility of using routine n-of-1 trials for this purpose. Stakeholders included government and non-government health care sector, and patient, clinician and consumer, organisations. Stakeholders supported more widespread implementation of n-of-1 trials, in a targeted fashion, with some caveats. Barriers to their widespread implementation included constraints on doctors' time, doctors' acceptance, drug company acceptance, patient willingness, and cost. Strategies for overcoming barriers included conditional Pharmaceutical Benefits Scheme listing if cost-effective. There was little consensus on which model of n-of-1 trial implementation would be most effective. We discuss different approaches to addressing the several concerns raised to enable widespread introduction of n-of-1 trials into routine clinical practice as a decision tool.

Support schemes and ownership structures - the policy context for fuel cell based micro-combined heat and power

NASA Astrophysics Data System (ADS)

Schroeder, Sascha Thorsten; Costa, Ana; Obé, Elisabeth

In recent years, fuel cell based micro-combined heat and power (mCHP) has received increasing attention due to its potential contribution to European energy policy goals, i.e., sustainability, competitiveness and security of supply. Besides technical advances, regulatory framework and ownership structures are of crucial importance in order to achieve greater diffusion of the technology in residential applications. This paper analyses the interplay of policy and ownership structures for the future deployment of mCHP. Furthermore, it regards the three country cases Denmark, France and Portugal. Firstly, the implications of different kinds of support schemes on investment risk and the diffusion of a technology are explained conceptually. Secondly, ownership arrangements are addressed. Then, a cross-country comparison on present support schemes for mCHP and competing technologies discusses the national implementation of European legislation in Denmark, France and Portugal. Finally, resulting implications for ownership arrangements on the choice of support scheme are explained. From a conceptual point of view, investment support, feed-in tariffs and price premiums are the most appropriate schemes for fuel cell mCHP. This can be used for improved analysis of operational strategies. The interaction of this plethora of elements necessitates careful balancing from a private- and socio-economic point of view.

Decision Support | Solar Research | NREL

Science.gov Websites

informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

PubMed

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-04-01

To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

PubMed

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Decentralising Zimbabwe’s water management: The case of Guyu-Chelesa irrigation scheme

NASA Astrophysics Data System (ADS)

Tambudzai, Rashirayi; Everisto, Mapedza; Gideon, Zhou

Smallholder irrigation schemes are largely supply driven such that they exclude the beneficiaries on the management decisions and the choice of the irrigation schemes that would best suit their local needs. It is against this background that the decentralisation framework and the Dublin Principles on Integrated Water Resource Management (IWRM) emphasise the need for a participatory approach to water management. The Zimbabwean government has gone a step further in decentralising the management of irrigation schemes, that is promoting farmer managed irrigation schemes so as to ensure effective management of scarce community based land and water resources. The study set to investigate the way in which the Guyu-Chelesa irrigation scheme is managed with specific emphasis on the role of the Irrigation Management Committee (IMC), the level of accountability and the powers devolved to the IMC. Merrey’s 2008 critique of IWRM also informs this study which views irrigation as going beyond infrastructure by looking at how institutions and decision making processes play out at various levels including at the irrigation scheme level. The study was positioned on the hypothesis that ‘decentralised or autonomous irrigation management enhances the sustainability and effectiveness of irrigation schemes’. To validate or falsify the stated hypothesis, data was gathered using desk research in the form of reviewing articles, documents from within the scheme and field research in the form of questionnaire surveys, key informant interviews and field observation. The Statistical Package for Social Sciences was used to analyse data quantitatively, whilst content analysis was utilised to analyse qualitative data whereby data was analysed thematically. Comparative analysis was carried out as Guyu-Chelesa irrigation scheme was compared with other smallholder irrigation scheme’s experiences within Zimbabwe and the Sub Saharan African region at large. The findings were that whilst the scheme is a model of a decentralised entity whose importance lies at improving food security and employment creation within the community, it falls short in representing a downwardly accountable decentralised irrigation scheme. The scheme is faced with various challenges which include its operation which is below capacity utilisation, absence of specialised technical human personnel to address infrastructural breakdowns, uneven distribution of water pressure, incapacitated Irrigation Management Committee (IMC), absence of a locally legitimate constitution, compromised beneficiary participation and unclear lines of communication between various institutions involved in water management. Understanding decentralization is important since one of the key tenets of IWRM is stakeholder participation which the decentralization framework interrogates.

Prediction-based association control scheme in dense femtocell networks.

PubMed

Sung, Nak Woon; Pham, Ngoc-Thai; Huynh, Thong; Hwang, Won-Joo; You, Ilsun; Choo, Kim-Kwang Raymond

2017-01-01

The deployment of large number of femtocell base stations allows us to extend the coverage and efficiently utilize resources in a low cost manner. However, the small cell size of femtocell networks can result in frequent handovers to the mobile user, and consequently throughput degradation. Thus, in this paper, we propose predictive association control schemes to improve the system's effective throughput. Our design focuses on reducing handover frequency without impacting on throughput. The proposed schemes determine handover decisions that contribute most to the network throughput and are proper for distributed implementations. The simulation results show significant gains compared with existing methods in terms of handover frequency and network throughput perspective.

Dual-balanced detection scheme with optical hard-limiters in an optical code division multiple access system

NASA Astrophysics Data System (ADS)

Liu, Maw-Yang; Hsu, Yi-Kai

2017-03-01

Three-arm dual-balanced detection scheme is studied in an optical code division multiple access system. As the MAI and beat noise are the main deleterious source of system performance, we utilize optical hard-limiters to alleviate such channel impairment. In addition, once the channel condition is improved effectively, the proposed two-dimensional error correction code can remarkably enhance the system performance. In our proposed scheme, the optimal thresholds of optical hard-limiters and decision circuitry are fixed, and they will not change with other system parameters. Our proposed scheme can accommodate a large number of users simultaneously and is suitable for burst traffic with asynchronous transmission. Therefore, it is highly recommended as the platform for broadband optical access network.

Balancing ecosystem services with energy and food security - Assessing trade-offs from reservoir operation and irrigation investments in Kenya's Tana Basin

NASA Astrophysics Data System (ADS)

Hurford, A. P.; Harou, J. J.

2014-08-01

Competition for water between key economic sectors and the environment means agreeing allocations is challenging. Managing releases from the three major dams in Kenya's Tana River basin with its 4.4 million inhabitants, 567 MW of installed hydropower capacity, 33 000 ha of irrigation and ecologically important wetlands and forests is a pertinent example. This research seeks firstly to identify and help decision-makers visualise reservoir management strategies which result in the best possible (Pareto-optimal) allocation of benefits between sectors. Secondly, it seeks to show how trade-offs between achievable benefits shift with the implementation of proposed new rice, cotton and biofuel irrigation projects. To approximate the Pareto-optimal trade-offs we link a water resources management simulation model to a multi-criteria search algorithm. The decisions or "levers" of the management problem are volume-dependent release rules for the three major dams and extent of investment in new irrigation schemes. These decisions are optimised for eight objectives covering the provision of water supply and irrigation, energy generation and maintenance of ecosystem services. Trade-off plots allow decision-makers to assess multi-reservoir rule-sets and irrigation investment options by visualising their impacts on different beneficiaries. Results quantify how economic gains from proposed irrigation schemes trade-off against the disturbance of ecosystems and local livelihoods that depend on them. Full implementation of the proposed schemes is shown to come at a high environmental and social cost. The clarity and comprehensiveness of "best-case" trade-off analysis is a useful vantage point from which to tackle the interdependence and complexity of "water-energy-food nexus" resource security issues.

Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care.

PubMed

Kovacs, Eva; Strobl, Ralf; Phillips, Amanda; Stephan, Anna-Janina; Müller, Martin; Gensichen, Jochen; Grill, Eva

2018-05-04

As clinical practice guidelines represent the most important evidence-based decision support tool, several strategies have been applied to improve their implementation into the primary health care system. This study aimed to evaluate the effect of intervention methods on the guideline adherence of primary care providers (PCPs). The studies selected through a systematic search in Medline and Embase were categorised according to intervention schemes and outcome indicator categories. Harvest plots and forest plots were applied to integrate results. The 36 studies covered six intervention schemes, with single interventions being the most effective and distribution of materials the least. The harvest plot displayed 27 groups having no effect, 14 a moderate and 21 a strong effect on the outcome indicators in the categories of knowledge transfer, diagnostic behaviour, prescription, counselling and patient-level results. The forest plot revealed a moderate overall effect size of 0.22 [0.15, 0.29] where single interventions were more effective (0.27 [0.17, 0.38]) than multifaceted interventions (0.13 [0.06, 0.19]). Guideline implementation strategies are heterogeneous. Reducing the complexity of strategies and tailoring to the local conditions and PCPs' needs may improve implementation and clinical practice.

Applications of Bayesian Procrustes shape analysis to ensemble radar reflectivity nowcast verification

NASA Astrophysics Data System (ADS)

Fox, Neil I.; Micheas, Athanasios C.; Peng, Yuqiang

2016-07-01

This paper introduces the use of Bayesian full Procrustes shape analysis in object-oriented meteorological applications. In particular, the Procrustes methodology is used to generate mean forecast precipitation fields from a set of ensemble forecasts. This approach has advantages over other ensemble averaging techniques in that it can produce a forecast that retains the morphological features of the precipitation structures and present the range of forecast outcomes represented by the ensemble. The production of the ensemble mean avoids the problems of smoothing that result from simple pixel or cell averaging, while producing credible sets that retain information on ensemble spread. Also in this paper, the full Bayesian Procrustes scheme is used as an object verification tool for precipitation forecasts. This is an extension of a previously presented Procrustes shape analysis based verification approach into a full Bayesian format designed to handle the verification of precipitation forecasts that match objects from an ensemble of forecast fields to a single truth image. The methodology is tested on radar reflectivity nowcasts produced in the Warning Decision Support System - Integrated Information (WDSS-II) by varying parameters in the K-means cluster tracking scheme.

Statistical analysis in MSW collection performance assessment.

PubMed

Teixeira, Carlos Afonso; Avelino, Catarina; Ferreira, Fátima; Bentes, Isabel

2014-09-01

The increase of Municipal Solid Waste (MSW) generated over the last years forces waste managers pursuing more effective collection schemes, technically viable, environmentally effective and economically sustainable. The assessment of MSW services using performance indicators plays a crucial role for improving service quality. In this work, we focus on the relevance of regular system monitoring as a service assessment tool. In particular, we select and test a core-set of MSW collection performance indicators (effective collection distance, effective collection time and effective fuel consumption) that highlights collection system strengths and weaknesses and supports pro-active management decision-making and strategic planning. A statistical analysis was conducted with data collected in mixed collection system of Oporto Municipality, Portugal, during one year, a week per month. This analysis provides collection circuits' operational assessment and supports effective short-term municipality collection strategies at the level of, e.g., collection frequency and timetables, and type of containers. Copyright © 2014 Elsevier Ltd. All rights reserved.

A medical economic fairy tale: Jack, the magic beans, Medicare and the US FDA.

PubMed

Nusbaum, Neil J

2006-01-01

The US Medicare programme, through its new Part D programme, now offers limited coverage for prescription medicines. The coverage is provided via a variety of drug plans and their respective formularies. The federal regulatory scheme generally requires that the formularies contain drugs representative of the various therapeutic classes. On the other hand, the federal government has generally refrained from making specific decisions that specific drug entities are the most cost effective and therefore must be included in the formularies. With the dawn of Medicare Part D in the US, the federal government will be increasingly involved in supporting the cost of medicines, and will need to confront this challenge in the face of tight overall economic constraints on the federal budget. Any spending on medications of questionable efficacy will inevitably compromise the ability to deliver more cost-effective healthcare measures. Laxity in the approval process for ineffective drugs may therefore result in lack of funds to support acquisition of more useful medicines for the elderly.

Inter-sectoral costs and benefits of mental health prevention: towards a new classification scheme.

PubMed

Drost, Ruben M W A; Paulus, Aggie T G; Ruwaard, Dirk; Evers, Silvia M A A

2013-12-01

Many preventive interventions for mental disorders have costs and benefits that spill over to sectors outside the healthcare sector. Little is known about these "inter-sectoral costs and benefits" (ICBs) of prevention. However, to achieve an efficient allocation of scarce resources, insights on ICBs are indispensable. The main aim was to identify the ICBs related to the prevention of mental disorders and provide a sector-specific classification scheme for these ICBs. Using PubMed, a literature search was conducted for ICBs of mental disorders and related (psycho)social effects. A policy perspective was used to build the scheme's structure, which was adapted to the outcomes of the literature search. In order to validate the scheme's international applicability inside and outside the mental health domain, semi-structured interviews were conducted with (inter)national experts in the broad fields of health promotion and disease prevention. The searched-for items appeared in a total of 52 studies. The ICBs found were classified in one of four sectors: "Education", "Labor and Social Security", "Household and Leisure" or "Criminal Justice System". Psycho(social) effects were placed in a separate section under "Individual and Family". Based on interviews, the scheme remained unadjusted, apart from adding a population-based dimension. This is the first study which offers a sector-specific classification of ICBs. Given the explorative nature of the study, no guidelines on sector-specific classification of ICBs were available. Nevertheless, the classification scheme was acknowledged by an international audience and could therefore provide added value to researchers and policymakers in the field of mental health economics and prevention. The identification and classification of ICBs offers decision makers supporting information on how to optimally allocate scarce resources with respect to preventive interventions for mental disorders. By exploring a new area of research, which has remained largely unexplored until now, the current study has an added value as it may form the basis for the development of a tool which can be used to calculate the ICBs of specific mental health related preventive interventions.

Automatic classification of protein structures using physicochemical parameters.

PubMed

Mohan, Abhilash; Rao, M Divya; Sunderrajan, Shruthi; Pennathur, Gautam

2014-09-01

Protein classification is the first step to functional annotation; SCOP and Pfam databases are currently the most relevant protein classification schemes. However, the disproportion in the number of three dimensional (3D) protein structures generated versus their classification into relevant superfamilies/families emphasizes the need for automated classification schemes. Predicting function of novel proteins based on sequence information alone has proven to be a major challenge. The present study focuses on the use of physicochemical parameters in conjunction with machine learning algorithms (Naive Bayes, Decision Trees, Random Forest and Support Vector Machines) to classify proteins into their respective SCOP superfamily/Pfam family, using sequence derived information. Spectrophores™, a 1D descriptor of the 3D molecular field surrounding a structure was used as a benchmark to compare the performance of the physicochemical parameters. The machine learning algorithms were modified to select features based on information gain for each SCOP superfamily/Pfam family. The effect of combining physicochemical parameters and spectrophores on classification accuracy (CA) was studied. Machine learning algorithms trained with the physicochemical parameters consistently classified SCOP superfamilies and Pfam families with a classification accuracy above 90%, while spectrophores performed with a CA of around 85%. Feature selection improved classification accuracy for both physicochemical parameters and spectrophores based machine learning algorithms. Combining both attributes resulted in a marginal loss of performance. Physicochemical parameters were able to classify proteins from both schemes with classification accuracy ranging from 90-96%. These results suggest the usefulness of this method in classifying proteins from amino acid sequences.

Citizen science based monitoring of Greylag goose (Anser anser) in Bavaria (Germany): combining count data and bag data to estimate long-term trends between 1988/89 and 2010/11.

PubMed

Grauer, Andreas; König, Andreas; Bunnefeld, Nils

2015-01-01

Numbers of large grazing bird (geese, swans, cranes) have increased all over Europe, but monitoring these species, e.g. for management purposes, can be time consuming and costly. In Bavaria, sedentary Greylag geese (Anser anser) are monitored during the winter by two different citizen-based monitoring schemes: the International Waterbird Census [IWC] and hunting bag statistics. We compared the results of both schemes for the seasons 1988/89 to 2010/11 by analysing annual indices calculated using the software TRends and Indices for Monitoring Data-TRIM. We identified similar, highly significant rates of increase in both data sets for the entire region of Bavaria (IWC 14% [13-15%], bag 13% [12-14%]). Furthermore, in all of the seven Bavarian regions, trends in annual indices of both data sets correlated significantly. The quality of both datasets as indicators of abundances in Greylag geese populations in Bavaria was not undermined by either weaknesses typically associated with citizen based monitoring or problems generally assumed for IWC and bag data. We also show that bag data are, under the German system of collecting bag statistics, a reliable indicator of species' distribution, especially for detecting newly colonized areas. Therefore, wildlife managers may want to consider bag data from citizen science led monitoring programmes as evidence supporting the decision making processes. We also discuss requirements for any bag monitoring schemes being established to monitor trends in species' distribution and abundance.

Rough Set Based Splitting Criterion for Binary Decision Tree Classifiers

DTIC Science & Technology

2006-09-26

Alata O. Fernandez-Maloigne C., and Ferrie J.C. (2001). Unsupervised Algorithm for the Segmentation of Three-Dimensional Magnetic Resonance Brain ...instinctual and learned responses in the brain , causing it to make decisions based on patterns in the stimuli. Using this deceptively simple process...2001. [2] Bohn C. (1997). An Incremental Unsupervised Learning Scheme for Function Approximation. In: Proceedings of the 1997 IEEE International

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

Information Management of Web Application Based Environmental Performance Management in Concentrating Division of PTFI

NASA Astrophysics Data System (ADS)

Susanto, Arif; Mulyono, Nur Budi

2018-02-01

The changes of environmental management system standards into the latest version, i.e. ISO 14001:2015, may cause a change on a data and information need in decision making and achieving the objectives in the organization coverage. Information management is the organization's responsibility to ensure that effectiveness and efficiency start from its creating, storing, processing and distribution processes to support operations and effective decision making activity in environmental performance management. The objective of this research was to set up an information management program and to adopt the technology as the supporting component of the program which was done by PTFI Concentrating Division so that it could be in line with the desirable organization objective in environmental management based on ISO 14001:2015 environmental management system standards. Materials and methods used covered technical aspects in information management, i.e. with web-based application development by using usage centered design. The result of this research showed that the use of Single Sign On gave ease to its user to interact further on the use of the environmental management system. Developing a web-based through creating entity relationship diagram (ERD) and information extraction by conducting information extraction which focuses on attributes, keys, determination of constraints. While creating ERD is obtained from relational database scheme from a number of database from environmental performances in Concentrating Division.

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

PubMed Central

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-01-01

OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

Preference phenotypes can be used to support shared decision-making at point-of-care for patients with rheumatoid arthritis: A proof of concept study.

PubMed

Hsiao, Betty; Binder-Finnema, Pauline; Benjamin Nowell, W; Michel, George; Wiedmeyer, Carole; Fraenkel, Liana

2018-06-28

In this proof-of-concept study, we sought to evaluate whether a value clarification tool enabling patients to view a set of rheumatoid arthritis (RA) treatment preference phenotypes could be used to support shared decision-making (SDM) at the point-of-care. We conducted a pre-post test study. All English-speaking RA patients presenting to their scheduled outpatient visits were asked to participate. Visits for patients with active RA were transcribed. SDM components were measured using a quantitative coding scheme based on an established model of SDM. Forty-six visits were included in the pre-test and 40 in the post-test phase. Providers offered more DMARDs (two or more) in the post-test visits (60%) compared to the pre-test visits (47.8%). Overall, more patients vocalized their values and/or preferences in the post-test visits compared to the pre-test visits for treatment escalation decisions including choice of one new DMARD (90.9% versus 56.3%), two or more new DMARDs (95.8% versus 86.4%), as well as prednisone (87.5% versus 66.7%). Providers were also more likely to base their recommendations on patients' values and/or preferences in the post-test (100% of six visits) than pre-test (64.3% of 14 visits) phase during visits in which a recommendation was made. The average (SD) length of the visit was 29.9 (11.6) minutes and 25.1 (10.7) minutes in the pre- and post-test phases respectively. This study provides an early indication that a value clarification tool allowing patients to consider a set of preference phenotypes can support SDM at the point-of-care without extending visit time. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics.

PubMed

Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba

2014-10-01

In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (p<0.01). Furthermore, the sensitivity and specificity values were 0.857 and 0.870, respectively. Our results show that the accurate classification of syndromes is feasible using ML techniques. Thus, a large number of syndromes with characteristic facial anomaly patterns could be diagnosed with similar diagnostic DSSs to that described in the present study, i.e., visual diagnostic DSS, thereby demonstrating the benefits of using hybrid image processing and ML-based computer-aided diagnostics for identifying facial phenotypes. Copyright © 2014. Published by Elsevier B.V.

Factors influencing the decision to drop out of health insurance enrolment among urban slum dwellers in Ghana.

PubMed

Atinga, Roger A; Abiiro, Gilbert Abotisem; Kuganab-Lem, Robert Bella

2015-03-01

To identify the factors influencing dropout from Ghana's health insurance scheme among populations living in slum communities. Cross-sectional data were collected from residents of 22 slums in the Accra Metropolitan Assembly. Cluster and systematic random sampling techniques were used to select and interview 600 individuals who had dropped out from the scheme 6 months prior to the study. Descriptive statistics and multivariate logistic regression models were computed to account for sample characteristics and reasons associated with the decision to dropout. The proportion of dropouts in the sample increased from the range of 6.8% in 2008 to 34.8% in 2012. Non-affordability of premium was the predominant reason followed by rare illness episodes, limited benefits of the scheme and poor service quality. Low-income earners and those with low education were significantly more likely to report premium non-affordability. Rare illness was a common reason among younger respondents, informal sector workers and respondents with higher education. All subgroups of age, education, occupation and income reported nominal benefits of the scheme as a reason for dropout. Interventions targeted at removing bottlenecks to health insurance enrolment are salient to maximising the size of the insurance pool. Strengthening service quality and extending the premium exemption to cover low-income families in slum communities is a valuable strategy to achieve universal health coverage. © 2014 John Wiley & Sons Ltd.

The implementation and use of Ada on distributed systems with high reliability requirements

NASA Technical Reports Server (NTRS)

Knight, J. C.

1987-01-01

Performance analysis was begin on the Ada implementations. The goal is to supply the system designer with tools that will allow a rational decision to be made about whether a particular implementation can support a given application early in the design cycle. Primary activities were: analysis of the original approach to recovery in distributed Ada programs using the Advanced Transport Operating System (ATOPS) example; review and assessment of the original approach which was found to be capable of improvement; preparation and presentation of a paper at the 1987 Washington DC Ada Symposium; development of a refined approach to recovery that is presently being applied to the ATOPS example; and design and development of a performance assessment scheme for Ada programs based on a flexible user-driven benchmarking system.

Exploring kidney patients’ experiences of receiving individual peer support

PubMed Central

Hughes, Jane; Wood, Eleri; Smith, Gaynor

2009-01-01

Abstract Background  Peer support schemes of various types are commonly offered to patients as an adjunct to health and social care services provided by professionals. For patients with chronic illness, peer support interventions have recently become associated with more directive attempts to increase self management and improve healthcare outcomes. There is little qualitative research on patients’ experiences of one‐to‐one peer support. Purpose  To explore kidney patients’ experiences of receiving individual peer support. Setting  Two large teaching hospital renal units in South London, with peer support services for patients on the pre‐dialysis care pathway. Methods  Qualitative telephone interviews with a purposive, maximum variation sample of 20 people who had received peer support. Results  The majority of respondents were overwhelmingly positive about their experience of peer support and its benefits. They valued peer support because it had given them access to practical information about kidney disease, based on lived experience, which helped them reach decisions about treatment. Peer supporters offered patients empathy and understanding; confirmation that they were not alone in suffering; positive role models of coping with treatment for kidney disease; and hope for the future. Peer support helped patients adapt to chronic illness by normalizing adherence to demanding treatment regimes and increasing patients’ sense of empowerment and agency. Conclusions  A brief meeting with a peer supporter delivered similar perceived benefits to those described by participants in support groups. Possible explanations for this include selection and training of peer supporters; careful matching of patients with peer supporters; and responsiveness to individual user‐defined needs for information and psychosocial support. PMID:19691464

Electronic decision support for diagnostic imaging in a primary care setting

PubMed Central

Reed, Martin H

2011-01-01

Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines. Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software. Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. PMID:21486884

Research on the supercapacitor support schemes for LVRT of variable-frequency drive in the thermal power plant

NASA Astrophysics Data System (ADS)

Han, Qiguo; Zhu, Kai; Shi, Wenming; Wu, Kuayu; Chen, Kai

2018-02-01

In order to solve the problem of low voltage ride through(LVRT) of the major auxiliary equipment’s variable-frequency drive (VFD) in thermal power plant, the scheme of supercapacitor paralleled in the DC link of VFD is put forward, furthermore, two solutions of direct parallel support and voltage boost parallel support of supercapacitor are proposed. The capacitor values for the relevant motor loads are calculated according to the law of energy conservation, and they are verified by Matlab simulation. At last, a set of test prototype is set up, and the test results prove the feasibility of the proposed schemes.

Supporting end of life decision making: Case studies of relational closeness in supported decision making for people with severe or profound intellectual disability.

PubMed

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-11-01

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. Five people with severe or profound intellectual disability's experiences of supported decision making were examined. This article is particularly focused on one participant's experiences at the end of his life. All five case studies identified that supporters were most effective in providing decision-making support for participants when they were relationally close to the person and had knowledge of the person's life story, particularly in relation to events that demonstrated preference. Findings from this study provide new understandings of supported decision making for people with severe or profound intellectual disability and have particular relevance for supporting decision making at the end of life. © 2017 John Wiley & Sons Ltd.

Healthcare use and voluntary health insurance after retirement in Thailand.

PubMed

Kananurak, Papar

2014-06-01

The dramatic changes occurring in the age structure of the Thai population make providing healthcare services for the elderly a major challenge for decision makers. Because the number of the elderly will be increasing, together with the number of retired workers, under the Social Health Insurance (SHI) scheme, there will be the unmet needs for healthcare use after retirement. The SHI scheme does not cover workers after retirement unless they could use free healthcare for the elderly. In addition, the government budget is tight regarding the support of universal healthcare and long-term care services for all of the elderly. Therefore, the government could support retired workers who have the ability to pay by facilitating voluntary health insurance. The main objectives of the present study are to analyze the characteristics of workers that need health insurance after retirement and to identify the factors explaining healthcare use to offer healthcare services to meet the workers' needs and expectations. Four hundred insured workers under the Social Health Insurance (SHI) Scheme in Thailand were interviewed using a structured questionnaire. The Anderson-Newman model of healthcare use is the conceptual framework used in this study to understand the factors that explain healthcare use patterns of workers. Multiple regressions are employed extensively to evaluate the variables that predict healthcare use. According to the survey, a person that purchases voluntary health insurance is likely to be female, have a higher personal income, and healthy. The characteristics related to healthcare use were poor health status, a high personal income, and peeople afflicted by chronic illness. There is a gap between healthcare service use and the demand for voluntary health insurance. People that have a high income are more likely to purchase voluntary health insurance, while people in worse health and afflicted by chronic illness may have greater difficulty purchasing voluntary health insurance because they face higher premiums or are denied coverage by insurers.

Household adoption of energy and water-efficient appliances: An analysis of attitudes, labelling and complementary green behaviours in selected OECD countries.

PubMed

Dieu-Hang, To; Grafton, R Quentin; Martínez-Espiñeira, Roberto; Garcia-Valiñas, Maria

2017-07-15

Using a household-based data set of more than 12,000 households from 11 OECD countries, we analyse the factors underlying the decision by households to adopt energy-efficient and water-efficient equipment. We evaluate the roles of both attitudes and labelling schemes on the adoption of energy and water-efficient equipment, and also the interaction and complementarity between energy and water conservation behaviours. Our findings show: one, 'green' social norms and favourable attitudes towards the environment are associated with an increased likelihood of households' adoption of energy and water-efficient appliances; two, households' purchase decisions are positively affected by their awareness, understanding, and trust of labelling schemes; and three, there is evidence of complementarity between energy conservation and water conservation behaviours. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intersubjective decision-making for computer-aided forging technology design

NASA Astrophysics Data System (ADS)

Kanyukov, S. I.; Konovalov, A. V.; Muizemnek, O. Yu.

2017-12-01

We propose a concept of intersubjective decision-making for problems of open-die forging technology design. The intersubjective decisions are chosen from a set of feasible decisions using the fundamentals of the decision-making theory in fuzzy environment according to the Bellman-Zadeh scheme. We consider the formalization of subjective goals and the choice of membership functions for the decisions depending on subjective goals. We study the arrangement of these functions into an intersubjective membership function. The function is constructed for a resulting decision, which is chosen from a set of feasible decisions. The choice of the final intersubjective decision is discussed. All the issues are exemplified by a specific technological problem. The considered concept of solving technological problems under conditions of fuzzy goals allows one to choose the most efficient decisions from a set of feasible ones. These decisions correspond to the stated goals. The concept allows one to reduce human participation in automated design. This concept can be used to develop algorithms and design programs for forging numerous types of forged parts.

Whole-system evaluation research of a scheme to support inner city recruitment and retention of GPs.

PubMed

Bellman, Loretta

2002-12-01

The GP Assistant/Research Associate scheme developed in the Guy's, King's and St Thomas' School of Medicine, London, aims to attract and recruit young GPs (GP Assistants) and develop their commitment to work in local inner city practices. Continuing professional development for both young and established GPs is a key feature of the scheme. The objectives of the whole-system evaluation research were to explore the perspectives of 34 stakeholders in the academic department, the practices and the PCGs, and to investigate the experiences of 19 GP Assistants who have participated in the scheme. Qualitative methods included semi-structured interviews, non-participant observations in the practices, audio-taped meetings and personal journals. Data collection also included reviewing documentation of the scheme, i.e. the previous quantitative evaluation report, publications and e-mails. The multi-method approach enabled individual, group and team perspectives of the scheme and triangulation of the data through comparing dialogue with observations and documentary evidence. Thematic analysis was undertaken to elicit the complex experiences of the GP Assistants. Wide-ranging findings included enthusiastic support for the continuation of the scheme. The GP Assistants' personal and professional development was clearly evident from the themes 'eye opener', new knowledge, managing multiple roles, feeling vulnerable, time constraints and empowering processes. Seven of the GP Assistants have become partners and ten chose to remain working in local practices. Significant challenges for managing and leading the scheme were apparent. Greater co-operation and collaborative working between the academic department and the practices is required. The scheme provides a highly valued visible means of support for GPs and could act as a model for a career pathway aimed at enhancing recruitment and retention of GPs. The scheme is also at the forefront of national initiatives aimed at supporting single-handed practices and helping GPs with their continuing professional development. An integrated approach to change, education, research and development is advocated to enable recruitment and retention of GPs, their academic development, and to underpin the evolution of PCTs as learning organizations.

Turning science on robust cattle into improved genetic selection decisions.

PubMed

Amer, P R

2012-04-01

More robust cattle have the potential to increase farm profitability, improve animal welfare, reduce the contribution of ruminant livestock to greenhouse gas emissions and decrease the risk of food shortages in the face of increased variability in the farm environment. Breeding is a powerful tool for changing the robustness of cattle; however, insufficient recording of breeding goal traits and selection of animals at younger ages tend to favour genetic change in productivity traits relative to robustness traits. This paper has extended a previously proposed theory of artificial evolution to demonstrate, using deterministic simulation, how choice of breeding scheme design can be used as a tool to manipulate the direction of genetic progress, whereas the breeding goal remains focussed on the factors motivating individual farm decision makers. Particular focus was placed on the transition from progeny testing or mass selection to genomic selection breeding strategies. Transition to genomic selection from a breeding strategy where candidates are selected before records from progeny being available was shown to be highly likely to favour genetic progress in robustness traits relative to productivity traits. This was shown even with modest numbers of animals available for training and when heritability for robustness traits was only slightly lower than that for productivity traits. When transitioning from progeny testing to a genomic selection strategy without progeny testing, it was shown that there is a significant risk that robustness traits could become less influential in selection relative to productivity traits. Augmentations of training populations using genotyped cows and support for industry-wide improvements in phenotypic recording of robustness traits were put forward as investment opportunities for stakeholders wishing to facilitate the application of science on robust cattle into improved genetic selection schemes.

Should I stay or should I go? A systematic review of factors that influence healthcare students' decisions around study abroad programmes.

PubMed

Brown, Mary; Boateng, Edward Appiah; Evans, Catrin

2016-04-01

Study abroad programmes have been shown to have significant benefits for participating healthcare students such as promoting cultural awareness and understanding of different healthcare settings, policies and practices. Healthcare students are encouraged to undertake elective or Erasmus placements overseas to enhance personal and professional development and to broaden horizons through lived cultural experience. However, there is a relatively low uptake of such opportunities amongst this student group. This systematic review aimed to explore factors that influence healthcare students' decision making around study abroad opportunities within undergraduate training programmes. A systematic review was undertaken utilising a narrative synthesis approach. A comprehensive literature search was conducted on MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and ERIC databases. Key institutions were contacted for grey literature. Studies that reported on factors that influence healthcare students' decisions regarding study abroad programmes were included in the review. Ten studies were identified for inclusion (5 qualitative studies, 5 surveys), indicating a paucity of research in this area. Data synthesis indicates that factors that influence healthcare students' decisions to participate in study abroad programmes are similar across different geographic locations and different professional groups. Factors that support decisions to study overseas include having sufficient information about study abroad programmes, especially early in an academic programme, having an interest in other cultures/countries and having academic staff and family as positive role models who motivate them to study abroad. Key barriers are cost and language issues. Language remains a significant barrier even when generous bursaries are available, as with the Erasmus scheme, when students are not proficient with the language spoken in host countries. Students tend to prefer destinations where language is not a problem or where countries have cultural or historical connections, such as being part of the Commonwealth countries. Promotion of study abroad opportunities needs to start early in an academic programme. It should include detailed information and provision of language support. Faculty have an important part to play as enthusiastic role models. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Projections of the number of Australians with disability aged 65 and over eligible for the National Disability Insurance Scheme: 2017-2026.

PubMed

Biddle, Nicholas; Crawford, Heather

2017-12-01

To develop projections of the size of the Australian population aged 65 years and over eligible for disability support through the National Disability Insurance Scheme (NDIS) for the decade following its introduction, to support planning and costing of the scheme. We estimate disability and mortality transition probabilities and develop projections of the NDIS-eligible, ageing population from 2017 to 2026. An estimated 8000 men and 10 200 women aged 65 years and over will be eligible for support through the NDIS in 2017 (the scheme's first full year), increasing to 48 800 men and 56 900 women in 2026. Growth in the NDIS-eligible, ageing population has implications for relative budget allocations between the NDIS and the aged-care system, and projections of the size of this population are useful for calculating the overall cost of the NDIS. © 2017 AJA Inc.

Comparison of the 1999 and 2006 Trauma Triage Guidelines: Where do Patients Go?

PubMed Central

Lerner, E. Brooke; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Guse, Clare E.; Brasel, Karen; Blatt, Alan; Jurkovich, Gregory J.

2010-01-01

In 2006, the CDC released a revised Field Triage Decision Scheme. It is unknown how this modified scheme will affect the number of patients identified by EMS for transport to a trauma center. Objective To determine the change in the number of patients transported by EMS who meet the 2006 scheme, compared to the 1999 scheme, and to determine how the scheme change would affect under- and over-triage rates. Methods EMS providers in charge of care for injured adult patients transported to a regional trauma center in three mid-sized cities were interviewed immediately after completing transport. All injured patients were included, regardless of severity. The interview included patient demographics, vital signs, apparent anatomic injury, and the mechanism of injury. Included patients were then followed through hospital discharge. The 1999 and 2006 scheme criteria were each retrospectively applied to the collected data. The number of patients identified by the two schemes was determined. Patients were considered to have needed a trauma center if they had non-orthopedic surgery within 24 hours, ICU admission, or died. Data were analyzed using descriptive statistics including 95% confidence intervals. Results EMS interviews were conducted for 11,892 patients and outcome data was unavailable for one patient. Average patient age was 48 years; 51% were men. Providers reported bringing 54% of the enrolled patients to the trauma center based on their local trauma protocol. 12% of enrolled patients were identified as needing a trauma center based on medical record review. Use of the 2006 scheme would have resulted in 1,423 fewer patients (12%; 95% CI:11-13%) being identified as needing a trauma center by EMS providers (40%; 95%CI:39-41% versus 28%; 95%CI:27-29%). 1,344 of those patients did not actually need the resources of a trauma center (94%). 78 (6%) of those patients actually needed the resources of a trauma center and would have been under-triaged. Conclusion Use of the 2006 Field Triage Decision Scheme would have resulted in a significant decrease in the number of patients identified as needing the resources of a trauma center. These changes reduced over-triage while causing a small increase in the number of patients who would have been under-triaged. PMID:21054176

Verifier-based three-party authentication schemes using extended chaotic maps for data exchange in telecare medicine information systems.

PubMed

Lee, Tian-Fu

2014-12-01

Telecare medicine information systems provide a communicating platform for accessing remote medical resources through public networks, and help health care workers and medical personnel to rapidly making correct clinical decisions and treatments. An authentication scheme for data exchange in telecare medicine information systems enables legal users in hospitals and medical institutes to establish a secure channel and exchange electronic medical records or electronic health records securely and efficiently. This investigation develops an efficient and secure verified-based three-party authentication scheme by using extended chaotic maps for data exchange in telecare medicine information systems. The proposed scheme does not require server's public keys and avoids time-consuming modular exponential computations and scalar multiplications on elliptic curve used in previous related approaches. Additionally, the proposed scheme is proven secure in the random oracle model, and realizes the lower bounds of messages and rounds in communications. Compared to related verified-based approaches, the proposed scheme not only possesses higher security, but also has lower computational cost and fewer transmissions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effect of different sampling schemes on the spatial placement of conservation reserves in Utah, USA

USGS Publications Warehouse

Bassett, S.D.; Edwards, T.C.

2003-01-01

We evaluated the effect of three different sampling schemes used to organize spatially explicit biological information had on the spatial placement of conservation reserves in Utah, USA. The three sampling schemes consisted of a hexagon representation developed by the EPA/EMAP program (statistical basis), watershed boundaries (ecological), and the current county boundaries of Utah (socio-political). Four decision criteria were used to estimate effects, including amount of area, length of edge, lowest number of contiguous reserves, and greatest number of terrestrial vertebrate species covered. A fifth evaluation criterion was the effect each sampling scheme had on the ability of the modeled conservation reserves to cover the six major ecoregions found in Utah. Of the three sampling schemes, county boundaries covered the greatest number of species, but also created the longest length of edge and greatest number of reserves. Watersheds maximized species coverage using the least amount of area. Hexagons and watersheds provide the least amount of edge and fewest number of reserves. Although there were differences in area, edge and number of reserves among the sampling schemes, all three schemes covered all the major ecoregions in Utah and their inclusive biodiversity. ?? 2003 Elsevier Science Ltd. All rights reserved.

Prediction-based association control scheme in dense femtocell networks

PubMed Central

Pham, Ngoc-Thai; Huynh, Thong; Hwang, Won-Joo; You, Ilsun; Choo, Kim-Kwang Raymond

2017-01-01

The deployment of large number of femtocell base stations allows us to extend the coverage and efficiently utilize resources in a low cost manner. However, the small cell size of femtocell networks can result in frequent handovers to the mobile user, and consequently throughput degradation. Thus, in this paper, we propose predictive association control schemes to improve the system’s effective throughput. Our design focuses on reducing handover frequency without impacting on throughput. The proposed schemes determine handover decisions that contribute most to the network throughput and are proper for distributed implementations. The simulation results show significant gains compared with existing methods in terms of handover frequency and network throughput perspective. PMID:28328992

A back-fitting algorithm to improve real-time flood forecasting

NASA Astrophysics Data System (ADS)

Zhang, Xiaojing; Liu, Pan; Cheng, Lei; Liu, Zhangjun; Zhao, Yan

2018-07-01

Real-time flood forecasting is important for decision-making with regards to flood control and disaster reduction. The conventional approach involves a postprocessor calibration strategy that first calibrates the hydrological model and then estimates errors. This procedure can simulate streamflow consistent with observations, but obtained parameters are not optimal. Joint calibration strategies address this issue by refining hydrological model parameters jointly with the autoregressive (AR) model. In this study, five alternative schemes are used to forecast floods. Scheme I uses only the hydrological model, while scheme II includes an AR model for error correction. In scheme III, differencing is used to remove non-stationarity in the error series. A joint inference strategy employed in scheme IV calibrates the hydrological and AR models simultaneously. The back-fitting algorithm, a basic approach for training an additive model, is adopted in scheme V to alternately recalibrate hydrological and AR model parameters. The performance of the five schemes is compared with a case study of 15 recorded flood events from China's Baiyunshan reservoir basin. Our results show that (1) schemes IV and V outperform scheme III during the calibration and validation periods and (2) scheme V is inferior to scheme IV in the calibration period, but provides better results in the validation period. Joint calibration strategies can therefore improve the accuracy of flood forecasting. Additionally, the back-fitting recalibration strategy produces weaker overcorrection and a more robust performance compared with the joint inference strategy.

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Decision algorithm for data center vortex beam receiver

NASA Astrophysics Data System (ADS)

Kupferman, Judy; Arnon, Shlomi

2017-12-01

We present a new scheme for a vortex beam communications system which exploits the radial component p of Laguerre-Gauss modes in addition to the azimuthal component l generally used. We derive a new encoding algorithm which makes use of the spatial distribution of intensity to create an alphabet dictionary for communication. We suggest an application of the scheme as part of an optical wireless link for intra data center communication. We investigate the probability of error in decoding, for several detector options.

Large Area Crop Inventory Experiment (LACIE). An early estimate of small grains acreage

NASA Technical Reports Server (NTRS)

Lea, R. N.; Kern, D. M. (Principal Investigator)

1979-01-01

The author has identified the following significant results. A major advantage of this scheme is that it needs minimal human intervention. The entire scheme, with the exception of the choice of dates, can be computerized and the results obtained in minutes. The decision to limit the number of acquisitions processed to four was made to facilitate operation on the particular computer being used. Some earlier runs on another computer system were based on as many as seven biophase-1 acquisitions.

Studies in integrated line-and packet-switched computer communication systems

NASA Astrophysics Data System (ADS)

Maglaris, B. S.

1980-06-01

The problem of efficiently allocating the bandwidth of a trunk to both types of traffic is handled for various system and traffic models. A performance analysis is carried out both for variable and fixed frame schemes. It is shown that variable frame schemes, adjusting the frame length according to the traffic variations, offer better trunk utilization at the cost of the additional hardware and software complexity needed because of the lack of synchronization. An optimization study on the fixed frame schemes follows. The problem of dynamically allocating the fixed frame to both types of traffic is formulated as a Markovian Decision process. It is shown that the movable boundary scheme, suggested for commercial implementations of integrated multiplexors, offers optimal or near optimal performance and simplicity of implementation. Finally, the behavior of the movable boundary integrated scheme is studied for tandem link connections. Under the assumptions made for the line-switched traffic, the forward allocation technique is found to offer the best alternative among different path set-up strategies.

Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

ERIC Educational Resources Information Center

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-01-01

Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

Does letter position coding depend on consonant/vowel status? Evidence with the masked priming technique.

PubMed

Perea, Manuel; Acha, Joana

2009-02-01

Recently, a number of input coding schemes (e.g., SOLAR model, SERIOL model, open-bigram model, overlap model) have been proposed that capture the transposed-letter priming effect (i.e., faster response times for jugde-JUDGE than for jupte-JUDGE). In their current version, these coding schemes do not assume any processing differences between vowels and consonants. However, in a lexical decision task, Perea and Lupker (2004, JML; Lupker, Perea, & Davis, 2008, L&CP) reported that transposed-letter priming effects occurred for consonant transpositions but not for vowel transpositions. This finding poses a challenge for these recently proposed coding schemes. Here, we report four masked priming experiments that examine whether this consonant/vowel dissociation in transposed-letter priming is task-specific. In Experiment 1, we used a lexical decision task and found a transposed-letter priming effect only for consonant transpositions. In Experiments 2-4, we employed a same-different task - a task which taps early perceptual processes - and found a robust transposed-letter priming effect that did not interact with consonant/vowel status. We examine the implications of these findings for the front-end of the models of visual word recognition.

Design of an extensive information representation scheme for clinical narratives.

PubMed

Deléger, Louise; Campillos, Leonardo; Ligozat, Anne-Laure; Névéol, Aurélie

2017-09-11

Knowledge representation frameworks are essential to the understanding of complex biomedical processes, and to the analysis of biomedical texts that describe them. Combined with natural language processing (NLP), they have the potential to contribute to retrospective studies by unlocking important phenotyping information contained in the narrative content of electronic health records (EHRs). This work aims to develop an extensive information representation scheme for clinical information contained in EHR narratives, and to support secondary use of EHR narrative data to answer clinical questions. We review recent work that proposed information representation schemes and applied them to the analysis of clinical narratives. We then propose a unifying scheme that supports the extraction of information to address a large variety of clinical questions. We devised a new information representation scheme for clinical narratives that comprises 13 entities, 11 attributes and 37 relations. The associated annotation guidelines can be used to consistently apply the scheme to clinical narratives and are https://cabernet.limsi.fr/annotation_guide_for_the_merlot_french_clinical_corpus-Sept2016.pdf . The information scheme includes many elements of the major schemes described in the clinical natural language processing literature, as well as a uniquely detailed set of relations.

Factors influencing support for National Health Insurance among patients attending specialist clinics in Malaysia.

PubMed

Almualm, Yasmin; Alkaff, Sharifa Ezat; Aljunid, Syed; Alsagoff, Syed Sagoff

2013-05-14

This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrollment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered.

Factors Influencing Support for National Health Insurance among Patients Attending Specialist Clinics in Malaysia

PubMed Central

Almualm, Yasmin; Alkaff, Sharifa Ezat; Aljunid, Syed; Alsagoff, Syed Sagoff

2013-01-01

This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrolment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered. PMID:23985101

Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

Treesearch

Erin K. Noonan-Wright; Tonja S. Opperman

2015-01-01

In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

Decision support for clinical laboratory capacity planning.

PubMed

van Merode, G G; Hasman, A; Derks, J; Goldschmidt, H M; Schoenmaker, B; Oosten, M

1995-01-01

The design of a decision support system for capacity planning in clinical laboratories is discussed. The DSS supports decisions concerning the following questions: how should the laboratory be divided into job shops (departments/sections), how should staff be assigned to workstations and how should samples be assigned to workstations for testing. The decision support system contains modules for supporting decisions at the overall laboratory level (concerning the division of the laboratory into job shops) and for supporting decisions at the job shop level (assignment of staff to workstations and sample scheduling). Experiments with these modules are described showing both the functionality and the validity.

Features of computerized clinical decision support systems supportive of nursing practice: a literature review.

PubMed

Lee, Seonah

2013-10-01

This study aimed to organize the system features of decision support technologies targeted at nursing practice into assessment, problem identification, care plans, implementation, and outcome evaluation. It also aimed to identify the range of the five stage-related sequential decision supports that computerized clinical decision support systems provided. MEDLINE, CINAHL, and EMBASE were searched. A total of 27 studies were reviewed. The system features collected represented the characteristics of each category from patient assessment to outcome evaluation. Several features were common across the reviewed systems. For the sequential decision support, all of the reviewed systems provided decision support in sequence for patient assessment and care plans. Fewer than half of the systems included problem identification. There were only three systems operating in an implementation stage and four systems in outcome evaluation. Consequently, the key steps for sequential decision support functions were initial patient assessment, problem identification, care plan, and outcome evaluation. Providing decision support in such a full scope will effectively help nurses' clinical decision making. By organizing the system features, a comprehensive picture of nursing practice-oriented computerized decision support systems was obtained; however, the development of a guideline for better systems should go beyond the scope of a literature review.

LevelScheme: A level scheme drawing and scientific figure preparation system for Mathematica

NASA Astrophysics Data System (ADS)

Caprio, M. A.

2005-09-01

LevelScheme is a scientific figure preparation system for Mathematica. The main emphasis is upon the construction of level schemes, or level energy diagrams, as used in nuclear, atomic, molecular, and hadronic physics. LevelScheme also provides a general infrastructure for the preparation of publication-quality figures, including support for multipanel and inset plotting, customizable tick mark generation, and various drawing and labeling tasks. Coupled with Mathematica's plotting functions and powerful programming language, LevelScheme provides a flexible system for the creation of figures combining diagrams, mathematical plots, and data plots. Program summaryTitle of program:LevelScheme Catalogue identifier:ADVZ Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADVZ Operating systems:Any which supports Mathematica; tested under Microsoft Windows XP, Macintosh OS X, and Linux Programming language used:Mathematica 4 Number of bytes in distributed program, including test and documentation:3 051 807 Distribution format:tar.gz Nature of problem:Creation of level scheme diagrams. Creation of publication-quality multipart figures incorporating diagrams and plots. Method of solution:A set of Mathematica packages has been developed, providing a library of level scheme drawing objects, tools for figure construction and labeling, and control code for producing the graphics.

Characterizing hydrological hazards and trends with the NASA South Asia Land Data Assimilation System

NASA Astrophysics Data System (ADS)

Ghatak, D.; Zaitchik, B. F.; Limaye, A. S.; Searby, N. D.; Doorn, B.; Bolten, J. D.; Toll, D. L.; Lee, S.; Mourad, B.; Narula, K.; Nischal, S.; Iceland, C.; Bajracharya, B.; Kumar, S.; Shrestha, B. R.; Murthy, M.; Hain, C.; Anderson, M. C.

2015-12-01

South Asia faces severe challenges to meet the need of water for agricultural, domestic and industrial purposes while coping with the threats posed by climate and land use/cover changes on regional hydrology. South Asia is also characterized by extreme climate contrasts, remote and poorly-monitored headwaters regions, and large uncertainties in estimates of consumptive water withdrawals. Here, we present results from the South Asia Land Data Assimilation System (South Asia LDAS) that apply multiple simulations involving different combination of forcing datasets, land surface models, and satellite-derived parameter datasets to characterize the distributed water balance of the subcontinent. The South Asia LDAS ensemble of simulations provides a range of uncertainty associated with model products. The system includes customized irrigation schemes to capture water use and HYMAP streamflow routing for application to floods. This presentation focuses on two key application areas for South Asia LDAS: the representation of extreme floods in transboundary rivers, and the estimate of water use in irrigated agriculture. We show that South Asia LDAS captures important features of both phenomena, address opportunities and barriers for the use of South Asia LDAS in decision support, and review uncertainties and limitations.This work is being performed by an interdisciplinary team of scientists and decision makers, to ensure that the modeling system meets the needs of decision makers at national and regional levels.

Development of a fuzzy-stochastic programming with Green Z-score criterion method for planning water resources systems with a trading mechanism.

PubMed

Zeng, X T; Huang, G H; Li, Y P; Zhang, J L; Cai, Y P; Liu, Z P; Liu, L R

2016-12-01

This study developed a fuzzy-stochastic programming with Green Z-score criterion (FSGZ) method for water resources allocation and water quality management with a trading-mechanism (WAQT) under uncertainties. FSGZ can handle uncertainties expressed as probability distributions, and it can also quantify objective/subjective fuzziness in the decision-making process. Risk-averse attitudes and robustness coefficient are joined to express the relationship between the expected target and outcome under various risk preferences of decision makers and systemic robustness. The developed method is applied to a real-world case of WAQT in the Kaidu-Kongque River Basin in northwest China, where an effective mechanism (e.g., market trading) to simultaneously confront severely diminished water availability and degraded water quality is required. Results of water transaction amounts, water allocation patterns, pollution mitigation schemes, and system benefits under various scenarios are analyzed, which indicate that a trading-mechanism is a more sustainable method to manage water-environment crisis in the study region. Additionally, consideration of anthropogenic (e.g., a risk-averse attitude) and systemic factors (e.g., the robustness coefficient) can support the generation of a robust plan associated with risk control for WAQT when uncertainty is present. These findings assist local policy and decision makers to gain insights into water-environment capacity planning to balance the basin's social and economic growth with protecting the region's ecosystems.

Revisiting the Decision of Death in Hurst v. Florida.

PubMed

Cooke, Brian K; Ginory, Almari; Zedalis, Jennifer

2016-12-01

The United States Supreme Court has considered the question of whether a judge or a jury must make the findings necessary to support imposition of the death penalty in several notable cases, including Spaziano v. Florida (1984), Hildwin v. Florida (1989), and Ring v. Arizona (2002). In 2016, the U.S. Supreme Court revisited the subject in Hurst v. Florida Florida Statute § 921.141 allows the judge, after weighing aggravating and mitigating circumstances, to enter a sentence of life imprisonment or death. Before Hurst, Florida's bifurcated sentencing proceedings included an advisory sentence from jurors and a separate judicial hearing without juror involvement. In Hurst, the Court revisited the question of whether Florida's capital sentencing scheme violates the Sixth Amendment, which requires a jury, not a judge, to find each fact necessary to impose a sentence of death in light of Ring In an eight-to-one decision, the Court reversed the judgment of the Florida Supreme Court, holding that the Sixth Amendment requires a jury to find the aggravating factors necessary for imposing the death penalty. The role of Florida juries in capital sentencing proceedings was thereby elevated from advisory to determinative. We examine the Court's decision and offer commentary regarding this shift from judge to jury in the final imposition of the death penalty and the overall effect of this landmark case. © 2016 American Academy of Psychiatry and the Law.

Farmer Attitudes and Livestock Disease: Exploring Citizenship Behaviour and Peer Monitoring across Two BVD Control Schemes in the UK.

PubMed

Heffernan, Claire; Azbel-Jackson, Lena; Brownlie, Joe; Gunn, George

2016-01-01

The eradication of BVD in the UK is technically possible but appears to be socially untenable. The following study explored farmer attitudes to BVD control schemes in relation to advice networks and information sharing, shared aims and goals, motivation and benefits of membership, notions of BVD as a priority disease and attitudes toward regulation. Two concepts from the organisational management literature framed the study: citizenship behaviour where actions of individuals support the collective good (but are not explicitly recognised as such) and peer to peer monitoring (where individuals evaluate other's behaviour). Farmers from two BVD control schemes in the UK participated in the study: Orkney Livestock Association BVD Eradication Scheme and Norfolk and Suffolk Cattle Breeders Association BVD Eradication Scheme. In total 162 farmers participated in the research (109 in-scheme and 53 out of scheme). The findings revealed that group helping and information sharing among scheme members was low with a positive BVD status subject to social censure. Peer monitoring in the form of gossip with regard to the animal health status of other farms was high. Interestingly, farmers across both schemes supported greater regulation with regard to animal health, largely due to the mistrust of fellow farmers following voluntary disease control measures. While group cohesiveness varied across the two schemes, without continued financial inducements, longer-term sustainability is questionable.

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

EPA Science Inventory

NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

Indigenous Tutorial Assistance Scheme. Tertiary Tuition and Beyond: Transitioning with Strengths and Promoting Opportunities

ERIC Educational Resources Information Center

Wilks, Judith; Fleeton, Ellen Radnidge; Wilson, Katie

2017-01-01

The Indigenous Tutorial Assistance Scheme-Tertiary Tuition (ITAS-TT) has provided Australian government funding for one-to-one and group tutorial study support for Aboriginal and Torres Strait Islander students attending Australian universities since 1989. It has been a central plank supporting Indigenous university students in their studies.…

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

PubMed Central

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

2017-01-01

Introduction: 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. Aim: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:28883671

Efficiency Assessment of Support Mechanisms for Wood-Fired Cogeneration Development in Estonia

NASA Astrophysics Data System (ADS)

Volkova, Anna; Siirde, Andres

2010-01-01

There are various support mechanisms for wood-fired cogeneration plants, which include both support for cogeneration development and stimulation for increasing consumption of renewable energy sources. The efficiency of these mechanisms is analysed in the paper. Overview of cogeneration development in Estonia is given with the focus on wood-fired cogeneration. Legislation acts and amendments, related to cogeneration support schemes, were described. For evaluating the efficiency of support mechanisms an indicator - fuel cost factor was defined. This indicator includes the costs related to the chosen fuel influence on the final electricity generation costs without any support mechanisms. The wood fuel cost factors were compared with the fuel cost factors for peat and oil shale. For calculating the fuel cost factors, various data sources were used. The fuel prices data were based on the average cost of fuels in Estonia for the period from 2000 till 2008. The data about operating and maintenance costs, related to the fuel type in the case of comparing wood fuel and oil shale fuel were taken from the CHP Balti and Eesti reports. The data about operating and maintenance costs used for peat and wood fuel comparison were taken from the Tallinn Elektrijaam reports. As a result, the diagrams were built for comparing wood and its competitive fuels. The decision boundary lines were constructed on the diagram for the situation, when no support was provided for wood fuels and for the situations, when various support mechanisms were provided during the last 12 years.

PFC neurons reflect categorical decisions about ambiguous stimuli.

PubMed

Roy, Jefferson E; Buschman, Timothy J; Miller, Earl K

2014-06-01

We examined whether PFC neuron activity reflects categorical decisions in monkeys categorizing ambiguous stimuli. A morphing system was used to systematically vary stimulus shape and precisely define category boundaries. Ambiguous stimuli were centered on a category boundary, that is, they were a mix of 50% of two prototypes and therefore had no category information, so monkeys guessed at their category membership. We found that the monkeys' trial-by-trial decision about the category membership of an ambiguous image was reflected in PFC activity. Activity to the same ambiguous image differed significantly, depending on which category the monkey had assigned it to. This effect only occurred when that scheme was behaviorally relevant. These indicate that PFC activity reflects categorical decisions.

The approaches for the decision support in case natural hazards

NASA Astrophysics Data System (ADS)

Vyazilov, Evgeny; Chunyaev, Nikita

2013-04-01

In spite of using highly automated systems of measurement, collecting, storing, handling, prediction and delivery of information on the marine environment, including natural hazards, the amount of damage from natural phenomena increases. Because information on the marine environment delivered to the industrial facilities not effectively used. To such information pays little attention by individual decision-makers and not always perform preventive measures necessary for reduce and prevent damage. Automation of information support will improve the efficiency management of the marine activities. In Russia develops "The Unified system of the information about World ocean" (ESIMO, http://esimo.ru/), that integrates observation, analysis, prognostic and climate data. Necessary to create tools to automatic selection natural disasters through all integrated data; notification decision-makers about arising natural hazards - software agent; provision of information in a compact form for the decision-makers; assessment of possible damage and costs to the preventive measures; providing information on the impacts of environment on economic facilities and recommendations for decision-making; the use of maps, diagrams, tables for reporting. Tools for automatic selection designed for identification of natural phenomena based on the resources ESIMO and corresponding critical values of the indicators environment. The result of this module will be constantly updated database of critical situations of environment for each object or technological process. To operational notify and provide current information about natural hazards proposes using a software agent that is installed on the computer decision-makers, which is activated in case critical situations and provides a minimum of information. In the event of natural disaster software agent should be able to inform decision-makers about this, providing information on the current situation, and the possibility for more and detailed information about natural hazard. Software agent must be able to be configured by the user to a specific object: a specific station or a drilling rigs that region or area, regardless of the size of the object. And depending on the selected settings and parameters it needs to apply the values of critical indexes. There is a need for real-time display hydrometeorological information with compact scheme that reflects the environment indicators that affect industrial facility in the form of devices (thermometer, aneroid, footstock, speedometer, hygrometer, thermograph, barograph, rain gauge, wind vane, etc.) with the ability to display indicators exceed a critical value. This scheme is designed to provide maximum information in the shortest possible time reference that provides an intuitive interface (display by generally accepted standardized instruments). Analytical services ESIMO combined with geographic information service provides information about area or point to decision-makers of showing the dynamics of changes of parameters in the form of graphics, diagrams, maps, tables. If the data sources are updated, analytical services automatically provides the relevance of the data in the analytical views of the complex. Analytical services works with database of integrated data and used for the preparation and presentation of the consumers of the federal and regional level for the analysis of information on the World Oceans. The analytic services show a set of indicators about the situation in the World Ocean. The complex provides the processing, analysis of qualitative and quantitative characteristics (indexes) of the marine environment and maritime activities of the Russian Federation. To assess the need for preventive measures, decision-makers require information in the form of potential economic consequences of natural hazard, cost of preventive measures to prevent damage. We can use for that the economic and mathematical models. When making the decision decision-makers must understand the possible consequences of natural phenomena and rely on the advice that they receive from a decision support system. Such information about the impacts and recommendations are based on the knowledge base (rules of "if, then"), formed on the basis of experience gained in the past. This should take into account not only the critical values for each object and technological process, but also the type of information (observations, forecasting, climate, and after the phenomenon), the level of decision-making, the season of the year, the climate zone where the object is located. Within ESIMO created integrated database that containing the results of the monitoring of the marine environment. The database includes the observation, analysis, and forecasting and climate data. Operational data is updated automatically at specified intervals of a few minutes to a week, depending on the frequency of observations. Climatic data is updated as needed, for example, once a year or once every five years. Integrated database contains a set of indicators related to a specific object, and to a certain geographic area, according to the observations made and the data entered data. In addition to hydrometeorological parameters database contains socio-economic information. At present, was created the database of critical values and information about the impacts of and recommendations for the 30 natural hazards, developed the data structure and software is under development. The interaction of all components of an information support will reduce the economic damage from natural disaster on individual objects economy (ships, ports, etc.) and improve public safety through more prompt delivery of information to decision-makers and the public, besides receive more informative data (district with symptoms natural phenomena , assessment of possible damage, the impact of and recommendations).

Judges, Legislators, and Social Change

ERIC Educational Resources Information Center

Dienes, C. Thomas

1970-01-01

The interaction analysis scheme describes the adjustment of the legal system to change. It is a dynamic decision-making process interacting internally among the judicial and legislative subsystems, and, externally with the social environment in the policy-making process. (SE)

Some implications of the technology assessment function for the effective public decision-making process

NASA Technical Reports Server (NTRS)

Mayo, L. H.

1971-01-01

A preliminary provisional assessment of the prospects for the establishment of an adequate technology assessment function and the implications of the assessment function for the public decision process are presented. Effects of the technology assessment function on each phase of the public decision process and briefly explored. Significant implications during the next decade are projected with respect to the following phases: invention and development of alternative means (technological configurations); evaluation, selection and promotion of preferred courses of action; and modification of statutory scheme or social action program as an outcome of continuing monitoring and appraisal.

Sustaining GAVI-supported vaccine introductions in resource-poor countries.

PubMed

Zuber, Patrick L F; El-Ziq, Ibrahim; Kaddar, Miloud; Ottosen, Ann E; Rosenbaum, Katinka; Shirey, Meredith; Kamara, Lidija; Duclos, Philippe

2011-04-12

Since 2000, GAVI provided essential support for an unprecedented increase in the use of hepatitis B (HepB) and Haemophilus influenzae (Hib) containing vaccines in resource poor countries. This increase was supported with significant funding from international donors, intended to be time-limited. To assess the sustainability of this important expansion of the global access to vaccines, we reviewed supply chains, financial resources for procurement and decision-making in countries that introduced hepatitis B or Hib vaccines with GAVI support. During the period studied, the types of vaccine products supplied fluctuated rapidly in relationship with the number of suppliers and availability of more combination products. The price of the cheaper vaccines decreased while that of pentavalent DTwP-HepB-Hib remained stable. In average, vaccine introduction was associated with an increase of national programs budget, with new vaccines representing more than half of that increase, while the part of GAVI contributions to the budget went from 25% to 46%. Less than 20% of the vaccine introductions were decided by a national advisory body. Strengthening supply chains, adjusting funding schemes and increasing national ownership will be key to the sustained use of hepatitis B and Hib vaccines and the eventual addition of other important vaccines where they are the most needed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Random access to mobile networks with advanced error correction

NASA Technical Reports Server (NTRS)

Dippold, Michael

1990-01-01

A random access scheme for unreliable data channels is investigated in conjunction with an adaptive Hybrid-II Automatic Repeat Request (ARQ) scheme using Rate Compatible Punctured Codes (RCPC) Forward Error Correction (FEC). A simple scheme with fixed frame length and equal slot sizes is chosen and reservation is implicit by the first packet transmitted randomly in a free slot, similar to Reservation Aloha. This allows the further transmission of redundancy if the last decoding attempt failed. Results show that a high channel utilization and superior throughput can be achieved with this scheme that shows a quite low implementation complexity. For the example of an interleaved Rayleigh channel and soft decision utilization and mean delay are calculated. A utilization of 40 percent may be achieved for a frame with the number of slots being equal to half the station number under high traffic load. The effects of feedback channel errors and some countermeasures are discussed.

SANDS: an architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2007-10-11

A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

Toward a Multilingual, Experiential Environment for Learning Decision Technology.

ERIC Educational Resources Information Center

Yeo, Gee Kin; Tan, Seng Teen

1999-01-01

Describes work at the National University of Singapore on the Internet in expanding a simulation game used in supporting a course in decision technology. Topics include decision support systems, multilingual support for cross-cultural decision studies, process support in a World Wide Web-enhanced multiuser domain (MUD) learning environment, and…

Maintenance and operations decision support tool : Clarus regional demonstrations.

DOT National Transportation Integrated Search

2011-01-01

Weather affects almost all maintenance activity decisions. The Federal Highway Administration (FHWA) tested a new decision support system for maintenance in Iowa, Indiana, and Illinois called the Maintenance and Operations Decision Support System (MO...

The Role of Health Care Provider and Partner Decisional Support in Patients' Cancer Treatment Decision-Making Satisfaction.

PubMed

Palmer-Wackerly, Angela L; Krieger, Janice L; Rhodes, Nancy D

2017-01-01

Cancer patients rely on multiple sources of support when making treatment decisions; however, most research studies examine the influence of health care provider support while the influence of family member support is understudied. The current study fills this gap by examining the influence of health care providers and partners on decision-making satisfaction. In a cross-sectional study via an online Qualtrics panel, we surveyed cancer patients who reported that they had a spouse or romantic partner when making cancer treatment decisions (n = 479). Decisional support was measured using 5-point, single-item scales for emotional support, informational support, informational-advice support, and appraisal support. Decision-making satisfaction was measured using Holmes-Rovner and colleagues' (1996) Satisfaction With Decision Scale. We conducted a mediated regression analysis to examine treatment decision-making satisfaction for all participants and a moderated mediation analysis to examine treatment satisfaction among those patients offered a clinical trial. Results indicated that partner support significantly and partially mediated the relationship between health care provider support and patients' decision-making satisfaction but that results did not vary by enrollment in a clinical trial. This study shows how and why decisional support from partners affects communication between health care providers and cancer patients.

An 11-bit 200 MS/s subrange SAR ADC with low-cost integrated reference buffer

NASA Astrophysics Data System (ADS)

He, Xiuju; Gu, Xian; Li, Weitao; Jiang, Hanjun; Li, Fule; Wang, Zhihua

2017-10-01

This paper presents an 11-bit 200 MS/s subrange SAR ADC with an integrated reference buffer in 65 nm CMOS. The proposed ADC employs a 3.5-bit flash ADC for coarse conversion, and a compact timing scheme at the flash/SAR boundary to speed up the conversion. The flash decision is used to control charge compensating for the reference voltage to reduce its input-dependent fluctuation. Measurement results show that the fabricated ADC has achieved significant improvement by applying the reference charge compensation. In addition, the ADC achieves a maximum signal-to-noise-and-distortion ratio of 59.3 dB at 200 MS/s. It consumes 3.91 mW from a 1.2 V supply, including the reference buffer. Project supported by the Zhongxing Telecommunication Equipment Corporation and Beijing Microelectronics Technology Institute.

Distinguishing Schemes and Tasks in Children's Development of Multiplicative Reasoning

ERIC Educational Resources Information Center

Tzur, Ron; Johnson, Heather L.; McClintock, Evan; Kenney, Rachael H.; Xin, Yan P.; Si, Luo; Woordward, Jerry; Hord, Casey; Jin, Xianyan

2013-01-01

We present a synthesis of findings from constructivist teaching experiments regarding six schemes children construct for reasoning multiplicatively and tasks to promote them. We provide a task-generating platform game, depictions of each scheme, and supporting tasks. Tasks must be distinguished from children's thinking, and learning situations…

Uncertainty and probability in wildfire management decision support: An example from the United States [Chapter 4

Treesearch

Matthew Thompson; David Calkin; Joe H. Scott; Michael Hand

2017-01-01

Wildfire risk assessment is increasingly being adopted to support federal wildfire management decisions in the United States. Existing decision support systems, specifically the Wildland Fire Decision Support System (WFDSS), provide a rich set of probabilistic and risk‐based information to support the management of active wildfire incidents. WFDSS offers a wide range...

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.

A Review of the Case of a Levy-Grant Scheme (LGS) in the UK Construction Industry

ERIC Educational Resources Information Center

Abdel-Wahab, Mohamed; Dainty, Andrew; Ison, Stephen

2010-01-01

A Levy-Grant Scheme (LGS) has existed in the UK construction industry since 1964 to provide financial support for companies undertaking training activities. Despite the support of the LGS for various training activities, notably apprenticeships, the construction industry continues to suffer from both labour shortages and an under-investment in…

Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

NASA Astrophysics Data System (ADS)

Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

2015-05-01

Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

Implementation of workflow engine technology to deliver basic clinical decision support functionality.

PubMed

Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

2011-04-10

Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform.

An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

PubMed Central

Aronsky, D.; Haug, P. J.

1999-01-01

Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

USGS Publications Warehouse

Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

2016-01-01

Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.

Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

PubMed

Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

2014-06-01

This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

Development of a decision support system for analysis and solutions of prolonged standing in the workplace.

PubMed

Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

2014-06-01

Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.

Development of a Decision Support System for Analysis and Solutions of Prolonged Standing in the Workplace

PubMed Central

Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

2014-01-01

Background Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. Methods The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Results Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. Conclusion The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially. PMID:25180141

How do values shape technology design? An exploration of what makes the pursuit of health and wealth legitimate in academic spin-offs.

PubMed

Lehoux, Pascale; Daudelin, Geneviève; Hivon, Myriam; Miller, Fiona Alice; Denis, Jean-Louis

2014-06-01

By actively supporting cooperation between academia, clinical settings and industry, several policy initiatives assume that the two policy agendas of health and wealth can be reconciled through the development of health technology. Our goal in this article is to shed light on the way the concurrent pursuit of health and wealth operates in practice by examining the valuation schemes, actions and decisions that shaped technology development in three Canadian spin-offs. Drawing on the sociology of judgement, our analytical framework conceives of technology development as a purposive collective action that unfolds in a normatively heterogeneous context (one pervaded with both corporate and public service mission values and norms). Our qualitative empirical analyses explore four valuation schemes and their corresponding regimes of engagement that characterise why and how technology developers commit themselves to addressing certain clinical, interactional, organisational and economic concerns throughout the development process. Our discussion suggests that the ability to reconcile health and wealth goals is to be found in the moral repertoires that provide meaning to, and render coherent technology developers' participation in corporate activities driven by economic growth. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Intellectual Production Supervision Perform based on RFID Smart Electricity Meter

NASA Astrophysics Data System (ADS)

Chen, Xiangqun; Huang, Rui; Shen, Liman; chen, Hao; Xiong, Dezhi; Xiao, Xiangqi; Liu, Mouhai; Xu, Renheng

2018-03-01

This topic develops the RFID intelligent electricity meter production supervision project management system. The system is designed for energy meter production supervision in the management of the project schedule, quality and cost information management requirements in RFID intelligent power, and provide quantitative information more comprehensive, timely and accurate for supervision engineer and project manager management decisions, and to provide technical information for the product manufacturing stage file. From the angle of scheme analysis, design, implementation and test, the system development of production supervision project management system for RFID smart meter project is discussed. Focus on the development of the system, combined with the main business application and management mode at this stage, focuses on the energy meter to monitor progress information, quality information and cost based information on RFID intelligent power management function. The paper introduces the design scheme of the system, the overall client / server architecture, client oriented graphical user interface universal, complete the supervision of project management and interactive transaction information display, the server system of realizing the main program. The system is programmed with C# language and.NET operating environment, and the client and server platforms use Windows operating system, and the database server software uses Oracle. The overall platform supports mainstream information and standards and has good scalability.

Work, Train, Win: Work-Based Learning Design and Management for Productivity Gains. OECD Education Working Papers, No. 135

ERIC Educational Resources Information Center

Kis, Viktoria

2016-01-01

Realising the potential of work-based learning schemes as a driver of productivity requires careful design and support. The length of work-based learning schemes should be adapted to the profile of productivity gains. A scheme that is too long for a given skill set might be unattractive for learners and waste public resources, but a scheme that is…

Developing the U.S. Wildland Fire Decision Support System

Treesearch

Erin Noonan-Wright; Tonja S. Opperman; Mark A. Finney; Tom Zimmerman; Robert C. Seli; Lisa M. Elenz; David E. Calkin; John R. Fiedler

2011-01-01

A new decision support tool, the Wildland Fire Decision Support System (WFDSS) has been developed to support risk-informed decision-making for individual fires in the United States. WFDSS accesses national weather data and forecasts, fire behavior prediction, economic assessment, smoke management assessment, and landscape databases to efficiently formulate and apply...

Decision Support for Ecosystem Management (Chapter 28)

Treesearch

Keith Reynolds; Jennifer Bjork; Rachel Riemann Hershey; Dan Schmoldt; John Payne; Susan King; Lee DeCola; Mark J. Twery; Pat Cunningham

1999-01-01

This chapter presents a management perspective on decision support for ecosystem management.The Introduction provides a brief historical overview of decision support technology as it has been used in natural resource management, discusses the role of decision support in ecosystem management as we see it, and summarizes the current state of the technology.

Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration

PubMed Central

2014-01-01

Background Nigeria has included a regulated community-based health insurance (CBHI) model within its National Health Insurance Scheme (NHIS). Uptake to date has been disappointing, however. The aim of this study is to review the present status of CBHI in SSA in general to highlight the issues that affect its successful integration within the NHIS of Nigeria and more widely in developing countries. Methods A literature survey using PubMed and EconLit was carried out to identify and review studies that report factors affecting implementation of CBHI in SSA with a focus on Nigeria. Results CBHI schemes with a variety of designs have been introduced across SSA but with generally disappointing results so far. Two exceptions are Ghana and Rwanda, both of which have introduced schemes with effective government control and support coupled with intensive implementation programmes. Poor support for CBHI is repeatedly linked elsewhere with failure to engage and account for the ‘real world’ needs of beneficiaries, lack of clear legislative and regulatory frameworks, inadequate financial support, and unrealistic enrolment requirements. Nigeria’s CBHI-type schemes for the informal sectors of its NHIS have been set up under an appropriate legislative framework, but work is needed to eliminate regressive financing, to involve scheme members in the setting up and management of programmes, to inform and educate more effectively, to eliminate lack of confidence in the schemes, and to address inequity in provision. Targeted subsidies should also be considered. Conclusions Disappointing uptake of CBHI-type NHIS elements in Nigeria can be addressed through closer integration of informal and formal programmes under the NHIS umbrella, with increasing involvement of beneficiaries in scheme design and management, improved communication and education, and targeted financial assistance. PMID:24559409

Locally adaptive decision in detection of clustered microcalcifications in mammograms.

PubMed

Sainz de Cea, María V; Nishikawa, Robert M; Yang, Yongyi

2018-02-15

In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  <10 -4 ). There was also a reduction in case-to-case variability in detected FPs at a given sensitivity level. The proposed adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.

Robust stochastic fuzzy possibilistic programming for environmental decision making under uncertainty.

PubMed

Zhang, Xiaodong; Huang, Guo H; Nie, Xianghui

2009-12-20

Nonpoint source (NPS) water pollution is one of serious environmental issues, especially within an agricultural system. This study aims to propose a robust chance-constrained fuzzy possibilistic programming (RCFPP) model for water quality management within an agricultural system, where solutions for farming area, manure/fertilizer application amount, and livestock husbandry size under different scenarios are obtained and interpreted. Through improving upon the existing fuzzy possibilistic programming, fuzzy robust programming and chance-constrained programming approaches, the RCFPP can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original fuzzy constraints, the RCFPP enhances the robustness of the optimization processes and resulting solutions. The results of the case study indicate that useful information can be obtained through the proposed RCFPP model for providing feasible decision schemes for different agricultural activities under different scenarios (combinations of different p-necessity and p(i) levels). A p-necessity level represents the certainty or necessity degree of the imprecise objective function, while a p(i) level means the probabilities at which the constraints will be violated. A desire to acquire high agricultural income would decrease the certainty degree of the event that maximization of the objective be satisfied, and potentially violate water management standards; willingness to accept low agricultural income will run into the risk of potential system failure. The decision variables under combined p-necessity and p(i) levels were useful for the decision makers to justify and/or adjust the decision schemes for the agricultural activities through incorporation of their implicit knowledge. The results also suggest that this developed approach is applicable to many practical problems where fuzzy and probabilistic distribution information simultaneously exist.

Multicriteria decision analysis for including health interventions in the universal health coverage benefit package in Thailand.

PubMed

Youngkong, Sitaporn; Baltussen, Rob; Tantivess, Sripen; Mohara, Adun; Teerawattananon, Yot

2012-01-01

Considering rising health expenditure on the one hand and increasing public expectations on the other hand, there is a need for explicit health care rationing to secure public acceptance of coverage decisions of health interventions. The National Health Security Office, the institute managing the Universal Coverage Scheme in Thailand, recently called for more rational, transparent, and fair decisions on the public reimbursement of health interventions. This article describes the application of multicriteria decision analysis (MCDA) to guide the coverage decisions on including health interventions in the Universal Coverage Scheme health benefit package in the period 2009-2010. We described the MCDA priority-setting process through participatory observation and evaluated the rational, transparency, and fairness of the priority-setting process against the accountability for reasonableness framework. The MCDA was applied in four steps: 1) 17 interventions were nominated for assessment; 2) nine interventions were selected for further quantitative assessment on the basis of the following criteria: size of population affected by disease, severity of disease, effectiveness of health intervention, variation in practice, economic impact on household expenditure, and equity and social implications; 3) these interventions were then assessed in terms of cost-effectiveness and budget impact; and 4) decision makers qualitatively appraised, deliberated, and reached consensus on which interventions should be adopted in the package. This project was carried out in a real-world context and has considerably contributed to the rational, transparent, and fair priority-setting process through the application of MCDA. Although the present project has applied MCDA in the Thai context, MCDA is adaptable to other settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Locally adaptive decision in detection of clustered microcalcifications in mammograms

NASA Astrophysics Data System (ADS)

Sainz de Cea, María V.; Nishikawa, Robert M.; Yang, Yongyi

2018-02-01

In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  <10-4). There was also a reduction in case-to-case variability in detected FPs at a given sensitivity level. The proposed adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.

A priori discretization error metrics for distributed hydrologic modeling applications

NASA Astrophysics Data System (ADS)

Liu, Hongli; Tolson, Bryan A.; Craig, James R.; Shafii, Mahyar

2016-12-01

Watershed spatial discretization is an important step in developing a distributed hydrologic model. A key difficulty in the spatial discretization process is maintaining a balance between the aggregation-induced information loss and the increase in computational burden caused by the inclusion of additional computational units. Objective identification of an appropriate discretization scheme still remains a challenge, in part because of the lack of quantitative measures for assessing discretization quality, particularly prior to simulation. This study proposes a priori discretization error metrics to quantify the information loss of any candidate discretization scheme without having to run and calibrate a hydrologic model. These error metrics are applicable to multi-variable and multi-site discretization evaluation and provide directly interpretable information to the hydrologic modeler about discretization quality. The first metric, a subbasin error metric, quantifies the routing information loss from discretization, and the second, a hydrological response unit (HRU) error metric, improves upon existing a priori metrics by quantifying the information loss due to changes in land cover or soil type property aggregation. The metrics are straightforward to understand and easy to recode. Informed by the error metrics, a two-step discretization decision-making approach is proposed with the advantage of reducing extreme errors and meeting the user-specified discretization error targets. The metrics and decision-making approach are applied to the discretization of the Grand River watershed in Ontario, Canada. Results show that information loss increases as discretization gets coarser. Moreover, results help to explain the modeling difficulties associated with smaller upstream subbasins since the worst discretization errors and highest error variability appear in smaller upstream areas instead of larger downstream drainage areas. Hydrologic modeling experiments under candidate discretization schemes validate the strong correlation between the proposed discretization error metrics and hydrologic simulation responses. Discretization decision-making results show that the common and convenient approach of making uniform discretization decisions across the watershed performs worse than the proposed non-uniform discretization approach in terms of preserving spatial heterogeneity under the same computational cost.

SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2008-12-01

In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

From vital signs to clinical outcomes for patients with sepsis: a machine learning basis for a clinical decision support system

PubMed Central

Gultepe, Eren; Green, Jeffrey P; Nguyen, Hien; Adams, Jason; Albertson, Timothy; Tagkopoulos, Ilias

2014-01-01

Objective To develop a decision support system to identify patients at high risk for hyperlactatemia based upon routinely measured vital signs and laboratory studies. Materials and methods Electronic health records of 741 adult patients at the University of California Davis Health System who met at least two systemic inflammatory response syndrome criteria were used to associate patients’ vital signs, white blood cell count (WBC), with sepsis occurrence and mortality. Generative and discriminative classification (naïve Bayes, support vector machines, Gaussian mixture models, hidden Markov models) were used to integrate heterogeneous patient data and form a predictive tool for the inference of lactate level and mortality risk. Results An accuracy of 0.99 and discriminability of 1.00 area under the receiver operating characteristic curve (AUC) for lactate level prediction was obtained when the vital signs and WBC measurements were analysed in a 24 h time bin. An accuracy of 0.73 and discriminability of 0.73 AUC for mortality prediction in patients with sepsis was achieved with only three features: median of lactate levels, mean arterial pressure, and median absolute deviation of the respiratory rate. Discussion This study introduces a new scheme for the prediction of lactate levels and mortality risk from patient vital signs and WBC. Accurate prediction of both these variables can drive the appropriate response by clinical staff and thus may have important implications for patient health and treatment outcome. Conclusions Effective predictions of lactate levels and mortality risk can be provided with a few clinical variables when the temporal aspect and variability of patient data are considered. PMID:23959843

Parent-to-parent peer support for parents of children with a disability: A mixed method study.

PubMed

Bray, Lucy; Carter, Bernie; Sanders, Caroline; Blake, Lucy; Keegan, Kimberley

2017-08-01

This paper will report on the findings of a study which investigated the influence of a befriending (parent-to-parent peer support) scheme on parents whose children have a disability or additional need. The scheme operated from an acute children's tertiary setting in the UK. A prospective concurrent mixed method design collected interview (n=70) and questionnaire (n=68) data at two time-points from befrienders (n=13) and befriendees (n=26). The main qualitative findings of the study relate to the different degrees parents (befriendees and befrienders) moved from being lost, to finding and being a guide and getting to a better place. The quantitative findings demonstrate that parent-to-parent peer support has a positive influence on parents' levels of psychological distress and their ability to cope with being a parent of a child with a disability. The befriending scheme acted as a catalyst for many parents to move towards a place where they could grow and begin to flourish and thrive. Professionals should inform parents who have a child with a disability that peer-to-peer parenting support schemes are a valuable and appropriate source of support and help. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

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.

A practical guidance for Cramer class determination.

PubMed

Roberts, David W; Aptula, Aynur; Schultz, Terry W; Shen, Jie; Api, Anne Marie; Bhatia, Sneha; Kromidas, Lambros

2015-12-01

Expanded use of the Threshold of Toxicological Concern (TTC) methodology has brought into discussion the intent of the original questions used in the Cramer scheme or Cramer decision tree. We have analysed, both manually and by Toxtree software, a large dataset of fragrance ingredients and identified several issues with the original Cramer questions. Some relate to definitions and wording of questions; others relate to in silico interpretation of the questions. We have endeavoured to address all of these inconsistencies and misinterpretations without changing the basic structure and principles of the original decision tree. Based on the analysis of a large data set of over 2500 fragrance ingredients, we found that most of the 33 questions in the original Cramer scheme are straightforward. Through repeated examination each of the 33 questions, we found 14 where the logic underlying the development of the rule is unclear. These questions are well served by minor wording changes and/or further explanation designed to capture what we perceive to be the intent of the original decision tree. The findings reported here could be used as a guidance for conducting Cramer classification and provide advices for the improvement of the in silico tools. Copyright © 2015 Elsevier Inc. All rights reserved.

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

PubMed

Trikha, S; Macgregor, C; Jeffery, M; Kirwan, J

2012-10-01

Glaucoma referrals continue to impart a significant burden on Hospital Eye Services (HES), with a large proportion of these false positives. To evaluate the Portsmouth glaucoma scheme, utilising virtual clinics, digital technology, and community optometrists to streamline glaucoma referrals. The stages of the patient trail were mapped and, at each step of the process, 100 consecutive patient decisions were identified. The diagnostic outcomes of 50 consecutive patients referred from the refinement scheme to the HES were identified. A total of 76% of 'glaucoma' referrals were suitable for the refinement scheme. Overall, 94% of disc images were gradeable in the virtual clinic. In all, 11% of patients 'attending' the virtual clinic were accepted into HES, with 89% being discharged for community follow-up. Of referrals accepted into HES, the positive predictive value (glaucoma/ocular hypertension/suspect) was 0.78 vs 0.37 in the predating 'unrefined' scheme (95% CI 0.65-0.87). The scheme has released 1400 clinic slots/year for HES, and has produced a £244 200/year cost saving for Portsmouth Hospitals' Trust. The refinement scheme is streamlining referrals and increasing the positive predictive rate in the diagnosis of glaucoma, glaucoma suspect or ocular hypertension. This consultant-led practice-based commissioning scheme, if adopted widely, is likely to incur a significant cost saving while maintaining high quality of care within the NHS.

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks.

PubMed

Kaleem, Zeeshan; Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq; Duong, Trung Q

2018-05-08

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme.

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks

PubMed Central

Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq

2018-01-01

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme. PMID:29738499

Polya's bees: A model of decentralized decision-making.

PubMed

Golman, Russell; Hagmann, David; Miller, John H

2015-09-01

How do social systems make decisions with no single individual in control? We observe that a variety of natural systems, including colonies of ants and bees and perhaps even neurons in the human brain, make decentralized decisions using common processes involving information search with positive feedback and consensus choice through quorum sensing. We model this process with an urn scheme that runs until hitting a threshold, and we characterize an inherent tradeoff between the speed and the accuracy of a decision. The proposed common mechanism provides a robust and effective means by which a decentralized system can navigate the speed-accuracy tradeoff and make reasonably good, quick decisions in a variety of environments. Additionally, consensus choice exhibits systemic risk aversion even while individuals are idiosyncratically risk-neutral. This too is adaptive. The model illustrates how natural systems make decentralized decisions, illuminating a mechanism that engineers of social and artificial systems could imitate.

Grey Language Hesitant Fuzzy Group Decision Making Method Based on Kernel and Grey Scale

PubMed Central

Diao, Yuzhu; Hu, Aqin

2018-01-01

Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method to avoid information distortion. This method is applied to the grey language hesitant fuzzy group decision making, and the grey correlation degree is used to sort the schemes. The effectiveness and practicability of the decision-making method are further verified by the industry chain sustainable development ability evaluation example of a circular economy. Moreover, its simplicity and feasibility are verified by comparing it with the traditional grey language decision-making method and the grey language hesitant fuzzy weighted arithmetic averaging (GLHWAA) operator integration method after determining the index weight based on the grey correlation. PMID:29498699

Grey Language Hesitant Fuzzy Group Decision Making Method Based on Kernel and Grey Scale.

PubMed

Li, Qingsheng; Diao, Yuzhu; Gong, Zaiwu; Hu, Aqin

2018-03-02

Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method to avoid information distortion. This method is applied to the grey language hesitant fuzzy group decision making, and the grey correlation degree is used to sort the schemes. The effectiveness and practicability of the decision-making method are further verified by the industry chain sustainable development ability evaluation example of a circular economy. Moreover, its simplicity and feasibility are verified by comparing it with the traditional grey language decision-making method and the grey language hesitant fuzzy weighted arithmetic averaging (GLHWAA) operator integration method after determining the index weight based on the grey correlation.

Polya’s bees: A model of decentralized decision-making

PubMed Central

Golman, Russell; Hagmann, David; Miller, John H.

2015-01-01

How do social systems make decisions with no single individual in control? We observe that a variety of natural systems, including colonies of ants and bees and perhaps even neurons in the human brain, make decentralized decisions using common processes involving information search with positive feedback and consensus choice through quorum sensing. We model this process with an urn scheme that runs until hitting a threshold, and we characterize an inherent tradeoff between the speed and the accuracy of a decision. The proposed common mechanism provides a robust and effective means by which a decentralized system can navigate the speed-accuracy tradeoff and make reasonably good, quick decisions in a variety of environments. Additionally, consensus choice exhibits systemic risk aversion even while individuals are idiosyncratically risk-neutral. This too is adaptive. The model illustrates how natural systems make decentralized decisions, illuminating a mechanism that engineers of social and artificial systems could imitate. PMID:26601255

An onboard navigation system which fulfills Mars aerocapture guidance requirements

NASA Technical Reports Server (NTRS)

Brand, Timothy J.; Fuhry, Douglas P.; Shepperd, Stanley W.

1989-01-01

The development of a candidate autonomous onboard Mars approach navigation scheme capable of supporting aerocapture into Mars orbit is discussed. An aerocapture guidance and navigation system which can run independently of the preaerocapture navigation was used to define a preliminary set of accuracy requirements at entry interface. These requirements are used to evaluate the proposed preaerocapture navigation scheme. This scheme uses optical sightings on Deimos with a star tracker and an inertial measurement unit for instrumentation as a source for navigation nformation. Preliminary results suggest that the approach will adequately support aerocaputre into Mars orbit.

Toward the Modularization of Decision Support Systems

NASA Astrophysics Data System (ADS)

Raskin, R. G.

2009-12-01

Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

75 FR 39940 - Notice of Debarment; Schools and Libraries Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... months of supervised release for federal crimes in connection with your participation in a scheme to... that you and others devised schemes to defraud school districts and the E-Rate program by having your... in the schemes.\\8\\ Such conduct constitutes the basis for your debarment, and your conviction falls...

Elderly demand for family-based care and support: evidence from a social intervention strategy.

PubMed

Aboagye, Emmanuel; Agyemang, Otuo Serebour; Tjerbo, Trond

2013-12-06

This paper examines the influence of the national health insurance scheme on elderly demand for family-based care and support. It contributes to the growing concern on the rapid increase in the elderly population globally using micro-level social theory to examine the influence the health insurance has on elderly demand for family support. A qualitative case study approach is applied to construct a comprehensive and thick description of how the national health insurance scheme influences the elderly in their demand for family support.Through focused interviews and direct observation of six selected cases, in-depth information on primary carers, living arrangement and the interaction between the health insurance as structure and elders as agents are analyzed. The study highlights that the interaction between the elderly and the national health insurance scheme has produced a new stratum of relationship between the elderly and their primary carers. Consequently, this has created equilibrium between the elderly demand for support and support made available by their primary carers. As the demand of the elderly for support is declining, supply of support by family members for the elderly is also on the decline.

Elderly Demand for Family-based Care and Support: Evidence from a Social Intervention Strategy

PubMed Central

Aboagye, Emmanuel; Agyemang, Otuo Serebour; Tjerbo, Trond

2014-01-01

This paper examines the influence of the national health insurance scheme on elderly demand for family-based care and support. It contributes to the growing concern on the rapid increase in the elderly population globally using micro-level social theory to examine the influence the health insurance has on elderly demand for family support. A qualitative case study approach is applied to construct a comprehensive and thick description of how the national health insurance scheme influences the elderly in their demand for family support. Through focused interviews and direct observation of six selected cases, in-depth information on primary carers, living arrangement and the interaction between the health insurance as structure and elders as agents are analyzed. The study highlights that the interaction between the elderly and the national health insurance scheme has produced a new stratum of relationship between the elderly and their primary carers. Consequently, this has created equilibrium between the elderly demand for support and support made available by their primary carers. As the demand of the elderly for support is declining, supply of support by family members for the elderly is also on the decline. PMID:24576369

Modeling and performance analysis of an improved movement-based location management scheme for packet-switched mobile communication systems.

PubMed

Chung, Yun Won; Kwon, Jae Kyun; Park, Suwon

2014-01-01

One of the key technologies to support mobility of mobile station (MS) in mobile communication systems is location management which consists of location update and paging. In this paper, an improved movement-based location management scheme with two movement thresholds is proposed, considering bursty data traffic characteristics of packet-switched (PS) services. The analytical modeling for location update and paging signaling loads of the proposed scheme is developed thoroughly and the performance of the proposed scheme is compared with that of the conventional scheme. We show that the proposed scheme outperforms the conventional scheme in terms of total signaling load with an appropriate selection of movement thresholds.

Supporting Seamless Mobility for P2P Live Streaming

PubMed Central

Kim, Eunsam; Kim, Sangjin; Lee, Choonhwa

2014-01-01

With advent of various mobile devices with powerful networking and computing capabilities, the users' demand to enjoy live video streaming services such as IPTV with mobile devices has been increasing rapidly. However, it is challenging to get over the degradation of service quality due to data loss caused by the handover. Although many handover schemes were proposed at protocol layers below the application layer, they inherently suffer from data loss while the network is being disconnected during the handover. We therefore propose an efficient application-layer handover scheme to support seamless mobility for P2P live streaming. By simulation experiments, we show that the P2P live streaming system with our proposed handover scheme can improve the playback continuity significantly compared to that without our scheme. PMID:24977171

How to guide - transit operations decision support systems (TODSS).

DOT National Transportation Integrated Search

2014-12-01

Transit Operations Decision Support Systems (TODSS) are decision support systems designed to support dispatchers in real-time bus operations management in response to incidents, special events, and other changing conditions in order to restore servic...

CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

PubMed Central

Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

2015-01-01

Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options. PMID:25848413

CorRECTreatment: a web-based decision support tool for rectal cancer treatment that uses the analytic hierarchy process and decision tree.

PubMed

Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C

2015-01-01

The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.

Energy Decision Science and Informatics | Integrated Energy Solutions |

Science.gov Websites

Science Advanced decision science methods include multi-objective and multi-criteria decision support. Our decision science methods, including multi-objective and multi-criteria decision support. For example, we

Experimental research of adaptive OFDM and OCT precoding with a high SE for VLLC system

NASA Astrophysics Data System (ADS)

Liu, Shuang-ao; He, Jing; Chen, Qinghui; Deng, Rui; Zhou, Zhihua; Chen, Shenghai; Chen, Lin

2017-09-01

In this paper, an adaptive orthogonal frequency division multiplexing (OFDM) modulation scheme with 128/64/32/16-quadrature amplitude modulation (QAM) and orthogonal circulant matrix transform (OCT) precoding is proposed and experimentally demonstrated for a visible laser light communication (VLLC) system with a cost-effective 450-nm blue-light laser diode (LD). The performance of OCT precoding is compared with conventional the adaptive Discrete Fourier Transform-spread (DFT-spread) OFDM scheme, 32 QAM OCT precoding OFDM scheme, 64 QAM OCT precoding OFDM scheme and adaptive OCT precoding OFDM scheme. The experimental results show that OCT precoding can achieve a relatively flat signal-to-noise ratio (SNR) curve, and it can provide performance improvement in bit error rate (BER). Furthermore, the BER of the proposed OFDM signal with a raw bit rate 5.04 Gb/s after 5-m free space transmission is less than 20% of soft-decision forward error correlation (SD-FEC) threshold of 2.4 × 10-2, and the spectral efficiency (SE) of 4.2 bit/s/Hz can be successfully achieved.

Sensor data security level estimation scheme for wireless sensor networks.

PubMed

Ramos, Alex; Filho, Raimir Holanda

2015-01-19

Due to their increasing dissemination, wireless sensor networks (WSNs) have become the target of more and more sophisticated attacks, even capable of circumventing both attack detection and prevention mechanisms. This may cause WSN users, who totally trust these security mechanisms, to think that a sensor reading is secure, even when an adversary has corrupted it. For that reason, a scheme capable of estimating the security level (SL) that these mechanisms provide to sensor data is needed, so that users can be aware of the actual security state of this data and can make better decisions on its use. However, existing security estimation schemes proposed for WSNs fully ignore detection mechanisms and analyze solely the security provided by prevention mechanisms. In this context, this work presents the sensor data security estimator (SDSE), a new comprehensive security estimation scheme for WSNs. SDSE is designed for estimating the sensor data security level based on security metrics that analyze both attack prevention and detection mechanisms. In order to validate our proposed scheme, we have carried out extensive simulations that show the high accuracy of SDSE estimates.

Sensor Data Security Level Estimation Scheme for Wireless Sensor Networks

PubMed Central

Ramos, Alex; Filho, Raimir Holanda

2015-01-01

Due to their increasing dissemination, wireless sensor networks (WSNs) have become the target of more and more sophisticated attacks, even capable of circumventing both attack detection and prevention mechanisms. This may cause WSN users, who totally trust these security mechanisms, to think that a sensor reading is secure, even when an adversary has corrupted it. For that reason, a scheme capable of estimating the security level (SL) that these mechanisms provide to sensor data is needed, so that users can be aware of the actual security state of this data and can make better decisions on its use. However, existing security estimation schemes proposed for WSNs fully ignore detection mechanisms and analyze solely the security provided by prevention mechanisms. In this context, this work presents the sensor data security estimator (SDSE), a new comprehensive security estimation scheme for WSNs. SDSE is designed for estimating the sensor data security level based on security metrics that analyze both attack prevention and detection mechanisms. In order to validate our proposed scheme, we have carried out extensive simulations that show the high accuracy of SDSE estimates. PMID:25608215

Trafficking in persons and victim health in Australia.

PubMed

Schloenhardt, Andreas; Klug, Benjamin

2011-12-01

This article explores the health problems experienced by victims of trafficking in persons in Australia and analyses the domestic support schemes established to assist these victims. It focuses specifically on the health of adult, female victims who constitute the majority of identified victims, and who are the principal recipients of government support services. Domestic experiences and support schemes are reviewed in the light of international law and best practice guidelines. Recommendations are made to improve the health services available to victims of trafficking in persons in Australia.

Computer-aided diagnosis of focal liver lesions by use of physicians' subjective classification of echogenic patterns in baseline and contrast-enhanced ultrasonography.

PubMed

Sugimoto, Katsutoshi; Shiraishi, Junji; Moriyasu, Fuminori; Doi, Kunio

2009-04-01

To develop a computer-aided diagnostic (CAD) scheme for classifying focal liver lesions (FLLs) by use of physicians' subjective classification of echogenic patterns of FLLs on baseline and contrast-enhanced ultrasonography (US). A total of 137 hepatic lesions in 137 patients were evaluated with B-mode and NC100100 (Sonazoid)-enhanced pulse-inversion US; lesions included 74 hepatocellular carcinomas (HCCs) (23: well-differentiated, 36: moderately differentiated, 15: poorly differentiated HCCs), 33 liver metastases, and 30 liver hemangiomas. Three physicians evaluated single images at B-mode and arterial phases with a cine mode. Physicians were asked to classify each lesion into one of eight B-mode and one of eight enhancement patterns, but did not make a diagnosis. To classify five types of FLLs, we employed a decision tree model with four decision nodes and four artificial neural networks (ANNs). The results of the physicians' pattern classifications were used successively for four different ANNs in making decisions at each of the decision nodes in the decision tree model. The classification accuracies for the 137 FLLs were 84.8% for metastasis, 93.3% for hemangioma, and 98.6% for all HCCs. In addition, the classification accuracies for histological differentiation types of HCCs were 65.2% for well-differentiated HCC, 41.7% for moderately differentiated HCC, and 80.0% for poorly differentiated HCC. This CAD scheme has the potential to improve the diagnostic accuracy of liver lesions. However, the accuracy in the histologic differential diagnosis of HCC based on baseline and contrast-enhanced US is still limited.

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed

Martinez, Kathryn A; Resnicow, Ken; Williams, Geoffrey C; Silva, Marlene; Abrahamse, Paul; Shumway, Dean A; Wallner, Lauren P; Katz, Steven J; Hawley, Sarah T

2016-12-01

Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed Central

Resnicow, Ken; Williams, Geoffrey C.; Silva, Marlene; Abrahamse, Paul; Shumway, Dean; Wallner, Lauren; Katz, Steven; Hawley, Sarah

2016-01-01

Objective Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Methods Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Results Among the 1,690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Conclusion Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Practice Implications Autonomy-supportive communication by cancer doctors can improve patients’ perceived decision quality. PMID:27395750

Insights for the assessment of the economic impact of endemic diseases: specific adaptation of economic frameworks using the case of bovine viral diarrhoea.

PubMed

Stott, A W; Gunn, G J

2017-04-01

Generic frameworks for the economic analysis of farm animal disease are now well established. The paper, therefore, uses bovine viral diarrhoea (BVD) as an example to explore how these frameworks need to be adapted to fit the characteristics of a particular disease and the specific objectives of the analysis. In the case of BVD, given the relative strength of tests available to correctly identify virus-positive animals, thus enabling them to be culled, the emphasis has been on cost-benefit analysis of regional and national certification/eradication schemes. Such analyses in turn raise interesting questions about farmer uptake and maintenance of certification schemes and the equity and cost-effective implementation of these schemes. The complex epidemiology of BVD virus infections and the long-term, widespread and often occult nature of BVD effects make economic analysis of the disease and its control particularly challenging. However, this has resulted in a wider whole-farm perspective that captures the influence of multiple decisions, not just those directly associated with disease prevention and control. There is a need to include management of reproduction, risk and enterprise mix in the research on farmer decision-making, as all these factors impinge on, and are affected by, the spread of BVD.

Towards ethical decision support and knowledge management in neonatal intensive care.

PubMed

Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

2004-01-01

Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

Implementation of workflow engine technology to deliver basic clinical decision support functionality

PubMed Central

2011-01-01

Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform. PMID:21477364

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

PubMed

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

2016-11-01

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

Military Medical Decision Support for Homeland Defense During Emergency

DTIC Science & Technology

2004-12-01

abstraction hierarchy, three levels of information requirement for designing emergency training interface are recognized. These are epistemological ...support human decision making process is considered to be decision-centric. A typical decision-centric interface is supported by at least four design ... Designing Emergency Training Interface ......................................................................................... 5 Epistemological

Recent developments in the structural design and optimization of ITER neutral beam manifold

NASA Astrophysics Data System (ADS)

Chengzhi, CAO; Yudong, PAN; Zhiwei, XIA; Bo, LI; Tao, JIANG; Wei, LI

2018-02-01

This paper describes a new design of the neutral beam manifold based on a more optimized support system. A proposed alternative scheme has presented to replace the former complex manifold supports and internal pipe supports in the final design phase. Both the structural reliability and feasibility were confirmed with detailed analyses. Comparative analyses between two typical types of manifold support scheme were performed. All relevant results of mechanical analyses for typical operation scenarios and fault conditions are presented. Future optimization activities are described, which will give useful information for a refined setting of components in the next phase.

A new approach to enhance the performance of decision tree for classifying gene expression data.

PubMed

Hassan, Md; Kotagiri, Ramamohanarao

2013-12-20

Gene expression data classification is a challenging task due to the large dimensionality and very small number of samples. Decision tree is one of the popular machine learning approaches to address such classification problems. However, the existing decision tree algorithms use a single gene feature at each node to split the data into its child nodes and hence might suffer from poor performance specially when classifying gene expression dataset. By using a new decision tree algorithm where, each node of the tree consists of more than one gene, we enhance the classification performance of traditional decision tree classifiers. Our method selects suitable genes that are combined using a linear function to form a derived composite feature. To determine the structure of the tree we use the area under the Receiver Operating Characteristics curve (AUC). Experimental analysis demonstrates higher classification accuracy using the new decision tree compared to the other existing decision trees in literature. We experimentally compare the effect of our scheme against other well known decision tree techniques. Experiments show that our algorithm can substantially boost the classification performance of the decision tree.

How health economic evaluation (HEE) contributes to decision-making in public health care: the case of Brazil.

PubMed

Elias, Flávia Tavares Silva; Araújo, Denizar Vianna

2014-01-01

The universal access to a health care system for the Brazilian population was established in 1990. Brazil is a country with no tradition in the production and use of health economic evaluation (HEE) to guide decision making in the public health system. It is only within the last two decades that HEEs using a microeconomic approach have appeared in the academic field. On a national level, HEE and Health Technology Assessment (HTA), in a wider sense, were first taken into account in 2003. Two policies deserve to be mentioned - (i) the regulation of medicines in the Brazilian market, and (ii) science, technology and innovation policy. The latter required the fostering of applied research to encourage the application of methods which employ systematic reviews and economic analyses of cost-effectiveness to guide the incorporation of technologies in the Brazilian health care system. The Ministry of Health has initiated the process of incorporating these new technologies on a federal level during the last ten years. In spite of the improvement of HEE methods at Brazilian universities and research institutes, these technologies have not yet reached the governmental bodies. In Brazil, the main challenge lies in the production, interpretation and application of HEE to all technologies within the access scheme(s), and there is limited capacity building. Setting priorities can be the solution for Brazil to be able to perform HEE for relevant technologies within the access scheme(s) while the universal coverage system struggles with a triple burden of disease. Copyright © 2014. Published by Elsevier GmbH.

Maintenance service contract model for heavy equipment in mining industry using principal agent theory

NASA Astrophysics Data System (ADS)

Pakpahan, Eka K. A.; Iskandar, Bermawi P.

2015-12-01

Mining industry is characterized by a high operational revenue, and hence high availability of heavy equipment used in mining industry is a critical factor to ensure the revenue target. To maintain high avaliability of the heavy equipment, the equipment's owner hires an agent to perform maintenance action. Contract is then used to control the relationship between the two parties involved. The traditional contracts such as fixed price, cost plus or penalty based contract studied is unable to push agent's performance to exceed target, and this in turn would lead to a sub-optimal result (revenue). This research deals with designing maintenance contract compensation schemes. The scheme should induce agent to select the highest possible maintenance effort level, thereby pushing agent's performance and achieve maximum utility for both parties involved. Principal agent theory is used as a modeling approach due to its ability to simultaneously modeled owner and agent decision making process. Compensation schemes considered in this research includes fixed price, cost sharing and revenue sharing. The optimal decision is obtained using a numerical method. The results show that if both parties are risk neutral, then there are infinite combination of fixed price, cost sharing and revenue sharing produced the same optimal solution. The combination of fixed price and cost sharing contract results in the optimal solution when the agent is risk averse, while the optimal combination of fixed price and revenue sharing contract is obtained when agent is risk averse. When both parties are risk averse, the optimal compensation scheme is a combination of fixed price, cost sharing and revenue sharing.

From randomized controlled trials to evidence grading schemes: current state of evidence-based practice in social sciences.

PubMed

Boruch, Robert; Rui, Ning

2008-11-01

With the advance of web search and navigation technology, enormous amount of information, non-information, and misinformation may be obtained in milliseconds in response to questions about 'what works' in social sciences. Today, policy makers in non-medical public service arenas are under increasing pressure to make sound decisions based on scientific evidence. Some of these decisions are a matter of legal requirement. This paper shows how such movements are closely aligned with the evolution of organizations that develop and apply evidence standards and evidence grading schemes within the social science communities. The current state of evidence-based practice in social sciences is examined by reviewing the latest development of randomized trials and evidence grading schemes in the fields of education, criminal justice, and social welfare. Studies conducted under the auspices of the Campbell Collaboration and What Works Clearinghouse are used to illustrate ingredients of evidence grading schemes, graphic display of results of systematic reviews, and discrepancies of evidence derived from randomized trials and non-experimental trials. Furthermore, it is argued that the use of evidence on 'what works' depends on the potential users' awareness, understanding of the evidence, as well as their capacity and willingness to use it. Awareness and understanding depends on the world wide web and its augmentations, while capacity and willingness depends more on incentives to use good evidence and on political and ethical values. Implications for the future development of evidence grading organizations are discussed. © 2008 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Teleportation of Unknown Superpositions of Collective Atomic Coherent States

NASA Astrophysics Data System (ADS)

Zheng, Shi-Biao

2001-06-01

We propose a scheme to teleport an unknown superposition of two atomic coherent states with different phases. Our scheme is based on resonant and dispersive atom-field interaction. Our scheme provides a possibility of teleporting macroscopic superposition states of many atoms first time. The project supported by National Natural Science Foundation of China under Grant No. 60008003

Semantic Clinical Guideline Documents

PubMed Central

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

2005-01-01

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

Supporting newly qualified dental therapists into practice: a longitudinal evaluation of a foundation training scheme for dental therapists (TFT).

PubMed

Bullock, A D; Barnes, E; Falcon, H C; Stearns, K

2013-04-01

Focused on the dental therapists foundation training (TFT) scheme run by the Postgraduate Dental Deaneries of Oxford and Wessex (NHS Education South Central - NESC) the objectives were (1) to evaluate the TFT 2010/11 scheme, identifying strengths, areas for development and drawing comparisons with the 2009 evaluation; and (2) to follow-up previous cohorts, reporting current work and retrospective reflections on the scheme. Data were collected from 2010/11 ('current') trainees (n = 10) through group discussion, questionnaire and portfolio extracts. Eleven past-trainees from 2008/09 and 2009/10 took part in a structured telephone interview or responded to questions via e-mail. Data from 2011 consolidated that collected earlier. The scheme was highly valued. Current participants thought the scheme should be mandatory and all past-participants would recommend it to others. Trainees attributed an increase in confidence and ability in their clinical skills to participation in TFT. Current trainees' concerns about finding therapy work were echoed in past-participants' post-scheme employment. At the point of qualification, trainees do not feel well-prepared for starting work as dental therapists. Opportunity to develop confidence and skills in a supportive environment is a key benefit of the scheme. Maintaining ability in the full range of duties requires continued use of skills and the opportunity to do this remains an ongoing challenge.

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems.

PubMed

DesAutels, Spencer J; Fox, Zachary E; Giuse, Dario A; Williams, Annette M; Kou, Qing-Hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems.

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Research on web-based decision support system for sports competitions

NASA Astrophysics Data System (ADS)

Huo, Hanqiang

2010-07-01

This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

A Peer-Mentoring Scheme for Immigrant Students in English Secondary Schools: A Support Mechanism for Promoting Inclusion?

ERIC Educational Resources Information Center

Messiou, Kyriaki; Azaola, Marta Cristina

2018-01-01

Immigration in Europe has increased rapidly over the last years. As a result, schools are accepting students arriving from other countries at various stages of the school year. This can be a challenging process both for students and for schools. This paper describes the introduction of a peer-mentoring scheme to support immigrant students in three…

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

A two-stage clinical decision support system for early recognition and stratification of patients with sepsis: an observational cohort study.

PubMed

Amland, Robert C; Lyons, Jason J; Greene, Tracy L; Haley, James M

2015-10-01

To examine the diagnostic accuracy of a two-stage clinical decision support system for early recognition and stratification of patients with sepsis. Observational cohort study employing a two-stage sepsis clinical decision support to recognise and stratify patients with sepsis. The stage one component was comprised of a cloud-based clinical decision support with 24/7 surveillance to detect patients at risk of sepsis. The cloud-based clinical decision support delivered notifications to the patients' designated nurse, who then electronically contacted a provider. The second stage component comprised a sepsis screening and stratification form integrated into the patient electronic health record, essentially an evidence-based decision aid, used by providers to assess patients at bedside. Urban, 284 acute bed community hospital in the USA; 16,000 hospitalisations annually. Data on 2620 adult patients were collected retrospectively in 2014 after the clinical decision support was implemented. 'Suspected infection' was the established gold standard to assess clinical decision support clinimetric performance. A sepsis alert activated on 417 (16%) of 2620 adult patients hospitalised. Applying 'suspected infection' as standard, the patient population characteristics showed 72% sensitivity and 73% positive predictive value. A postalert screening conducted by providers at bedside of 417 patients achieved 81% sensitivity and 94% positive predictive value. Providers documented against 89% patients with an alert activated by clinical decision support and completed 75% of bedside screening and stratification of patients with sepsis within one hour from notification. A clinical decision support binary alarm system with cross-checking functionality improves early recognition and facilitates stratification of patients with sepsis.

Automatic staging of bladder cancer on CT urography

NASA Astrophysics Data System (ADS)

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

2016-03-01

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

Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.

PubMed

McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M

2012-07-01

There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.

What is on your mind? Using the perceptual cycle model and critical decision method to understand the decision-making process in the cockpit.

PubMed

Plant, Katherine L; Stanton, Neville A

2013-01-01

Aeronautical decision-making is complex as there is not always a clear coupling between the decision made and decision outcome. As such, there is a call for process-orientated decision research in order to understand why a decision made sense at the time it was made. Schema theory explains how we interact with the world using stored mental representations and forms an integral part of the perceptual cycle model (PCM); proposed here as a way to understand the decision-making process. This paper qualitatively analyses data from the critical decision method (CDM) based on the principles of the PCM. It is demonstrated that the approach can be used to understand a decision-making process and highlights how influential schemata can be at informing decision-making. The reliability of this approach is established, the general applicability is discussed and directions for future work are considered. This paper introduces the PCM, and the associated schema theory, as a framework to structure and explain data collected from the CDM. The reliability of both the method and coding scheme is addressed.

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

Health information technology in primary health care in developing countries: a literature review.

PubMed Central

Tomasi, Elaine; Facchini, Luiz Augusto; Maia, Maria de Fatima Santos

2004-01-01

This paper explores the debate and initiatives concerning the use of information technology (IT) in primary health care in developing countries. The literature from 1992-2002 was identified from searches of the MEDLINE, Latin American and Caribbean Health Science Literature Database (LILACS), Cochrane Library and Web of Science databases. The search identified 884 references, 350 of which were classified according to the scheme described by the Pan American Health Organization (PAHO). For the analysis of advantages, problems and perspectives of IT applications and systems, 52 articles were selected according to their potential contribution to the primary health-care processes in non-developed countries. These included: 10 on electronic patient registries (EPR), 22 on process and programmatic action evaluation and management systems (PPAEM) and 20 on clinical decision-support systems (CDS). The main advantages, limitations and perspectives are discussed. PMID:15640923

Risk stratification for sudden death in arrhythmogenic right ventricular cardiomyopathy.

PubMed

Cadrin-Tourigny, Julia; Tadros, Rafik; Talajic, Mario; Rivard, Lena; Abadir, Sylvia; Khairy, Paul

2015-06-01

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC) is an uncommon but increasingly recognized inherited cardiomyopathy that is associated with malignant ventricular arrhythmias and sudden cardiac death, particularly in young individuals. The implantable cardioverter-defibrillator (ICD) is widely regarded as the only treatment modality with evidence to support improved survival in patients with ARVC and secondary prevention indications. In contrast, there is no universally accepted risk stratification scheme to guide ICD therapy for primary prevention against sudden cardiac death. Potential benefits must be weighed against the considerable risks of complications and inappropriate shocks in this young patient population. This article tackles the challenges of risk stratification for sudden cardiac death in ARVC and critically appraises available evidence for various proposed risk factors. The authors' over-arching objective is to provide the clinician with evidence-based guidance to inform decisions regarding the selection of appropriate candidates with ARVC for ICD therapy.

Non-linear multi-objective model for planning water-energy modes of Novosibirsk Hydro Power Plant

NASA Astrophysics Data System (ADS)

Alsova, O. K.; Artamonova, A. V.

2018-05-01

This paper presents a non-linear multi-objective model for planning and optimizing of water-energy modes for the Novosibirsk Hydro Power Plant (HPP) operation. There is a very important problem of developing a strategy to improve the scheme of water-power modes and ensure the effective operation of hydropower plants. It is necessary to determine the methods and criteria for the optimal distribution of water resources, to develop a set of models and to apply them to the software implementation of a DSS (decision-support system) for managing Novosibirsk HPP modes. One of the possible versions of the model is presented and investigated in this paper. Experimental study of the model has been carried out with 2017 data and the task of ten-day period planning from April to July (only 12 ten-day periods) was solved.

Are people who claim compensation "cured by a verdict"? A longitudinal study of health outcomes after whiplash.

PubMed

Spearing, Natalie M; Gyrd-Hansen, Dorte; Pobereskin, Louis H; Rowell, David S; Connelly, Luke B

2012-09-01

This study examines whether the lure of injury compensation prompts whiplash claimants to overstate their symptoms. Claim settlement is the intervention of interest, as it represents the point at which there is no further incentive to exaggerate symptoms, and neck pain at 24 months is the outcome of interest. Longitudinal data on neck pain scores and timing of claim settlement were regressed, controlling for the effect of time on recovery, to compare outcomes in claimants who had and had not settled their compensation claims. The results show clearly that removing the financial incentive to over-report symptoms has no effect on self-reported neck pain in a fault-based compensation scheme, and this finding concurs with other studies on this topic. Policy decisions to limit compensation in the belief that claimants systematically misrepresent their health status are not supported empirically Claimants do not appear to be "cured by a verdict".

Pay as you throw

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

Dahlen, Lisa, E-mail: lisa.dahlen@ltu.s; Lagerkvist, Anders

2010-01-15

Householders' response to weight-based billing for the collection of household waste was investigated with the aim of providing decision support for waste management policies. Three questions were addressed: How much and what kind of information on weight-based billing is discernible in generic Swedish waste collection statistics? Why do local authorities implement weight-based billing, and how do they perceive the results? and, Which strengths and weaknesses of weight-based billing have been observed on the local level? The study showed that municipalities with pay-by-weight schemes collected 20% less household waste per capita than other municipalities. Surprisingly, no part of this difference couldmore » be explained by higher recycling rates. Nevertheless, the majority of waste management professionals were convinced that recycling had increased as a result of the billing system. A number of contradicting strengths and weaknesses of weight-based billing were revealed.« less

Comparing cosmic web classifiers using information theory

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

Leclercq, Florent; Lavaux, Guilhem; Wandelt, Benjamin

We introduce a decision scheme for optimally choosing a classifier, which segments the cosmic web into different structure types (voids, sheets, filaments, and clusters). Our framework, based on information theory, accounts for the design aims of different classes of possible applications: (i) parameter inference, (ii) model selection, and (iii) prediction of new observations. As an illustration, we use cosmographic maps of web-types in the Sloan Digital Sky Survey to assess the relative performance of the classifiers T-WEB, DIVA and ORIGAMI for: (i) analyzing the morphology of the cosmic web, (ii) discriminating dark energy models, and (iii) predicting galaxy colors. Ourmore » study substantiates a data-supported connection between cosmic web analysis and information theory, and paves the path towards principled design of analysis procedures for the next generation of galaxy surveys. We have made the cosmic web maps, galaxy catalog, and analysis scripts used in this work publicly available.« less

Dopamine, reward learning, and active inference

PubMed Central

FitzGerald, Thomas H. B.; Dolan, Raymond J.; Friston, Karl

2015-01-01

Temporal difference learning models propose phasic dopamine signaling encodes reward prediction errors that drive learning. This is supported by studies where optogenetic stimulation of dopamine neurons can stand in lieu of actual reward. Nevertheless, a large body of data also shows that dopamine is not necessary for learning, and that dopamine depletion primarily affects task performance. We offer a resolution to this paradox based on an hypothesis that dopamine encodes the precision of beliefs about alternative actions, and thus controls the outcome-sensitivity of behavior. We extend an active inference scheme for solving Markov decision processes to include learning, and show that simulated dopamine dynamics strongly resemble those actually observed during instrumental conditioning. Furthermore, simulated dopamine depletion impairs performance but spares learning, while simulated excitation of dopamine neurons drives reward learning, through aberrant inference about outcome states. Our formal approach provides a novel and parsimonious reconciliation of apparently divergent experimental findings. PMID:26581305

Dopamine, reward learning, and active inference.

PubMed

FitzGerald, Thomas H B; Dolan, Raymond J; Friston, Karl

2015-01-01

Temporal difference learning models propose phasic dopamine signaling encodes reward prediction errors that drive learning. This is supported by studies where optogenetic stimulation of dopamine neurons can stand in lieu of actual reward. Nevertheless, a large body of data also shows that dopamine is not necessary for learning, and that dopamine depletion primarily affects task performance. We offer a resolution to this paradox based on an hypothesis that dopamine encodes the precision of beliefs about alternative actions, and thus controls the outcome-sensitivity of behavior. We extend an active inference scheme for solving Markov decision processes to include learning, and show that simulated dopamine dynamics strongly resemble those actually observed during instrumental conditioning. Furthermore, simulated dopamine depletion impairs performance but spares learning, while simulated excitation of dopamine neurons drives reward learning, through aberrant inference about outcome states. Our formal approach provides a novel and parsimonious reconciliation of apparently divergent experimental findings.

A learning scheme for reach to grasp movements: on EMG-based interfaces using task specific motion decoding models.

PubMed

Liarokapis, Minas V; Artemiadis, Panagiotis K; Kyriakopoulos, Kostas J; Manolakos, Elias S

2013-09-01

A learning scheme based on random forests is used to discriminate between different reach to grasp movements in 3-D space, based on the myoelectric activity of human muscles of the upper-arm and the forearm. Task specificity for motion decoding is introduced in two different levels: Subspace to move toward and object to be grasped. The discrimination between the different reach to grasp strategies is accomplished with machine learning techniques for classification. The classification decision is then used in order to trigger an EMG-based task-specific motion decoding model. Task specific models manage to outperform "general" models providing better estimation accuracy. Thus, the proposed scheme takes advantage of a framework incorporating both a classifier and a regressor that cooperate advantageously in order to split the task space. The proposed learning scheme can be easily used to a series of EMG-based interfaces that must operate in real time, providing data-driven capabilities for multiclass problems, that occur in everyday life complex environments.

Scheduling Future Water Supply Investments Under Uncertainty

NASA Astrophysics Data System (ADS)

Huskova, I.; Matrosov, E. S.; Harou, J. J.; Kasprzyk, J. R.; Reed, P. M.

2014-12-01

Uncertain hydrological impacts of climate change, population growth and institutional changes pose a major challenge to planning of water supply systems. Planners seek optimal portfolios of supply and demand management schemes but also when to activate assets whilst considering many system goals and plausible futures. Incorporation of scheduling into the planning under uncertainty problem strongly increases its complexity. We investigate some approaches to scheduling with many-objective heuristic search. We apply a multi-scenario many-objective scheduling approach to the Thames River basin water supply system planning problem in the UK. Decisions include which new supply and demand schemes to implement, at what capacity and when. The impact of different system uncertainties on scheme implementation schedules are explored, i.e. how the choice of future scenarios affects the search process and its outcomes. The activation of schemes is influenced by the occurrence of extreme hydrological events in the ensemble of plausible scenarios and other factors. The approach and results are compared with a previous study where only the portfolio problem is addressed (without scheduling).

How is intensive care reimbursed? A review of eight European countries

PubMed Central

2013-01-01

Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries’ reimbursement schemes-despite all of them originating from a DRG system-, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to assist the intensivist clinician and researcher in understanding neighbouring countries’ approaches and in putting research into the context of a European perspective. In addition, steering committees and decision makers might find this a valuable source to compare different reimbursement schemes. PMID:24216146

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

PubMed Central

Trikha, S; Macgregor, C; Jeffery, M; Kirwan, J

2012-01-01

Background Glaucoma referrals continue to impart a significant burden on Hospital Eye Services (HES), with a large proportion of these false positives. Aims To evaluate the Portsmouth glaucoma scheme, utilising virtual clinics, digital technology, and community optometrists to streamline glaucoma referrals. Method The stages of the patient trail were mapped and, at each step of the process, 100 consecutive patient decisions were identified. The diagnostic outcomes of 50 consecutive patients referred from the refinement scheme to the HES were identified. Results A total of 76% of ‘glaucoma' referrals were suitable for the refinement scheme. Overall, 94% of disc images were gradeable in the virtual clinic. In all, 11% of patients ‘attending' the virtual clinic were accepted into HES, with 89% being discharged for community follow-up. Of referrals accepted into HES, the positive predictive value (glaucoma/ocular hypertension/suspect) was 0.78 vs 0.37 in the predating ‘unrefined' scheme (95% CI 0.65–0.87). The scheme has released 1400 clinic slots/year for HES, and has produced a £244 200/year cost saving for Portsmouth Hospitals' Trust. Conclusion The refinement scheme is streamlining referrals and increasing the positive predictive rate in the diagnosis of glaucoma, glaucoma suspect or ocular hypertension. This consultant-led practice-based commissioning scheme, if adopted widely, is likely to incur a significant cost saving while maintaining high quality of care within the NHS. PMID:22766539

A robust anonymous biometric-based authenticated key agreement scheme for multi-server environments

PubMed Central

Huang, Yuanfei; Ma, Fangchao

2017-01-01

In order to improve the security in remote authentication systems, numerous biometric-based authentication schemes using smart cards have been proposed. Recently, Moon et al. presented an authentication scheme to remedy the flaws of Lu et al.’s scheme, and claimed that their improved protocol supports the required security properties. Unfortunately, we found that Moon et al.’s scheme still has weaknesses. In this paper, we show that Moon et al.’s scheme is vulnerable to insider attack, server spoofing attack, user impersonation attack and guessing attack. Furthermore, we propose a robust anonymous multi-server authentication scheme using public key encryption to remove the aforementioned problems. From the subsequent formal and informal security analysis, we demonstrate that our proposed scheme provides strong mutual authentication and satisfies the desirable security requirements. The functional and performance analysis shows that the improved scheme has the best secure functionality and is computational efficient. PMID:29121050

A robust anonymous biometric-based authenticated key agreement scheme for multi-server environments.

PubMed

Guo, Hua; Wang, Pei; Zhang, Xiyong; Huang, Yuanfei; Ma, Fangchao

2017-01-01

In order to improve the security in remote authentication systems, numerous biometric-based authentication schemes using smart cards have been proposed. Recently, Moon et al. presented an authentication scheme to remedy the flaws of Lu et al.'s scheme, and claimed that their improved protocol supports the required security properties. Unfortunately, we found that Moon et al.'s scheme still has weaknesses. In this paper, we show that Moon et al.'s scheme is vulnerable to insider attack, server spoofing attack, user impersonation attack and guessing attack. Furthermore, we propose a robust anonymous multi-server authentication scheme using public key encryption to remove the aforementioned problems. From the subsequent formal and informal security analysis, we demonstrate that our proposed scheme provides strong mutual authentication and satisfies the desirable security requirements. The functional and performance analysis shows that the improved scheme has the best secure functionality and is computational efficient.

Overview of EPA tools for supporting local-, state- and regional-level decision makers addressing energy and environmental issues: NYC MARKAL Energy Systems Model and Municipal Solid Waste Decision Support Tool

EPA Science Inventory

A workshop will be conducted to demonstrate and focus on two decision support tools developed at EPA/ORD: 1. Community-scale MARKAL model: an energy-water technology evaluation tool and 2. Municipal Solid Waste Decision Support Tool (MSW DST). The Workshop will be part of Southea...

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

DOT National Transportation Integrated Search

2000-07-14

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

Impact of subsidies on cancer genetic testing uptake in Singapore.

PubMed

Li, Shao-Tzu; Yuen, Jeanette; Zhou, Ke; Binte Ishak, Nur Diana; Chen, Yanni; Met-Domestici, Marie; Chan, Sock Hoai; Tan, Yee Pin; Allen, John Carson; Lim, Soon Thye; Soo, Khee Chee; Ngeow, Joanne

2017-04-01

Previous reports cite high costs of clinical cancer genetic testing as main barriers to patient's willingness to test. We report findings of a pilot study that evaluates how different subsidy schemes impact genetic testing uptake and total cost of cancer management. We included all patients who attended the Cancer Genetics Service at the National Cancer Centre Singapore (January 2014-May 2016). Two subsidy schemes, the blanket scheme (100% subsidy to all eligible patients), and the varied scheme (patients received 50%-100% subsidy dependent on financial status) were compared. We estimated total spending on cancer management from government's perspective using a decision model. 445 patients were included. Contrasting against the blanket scheme, the varied scheme observed a higher attendance of patients (34 vs 8 patients per month), of which a higher proportion underwent genetic testing (5% vs 38%), while lowering subsidy spending per person (S$1098 vs S$1161). The varied scheme may potentially save cost by reducing unnecessary cancer surveillance when first-degree relatives uptake rate is above 36%. Provision of subsidy leads to a considerable increase in genetic testing uptake rate. From the government's perspective, subsidising genetic testing may potentially reduce total costs on cancer management. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to Defence Transformation

DTIC Science & Technology

2005-04-01

RTO-MP-SAS-055 4 - 1 UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Analytical Support Capabilities of Turkish General Staff Scientific...the end failed to achieve anything commensurate with the effort. The analytical support capabilities of Turkish Scientific Decision Support Center to...percent of the İpekkan, Z.; Özkil, A. (2005) Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to

Peer-supported review of teaching: an evaluation.

PubMed

Thampy, Harish; Bourke, Michael; Naran, Prasheena

2015-09-01

Peer-supported review (also called peer observation) of teaching is a commonly implemented method of ascertaining teaching quality that supplements student feedback. A large variety of scheme formats with rather differing purposes are described in the literature. They range from purely formative, developmental formats that facilitate a tutor's reflection of their own teaching to reaffirm strengths and identify potential areas for development through to faculty- or institution-driven summative quality assurance-based schemes. Much of the current literature in this field focuses within general higher education and on the development of rating scales, checklists or observation tools to help guide the process. This study reports findings from a qualitative evaluation of a purely formative peer-supported review of teaching scheme that was implemented for general practice clinical tutors at our medical school and describes tutors' attitudes and perceived benefits and challenges when undergoing observation.

Bi-Level Decision Making for Supporting Energy and Water Nexus

NASA Astrophysics Data System (ADS)

Zhang, X.; Vesselinov, V. V.

2016-12-01

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

Effects of regionalization decisions on an O/E index for the US national assessment

EPA Science Inventory

We examined the effects of different regionalization schemes on the performance of River Invertebrate Prediction and Classification System (RIVPACS)-type predictive models in assessing the biological conditions of streams of the US for the National Wadeable Streams Assessment (WS...

Community mobilization and empowerment for health.

PubMed

Saludung, D

1997-01-01

The present article traces the history of "dana sehat", a scheme of social funding devised in Indonesia three decades ago which has proved to be of particular significance as a means of inducing communities to accept responsibility for decision-making on the development of health care.

[Physician's competence and obligations at the place of subject's death outside the health-care facilities].

PubMed

Dvorácek, I

2005-10-01

The valid law does not unequivocally define a physician's competence and obligations at the place of a subject's death outside the health-care facilities. The scheme creates a general instruction for the medical personnel to be used in cases of death outside health-care facilities. It is aimed at a better understanding of the problem, and it is supplemented with relevant legal regulations. The scheme is divided into 3 horizontal levels, the death being placed on the first level, the decision about autopsy on the second level, and the burial on the third level. These three levels are interconnected vertically, in order to represent the chronological sequence of individual steps and the respective decisions made by the examining physician. The schematic representation of the problems of death outside health-care facilities resulted in several lines of action, all that with regard to the medical and forensic aspects of the death. In every line of action, the work of the examining physician's is summarised.

Development of transportation asset management decision support tools : final report.

DOT National Transportation Integrated Search

2017-08-09

This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...

Prediction of cause of death from forensic autopsy reports using text classification techniques: A comparative study.

PubMed

Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa

2018-07-01

Automatic text classification techniques are useful for classifying plaintext medical documents. This study aims to automatically predict the cause of death from free text forensic autopsy reports by comparing various schemes for feature extraction, term weighing or feature value representation, text classification, and feature reduction. For experiments, the autopsy reports belonging to eight different causes of death were collected, preprocessed and converted into 43 master feature vectors using various schemes for feature extraction, representation, and reduction. The six different text classification techniques were applied on these 43 master feature vectors to construct a classification model that can predict the cause of death. Finally, classification model performance was evaluated using four performance measures i.e. overall accuracy, macro precision, macro-F-measure, and macro recall. From experiments, it was found that that unigram features obtained the highest performance compared to bigram, trigram, and hybrid-gram features. Furthermore, in feature representation schemes, term frequency, and term frequency with inverse document frequency obtained similar and better results when compared with binary frequency, and normalized term frequency with inverse document frequency. Furthermore, the chi-square feature reduction approach outperformed Pearson correlation, and information gain approaches. Finally, in text classification algorithms, support vector machine classifier outperforms random forest, Naive Bayes, k-nearest neighbor, decision tree, and ensemble-voted classifier. Our results and comparisons hold practical importance and serve as references for future works. Moreover, the comparison outputs will act as state-of-art techniques to compare future proposals with existing automated text classification techniques. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Conflict resolution in the zoning of eco-protected areas in fast-growing regions based on game theory.

PubMed

Lin, Jinyao; Li, Xia

2016-04-01

Zoning eco-protected areas is important for ecological conservation and environmental management. Rapid and continuous urban expansion, however, may exert negative effects on the performance of practical zoning designs. Various methods have been developed for protected area zoning, but most of them failed to consider the conflicts between urban development (for the benefit of land developers) and ecological protection (local government). Some real-world zoning schemes even have to be modified occasionally after the lengthy negotiations between the government and land developers. Therefore, our study has presented a game theory-based method to deal with this problem. Future urban expansion in the study area will be predicted by a logistic regression cellular automaton, while eco-protected areas will be delimitated using multi-objective optimization algorithm. Then, two types of conflicts between them can be resolved based on game theory, a theory of decision-making. We established a two-person dynamic game for each conflict zone. The ecological compensation mechanism was taken into account by simulating the negotiation processes between the government and land developers. A final zoning scheme can be obtained when the two sides reach agreements. The proposed method is applied to the eco-protected area zoning in Guangzhou, a fast-growing city in China. The experiments indicate that the conflicts between eco-protection and urban development will inevitably arise when using only traditional zoning methods. Based on game theory, our method can effectively resolve those conflicts, and can provide a relatively reasonable zoning scheme. This method is expected to support policy-making in environmental management and urban planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

Funding the unfundable: mechanisms for managing uncertainty in decisions on the introduction of new and innovative technologies into healthcare systems.

PubMed

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

2010-01-01

As tensions between payers, responsible for ensuring prudent and principled use of scarce resources, and both providers and patients, who legitimately want access to technologies from which they could benefit, continue to mount, interest in approaches to managing the uncertainty surrounding the introduction of new health technologies has heightened. The purpose of this project was to compile an inventory of various types of 'access with evidence development' (AED) schemes, examining characteristics of the technologies to which they have been applied, the uncertainty they sought to address, the terms of arrangements of each scheme, and the policy outcomes. It also aimed to identify issues related to such schemes, including advantages and disadvantages from the perspectives of various stakeholder groups. A comprehensive search, review and appraisal of peer-reviewed and 'grey' literature were performed, followed by a facilitated workshop of academics and decision makers with expertise in AED schemes. Information was extracted and compiled in tabular form to identify patterns or trends. To enhance the validity of interpretations made, member checking was performed. Although the concept of AED is not new, evaluative data are sparse. Despite varying opinions on the 'right' answers to some of the questions raised, there appears to be consensus on a 'way forward'--development of methodological guidelines. All stakeholders seemed to share the view that AEDs offer the potential to facilitate patient access to promising new technologies and encourage innovation while ensuring effective use of scarce healthcare resources. There is no agreement on what constitutes 'sufficient evidence', and it depends on the specific uncertainty in question. There is agreement on the need for 'best practice' guidelines around the implementation and evaluation of AED schemes. This is the first attempt at a comprehensive analysis of methods that have been used to address uncertainty concerning a new drug or other technology. The analysis reveals that, although various approaches have been experimented with, many of them have not achieved the ostensible goal of the approach. This article outlines challenges related to AED schemes and issues that remain unresolved.

Considerations of private sector obstetricians on participation in the state led "Chiranjeevi Yojana" scheme to promote institutional delivery in Gujarat, India: a qualitative study.

PubMed

Ganguly, Parthasarathi; Jehan, Kate; de Costa, Ayesha; Mavalankar, Dileep; Smith, Helen

2014-11-05

In India a lack of access to emergency obstetric care contributes to maternal deaths. In 2005 Gujarat state launched a public-private partnership (PPP) programme, Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians a fixed fee for providing free intrapartum care to poor and tribal women. A million women have delivered under CY so far. The participation of private obstetricians in the partnership is central to the programme's effectiveness. We explored with private obstetricians the reasons and experiences that influenced their decisions to participate in the CY programme. In this qualitative study we interviewed 24 purposefully selected private obstetricians in Gujarat. We explored their views on the scheme, the reasons and experiences leading up to decisions to participate, not participate or withdraw from the CY, as well as their opinions about the scheme's impact. We analysed data using the Framework approach. Participants expressed a tension between doing public good and making a profit. Bureaucratic procedures and perceptions of programme misuse seemed to influence providers to withdraw from the programme or not participate at all. Providers feared that participating in CY would lower the status of their practices and some were deterred by the likelihood of more clinically difficult cases among eligible CY beneficiaries. Some providers resented taking on what they saw as a state responsibility to provide safe maternity services to poor women. Younger obstetricians in the process of establishing private practices, and those in more remote, 'less competitive' areas, were more willing to participate in CY. Some doctors had reservations over the quality of care that doctors could provide given the financial constraints of the scheme. While some private obstetricians willingly participate in CY and are satisfied with its functioning, a larger number shared concerns about participation. Operational difficulties and a trust deficit between the public and private health sectors affect retention of private providers in the scheme. Further refinement of the scheme, in consultation with private partners, and trust building initiatives could strengthen the programme. These findings offer lessons to those developing public-private partnerships to widen access to health services for underprivileged groups.

Determining a Method of Enabling and Disabling the Integral Torque in the SDO Science and Inertial Mode Controllers

NASA Technical Reports Server (NTRS)

Vess, Melissa F.; Starin, Scott R.

2007-01-01

During design of the SDO Science and Inertial mode PID controllers, the decision was made to disable the integral torque whenever system stability was in question. Three different schemes were developed to determine when to disable or enable the integral torque, and a trade study was performed to determine which scheme to implement. The trade study compared complexity of the control logic, risk of not reenabling the integral gain in time to reject steady-state error, and the amount of integral torque space used. The first scheme calculated a simplified Routh criterion to determine when to disable the integral torque. The second scheme calculates the PD part of the torque and looked to see if that torque would cause actuator saturation. If so, only the PD torque is used. If not, the integral torque is added. Finally, the third scheme compares the attitude and rate errors to limits and disables the integral torque if either of the errors is greater than the limit. Based on the trade study results, the third scheme was selected. Once it was decided when to disable the integral torque, analysis was performed to determine how to disable the integral torque and whether or not to reset the integrator once the integral torque was reenabled. Three ways to disable the integral torque were investigated: zero the input into the integrator, which causes the integral part of the PID control torque to be held constant; zero the integral torque directly but allow the integrator to continue integrating; or zero the integral torque directly and reset the integrator on integral torque reactivation. The analysis looked at complexity of the control logic, slew time plus settling time between each calibration maneuver step, and ability to reject steady-state error. Based on the results of the analysis, the decision was made to zero the input into the integrator without resetting it. Throughout the analysis, a high fidelity simulation was used to test the various implementation methods.

75 FR 39943 - Notice of Debarment; Schools and Libraries Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... release for federal crimes in connection with your participation in a scheme to defraud the E-Rate program... devised schemes to defraud school districts and the E-Rate program by having your co-conspirators steer E... company.\\7\\ You were also ordered to pay $271,716 in restitution to USAC for your role in the schemes.\\8...

Knowledge producers or knowledge consumers? Argumentation and decision making about environmental management

NASA Astrophysics Data System (ADS)

JiméNez-Aleixandre, Maria-Pilar

2002-11-01

This paper describes a case study involving decision making and argumentation, in the context of wetland environmental management, by 11th-grade students (16-17 years old). The purpose was to study the components of knowledge and skills needed to reach a decision in socio-scientific contexts and to identify them in classroom discourse. The following dimensions of decision making were explored: the use of relevant knowledge to understand and make decisions about the problem; and the critical processing of sources of information and authority and the development of criteria for evaluating possible solutions to the problem. Students' conversations were recorded and analysed using Toulmin's (1958) and Walton's (1996) argument schemes. The students' arguments and warrants were compared with the argument of an external 'official' expert. Issues such as expert status, that is, who can be considered as a source of knowledge and authority and the participation of citizens in scientific practice are also discussed.

Accuracy of parameterized proton range models; A comparison

NASA Astrophysics Data System (ADS)

Pettersen, H. E. S.; Chaar, M.; Meric, I.; Odland, O. H.; Sølie, J. R.; Röhrich, D.

2018-03-01

An accurate calculation of proton ranges in phantoms or detector geometries is crucial for decision making in proton therapy and proton imaging. To this end, several parameterizations of the range-energy relationship exist, with different levels of complexity and accuracy. In this study we compare the accuracy of four different parameterizations models for proton range in water: Two analytical models derived from the Bethe equation, and two different interpolation schemes applied to range-energy tables. In conclusion, a spline interpolation scheme yields the highest reproduction accuracy, while the shape of the energy loss-curve is best reproduced with the differentiated Bragg-Kleeman equation.

Bank Size and Small- and Medium-sized Enterprise (SME) Lending: Evidence from China.

PubMed

Shen, Yan; Shen, Minggao; Xu, Zhong; Bai, Ying

2009-04-01

Using panel data collected in 2005, we evaluate how bank size, discretion over credit, incentive schemes, competition, and the institutional environment affect lending to small- and medium-sized enterprises in China. We deal with the endogeneity problem using instrumental variables, and a reduced-form approach is also applied to allow for weak instruments in estimation. We find that total bank asset is an insignificant factor for banks' decision on small- and medium-enterprise (SME) lending, but more local lending authority, more competition, carefully designed incentive schemes, and stronger law enforcement encourage commercial banks to lend to SMEs.

Modifications and integration of the electronic tracking board in a pediatric emergency department.

PubMed

Dexheimer, Judith W; Kennebeck, Stephanie

2013-07-01

Electronic health records (EHRs) are used for data storage; provider, laboratory, and patient communication; clinical decision support; procedure and medication orders; and decision support alerts. Clinical decision support is part of any EHR and is designed to help providers make better decisions. The emergency department (ED) poses a unique environment to the use of EHRs and clinical decision support. Used effectively, computerized tracking boards can help improve flow, communication, and the dissemination of pertinent visit information between providers and other departments in a busy ED. We discuss the unique modifications and decisions made in the implementation of an EHR and computerized tracking board in a pediatric ED. We discuss the changing views based on provider roles, customization to the user interface including the layout and colors, decision support, tracking board best practices collected from other institutions and colleagues, and a case study of using reminders on the electronic tracking board to drive pain reassessments.

Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS).

PubMed

Saposnik, Gustavo; Sempere, Angel Perez; Raptis, Roula; Prefasi, Daniel; Selchen, Daniel; Maurino, Jorge

2016-05-04

The management of multiple sclerosis (MS) is rapidly changing by the introduction of new and more effective disease-modifying agents. The importance of risk stratification was confirmed by results on disease progression predicted by different risk score systems. Despite these advances, we know very little about medical decisions under uncertainty in the management of MS. The goal of this study is to i) identify whether overconfidence, tolerance to risk/uncertainty, herding influence medical decisions, and ii) to evaluate the frequency of therapeutic inertia (defined as lack of treatment initiation or intensification in patients not at goals of care) and its predisposing factors in the management of MS. This is a prospective study comprising a combination of case-vignettes and surveys and experiments from Neuroeconomics/behavioral economics to identify cognitive distortions associated with medical decisions and therapeutic inertia. Participants include MS fellows and MS experts from across Spain. Each participant will receive an individual link using Qualtrics platform(©) that includes 20 case-vignettes, 3 surveys, and 4 behavioral experiments. The total time for completing the study is approximately 30-35 min. Case vignettes were selected to be representative of common clinical encounters in MS practice. Surveys and experiments include standardized test to measure overconfidence, aversion to risk and ambiguity, herding (following colleague's suggestions even when not supported by the evidence), physicians' reactions to uncertainty, and questions from the Socio-Economic Panel Study (SOEP) related to risk preferences in different domains. By applying three different MS score criteria (modified Rio, EMA, Prosperini's scheme) we take into account physicians' differences in escalating therapy when evaluating medical decisions across case-vignettes. The present study applies an innovative approach by combining tools to assess medical decisions with experiments from Neuroeconomics that applies to common scenarios in MS care. Our results will help advance the field by providing a better understanding on the influence of cognitive factors (e.g., overconfidence, aversion to risk and uncertainty, herding) on medical decisions and therapeutic inertia in the management of MS which could lead to better outcomes.

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 (...

The design of patient decision support interventions: addressing the theory-practice gap.

PubMed

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards Collaboration influence standards for the design of decision support interventions. However, this analysis points to the need to undertake more work in providing theoretical foundations for these interventions. © 2010 Blackwell Publishing Ltd.

Advanced decision support for winter road maintenance

DOT National Transportation Integrated Search

2008-01-01

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

Detroit deicing decision support tool : description, operation, and simulation results

DOT National Transportation Integrated Search

2006-01-01

The John A. Volpe National Transportation Systems Center, sponsored by the National Aeronautics and Space Administration, : developed a deicing decision support tool, for Detroit Metropolitan Wayne County Airport (DTW).1 The deicing decision support ...

Developing a Software for Fuzzy Group Decision Support System: A Case Study

ERIC Educational Resources Information Center

Baba, A. Fevzi; Kuscu, Dincer; Han, Kerem

2009-01-01

The complex nature and uncertain information in social problems required the emergence of fuzzy decision support systems in social areas. In this paper, we developed user-friendly Fuzzy Group Decision Support Systems (FGDSS) software. The software can be used for multi-purpose decision making processes. It helps the users determine the main and…

Supported Decision Making: A Synthesis of the Literature across Intellectual Disability, Mental Health, and Aging

ERIC Educational Resources Information Center

Shogren, Karrie A.; Wehmeyer, Michael L.; Lassmann, Heather; Forber-Pratt, Anjali J.

2017-01-01

Supported decision making (SDM) has begun to receive significant attention as means to enable people to exercise autonomy and self-determination over decisions about their life. Practice frameworks that can be used to promote the provision of supports for decision making are needed. This paper integrates the literature across intellectual and…

Judging without criteria? Sickness certification in Dutch disability schemes.

PubMed

Meershoek, Agnes; Krumeich, Anja; Vos, Rein

2007-05-01

The gate-keeping function that physicians perform in determining clients' physical and mental incapacities is widely assumed to be the main reason for the rising numbers of disabled people. The sharp rise in the number of disabled has led many to claim that the disability benefits schemes are untenable. In order to regain public control and to make disabled eligibility procedures more transparent guidelines have been introduced in which medical evaluations are conceptualised as formal rational decisions. It is, however, questionable whether such measures are helpful in achieving their stated aims. This paper is based on ethnographic research on the ways physicians evaluate the eligibility of clients for disability benefits. It argues that assessing incapacity involves much more than formal rational decision-making. Doctors' reasoning is contextual and deliberative in character, and thus their assessment of a client's incapacity is less a technical matter than a normative one. Instead of generating transparency, guidelines based on formal rationality make the complex deliberations on which such judgments are based invisible, because they deny the normative dimension of medical expert decision-making. Therefore, different measures have to be developed that allow this normative dimension to be articulated, since insight into this normative dimension is a necessary pre-condition to be able to criticise disability judgments at all.

Local classifier weighting by quadratic programming.

PubMed

Cevikalp, Hakan; Polikar, Robi

2008-10-01

It has been widely accepted that the classification accuracy can be improved by combining outputs of multiple classifiers. However, how to combine multiple classifiers with various (potentially conflicting) decisions is still an open problem. A rich collection of classifier combination procedures -- many of which are heuristic in nature -- have been developed for this goal. In this brief, we describe a dynamic approach to combine classifiers that have expertise in different regions of the input space. To this end, we use local classifier accuracy estimates to weight classifier outputs. Specifically, we estimate local recognition accuracies of classifiers near a query sample by utilizing its nearest neighbors, and then use these estimates to find the best weights of classifiers to label the query. The problem is formulated as a convex quadratic optimization problem, which returns optimal nonnegative classifier weights with respect to the chosen objective function, and the weights ensure that locally most accurate classifiers are weighted more heavily for labeling the query sample. Experimental results on several data sets indicate that the proposed weighting scheme outperforms other popular classifier combination schemes, particularly on problems with complex decision boundaries. Hence, the results indicate that local classification-accuracy-based combination techniques are well suited for decision making when the classifiers are trained by focusing on different regions of the input space.

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems

PubMed Central

DesAutels, Spencer J.; Fox, Zachary E.; Giuse, Dario A.; Williams, Annette M.; Kou, Qing-hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems. PMID:28269846

Consume, Modify, Share (CMS): The Interplay between Individual Decisions and Structural Network Properties in the Diffusion of Information

PubMed Central

Koren, Hila; Kaminer, Ido

2016-01-01

Widely used information diffusion models such as Independent Cascade Model, Susceptible Infected Recovered (SIR) and others fail to acknowledge that information is constantly subject to modification. Some aspects of information diffusion are best explained by network structural characteristics while in some cases strong influence comes from individual decisions. We introduce reinvention, the ability to modify information, as an individual level decision that affects the diffusion process as a whole. Based on a combination of constructs from the Diffusion of Innovations and the Critical Mass Theories, the present study advances the CMS (consume, modify, share) model which accounts for the interplay between network structure and human behavior and interactions. The model's building blocks include processes leading up to and following the formation of a critical mass of information adopters and disseminators. We examine the formation of an inflection point, information reach, sustainability of the diffusion process and collective value creation. The CMS model is tested on two directed networks and one undirected network, assuming weak or strong ties and applying constant and relative modification schemes. While all three networks are designed for disseminating new knowledge they differ in structural properties. Our findings suggest that modification enhances the diffusion of information in networks that support undirected connections and carries the biggest effect when information is shared via weak ties. Rogers' diffusion model and traditional information contagion models are fine tuned. Our results show that modifications not only contribute to a sustainable diffusion process, but also aid information in reaching remote areas of the network. The results point to the importance of cultivating weak ties, allowing reciprocal interaction among nodes and supporting the modification of information in promoting diffusion processes. These results have theoretical and practical implications for designing networks aimed at accelerating the creation and diffusion of information. PMID:27798636

Consume, Modify, Share (CMS): The Interplay between Individual Decisions and Structural Network Properties in the Diffusion of Information.

PubMed

Koren, Hila; Kaminer, Ido; Raban, Daphne Ruth

2016-01-01

Widely used information diffusion models such as Independent Cascade Model, Susceptible Infected Recovered (SIR) and others fail to acknowledge that information is constantly subject to modification. Some aspects of information diffusion are best explained by network structural characteristics while in some cases strong influence comes from individual decisions. We introduce reinvention, the ability to modify information, as an individual level decision that affects the diffusion process as a whole. Based on a combination of constructs from the Diffusion of Innovations and the Critical Mass Theories, the present study advances the CMS (consume, modify, share) model which accounts for the interplay between network structure and human behavior and interactions. The model's building blocks include processes leading up to and following the formation of a critical mass of information adopters and disseminators. We examine the formation of an inflection point, information reach, sustainability of the diffusion process and collective value creation. The CMS model is tested on two directed networks and one undirected network, assuming weak or strong ties and applying constant and relative modification schemes. While all three networks are designed for disseminating new knowledge they differ in structural properties. Our findings suggest that modification enhances the diffusion of information in networks that support undirected connections and carries the biggest effect when information is shared via weak ties. Rogers' diffusion model and traditional information contagion models are fine tuned. Our results show that modifications not only contribute to a sustainable diffusion process, but also aid information in reaching remote areas of the network. The results point to the importance of cultivating weak ties, allowing reciprocal interaction among nodes and supporting the modification of information in promoting diffusion processes. These results have theoretical and practical implications for designing networks aimed at accelerating the creation and diffusion of information.

The value of innovation in decision-making in health care in Central Eastern Europe - The Sixth International Conference, 2 June 2017, Belgrade, Serbia.

PubMed

Novakovic, Tanja; Martin, Antony P; Parker, Mark; Ferrario, Alessandra; Vukovic, Simo; Łanda, Krzysztof; Duba, Jaroslav; Dankó, Dávid; Kotsopoulos, Nikolaos; Godman, Brian; Ristic, Jelena; Stefanovic, Danka; Tesic, Danka

2017-12-01

The Pharmacoeconomics Section of the Pharmaceutical Association of Serbia organised a one day international conference on the value of innovation in decision-making in health care in Central and Eastern Europe. The focus of the conference was on reimbursement decisions for medicines using health technology assessment and the use of managed entry agreements (MEAs). The objectives of this conference were firstly to discuss the challenges and opportunities with the use of MEAs in Central and Eastern European countries; secondly the role of patient registries especially with outcome based schemes, and finally new approaches to improve accessibility to new medicines including better managing their entry.

Research on filter’s parameter selection based on PROMETHEE method

NASA Astrophysics Data System (ADS)

Zhu, Hui-min; Wang, Hang-yu; Sun, Shi-yan

2018-03-01

The selection of filter’s parameters in target recognition was studied in this paper. The PROMETHEE method was applied to the optimization problem of Gabor filter parameters decision, the correspondence model of the elemental relation between two methods was established. The author took the identification of military target as an example, problem about the filter’s parameter decision was simulated and calculated by PROMETHEE. The result showed that using PROMETHEE method for the selection of filter’s parameters was more scientific. The human disturbance caused by the experts method and empirical method could be avoided by this way. The method can provide reference for the parameter configuration scheme decision of the filter.

A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

PubMed

Fowler, G E; Baker, D M; Lee, M J; Brown, S R

2017-11-01

The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

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

PubMed

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

2011-06-01

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

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence

PubMed Central

2014-01-01

Background Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. Methods We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Results Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association between formulary decision support usage and adherence. Conclusion Interruptive formulary decision support shifted prescribing toward preferred tiers, but these medications were only minimally less expensive in the studied patient population. In this context, formulary decision support did not significantly increase adherence. To impact cost-related non-adherence, formulary decision support will likely need to be paired with complementary drug benefit design. Formulary decision support should be studied further, with particular attention to its effect on adherence in the setting of different benefit designs. PMID:25167807

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.

PubMed

Pevnick, Joshua M; Li, Ning; Asch, Steven M; Jackevicius, Cynthia A; Bell, Douglas S

2014-08-28

Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association between formulary decision support usage and adherence. Interruptive formulary decision support shifted prescribing toward preferred tiers, but these medications were only minimally less expensive in the studied patient population. In this context, formulary decision support did not significantly increase adherence. To impact cost-related non-adherence, formulary decision support will likely need to be paired with complementary drug benefit design. Formulary decision support should be studied further, with particular attention to its effect on adherence in the setting of different benefit designs.

Information Literacy Advocates: developing student skills through a peer support approach.

PubMed

Curtis, Ruth

2016-12-01

Since 2013/2014, an Information Literacy Advocates (ILA) scheme has been running at the University of Nottingham as an extracurricular module on the Nottingham Advantage Award programme. The Information Literacy Advocates scheme, which recruits medicine and health sciences students in their second year or above, aims to facilitate development of information literacy skills and confidence, as well as communication, organisation and teamwork, through the provision of peer support. Previous research indicates peer assistance effectively enhances such skills and is valued by fellow students who welcome the opportunity to approach more experienced students for help. This article, written by guest writer Ruth Curtis from the University of Nottingham, provides an overview of administering the ILA scheme and explores its impact on the Information Literacy Advocates, peers and librarians, and discusses future developments for taking the scheme forward. H. S. © 2016 Health Libraries Group.

Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

PubMed

Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

2017-12-28

Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision-making with the patient. These factors fostered an in-depth knowledge of the patients and acted as a foundation for the nurses' reasoning process. Nurses' reasoning frequently advanced beyond the computerised decision support system recommendations. Future studies are warranted to develop more accurate algorithms, increase system maturity, and improve the integration of the digital clinical information with clinical experiences, to support telemedicine nurses' reasoning process.

Manufacturing process and material selection in concurrent collaborative design of MEMS devices

NASA Astrophysics Data System (ADS)

Zha, Xuan F.; Du, H.

2003-09-01

In this paper we present knowledge of an intensive approach and system for selecting suitable manufacturing processes and materials for microelectromechanical systems (MEMS) devices in concurrent collaborative design environment. In the paper, fundamental issues on MEMS manufacturing process and material selection such as concurrent design framework, manufacturing process and material hierarchies, and selection strategy are first addressed. Then, a fuzzy decision support scheme for a multi-criteria decision-making problem is proposed for estimating, ranking and selecting possible manufacturing processes, materials and their combinations. A Web-based prototype advisory system for the MEMS manufacturing process and material selection, WebMEMS-MASS, is developed based on the client-knowledge server architecture and framework to help the designer find good processes and materials for MEMS devices. The system, as one of the important parts of an advanced simulation and modeling tool for MEMS design, is a concept level process and material selection tool, which can be used as a standalone application or a Java applet via the Web. The running sessions of the system are inter-linked with webpages of tutorials and reference pages to explain the facets, fabrication processes and material choices, and calculations and reasoning in selection are performed using process capability and material property data from a remote Web-based database and interactive knowledge base that can be maintained and updated via the Internet. The use of the developed system including operation scenario, use support, and integration with an MEMS collaborative design system is presented. Finally, an illustration example is provided.

Gray-box reservoir routing to compute flow propagation in operational forecasting and decision support systems

NASA Astrophysics Data System (ADS)

Russano, Euan; Schwanenberg, Dirk; Alvarado Montero, Rodolfo

2017-04-01

Operational forecasting and decision support systems for flood mitigation and the daily management of water resources require computationally efficient flow routing models. If backwater effects do not play an important role, a hydrological routing approach is often a pragmatic choice. It offers a reasonable accuracy at low computational costs in comparison to a more detailed hydraulic model. This work presents a nonlinear reservoir routing scheme as well as its implementation for the flow propagation between the hydro reservoir Três Marias and a downstream inundation-affected city Pirapora in Brazil. We refer to the model as a gray-box approach due to the identification of the parameter k by a data-driven approach for each reservoir of the cascade, instead of using estimates based on physical characteristics. The model reproduces the discharge at the gauge Pirapora, using 15 reservoirs in the cascade. The obtained results are compared with the ones obtained from the full-hydrodynamic model SOBEK. Results show a relatively good performance for the validation period, with a RMSE of 139.48 for the gray-box model, while the full-hydrodynamic model shows a RMSE of 136.67. The simulation time for a period of several years for the full-hydrodynamic took approximately 64s, while the gray-box model only required about 0.50s. This provides a significant speedup of the computation by only a little trade-off in accuracy, pointing at the potential of the simple approach in the context of time-critical, operational applications. Key-words: flow routing, reservoir routing, gray-box model

Individualized Gaussian process-based prediction and detection of local and global gray matter abnormalities in elderly subjects.

PubMed

Ziegler, G; Ridgway, G R; Dahnke, R; Gaser, C

2014-08-15

Structural imaging based on MRI is an integral component of the clinical assessment of patients with potential dementia. We here propose an individualized Gaussian process-based inference scheme for clinical decision support in healthy and pathological aging elderly subjects using MRI. The approach aims at quantitative and transparent support for clinicians who aim to detect structural abnormalities in patients at risk of Alzheimer's disease or other types of dementia. Firstly, we introduce a generative model incorporating our knowledge about normative decline of local and global gray matter volume across the brain in elderly. By supposing smooth structural trajectories the models account for the general course of age-related structural decline as well as late-life accelerated loss. Considering healthy subjects' demography and global brain parameters as informative about normal brain aging variability affords individualized predictions in single cases. Using Gaussian process models as a normative reference, we predict new subjects' brain scans and quantify the local gray matter abnormalities in terms of Normative Probability Maps (NPM) and global z-scores. By integrating the observed expectation error and the predictive uncertainty, the local maps and global scores exploit the advantages of Bayesian inference for clinical decisions and provide a valuable extension of diagnostic information about pathological aging. We validate the approach in simulated data and real MRI data. We train the GP framework using 1238 healthy subjects with ages 18-94 years, and predict in 415 independent test subjects diagnosed as healthy controls, Mild Cognitive Impairment and Alzheimer's disease. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Individualized Gaussian process-based prediction and detection of local and global gray matter abnormalities in elderly subjects

PubMed Central

Ziegler, G.; Ridgway, G.R.; Dahnke, R.; Gaser, C.

2014-01-01

Structural imaging based on MRI is an integral component of the clinical assessment of patients with potential dementia. We here propose an individualized Gaussian process-based inference scheme for clinical decision support in healthy and pathological aging elderly subjects using MRI. The approach aims at quantitative and transparent support for clinicians who aim to detect structural abnormalities in patients at risk of Alzheimer's disease or other types of dementia. Firstly, we introduce a generative model incorporating our knowledge about normative decline of local and global gray matter volume across the brain in elderly. By supposing smooth structural trajectories the models account for the general course of age-related structural decline as well as late-life accelerated loss. Considering healthy subjects' demography and global brain parameters as informative about normal brain aging variability affords individualized predictions in single cases. Using Gaussian process models as a normative reference, we predict new subjects' brain scans and quantify the local gray matter abnormalities in terms of Normative Probability Maps (NPM) and global z-scores. By integrating the observed expectation error and the predictive uncertainty, the local maps and global scores exploit the advantages of Bayesian inference for clinical decisions and provide a valuable extension of diagnostic information about pathological aging. We validate the approach in simulated data and real MRI data. We train the GP framework using 1238 healthy subjects with ages 18–94 years, and predict in 415 independent test subjects diagnosed as healthy controls, Mild Cognitive Impairment and Alzheimer's disease. PMID:24742919

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

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.

Asynchronous Gossip for Averaging and Spectral Ranking

NASA Astrophysics Data System (ADS)

Borkar, Vivek S.; Makhijani, Rahul; Sundaresan, Rajesh

2014-08-01

We consider two variants of the classical gossip algorithm. The first variant is a version of asynchronous stochastic approximation. We highlight a fundamental difficulty associated with the classical asynchronous gossip scheme, viz., that it may not converge to a desired average, and suggest an alternative scheme based on reinforcement learning that has guaranteed convergence to the desired average. We then discuss a potential application to a wireless network setting with simultaneous link activation constraints. The second variant is a gossip algorithm for distributed computation of the Perron-Frobenius eigenvector of a nonnegative matrix. While the first variant draws upon a reinforcement learning algorithm for an average cost controlled Markov decision problem, the second variant draws upon a reinforcement learning algorithm for risk-sensitive control. We then discuss potential applications of the second variant to ranking schemes, reputation networks, and principal component analysis.

Key Management Schemes for Peer-to-Peer Multimedia Streaming Overlay Networks

NASA Astrophysics Data System (ADS)

Naranjo, J. A. M.; López-Ramos, J. A.; Casado, L. G.

Key distribution for multimedia live streaming peer-to-peer overlay networks is a field still in its childhood stage. A scheme designed for networks of this kind must seek security and efficiency while keeping in mind the following restrictions: limited bandwidth, continuous playing, great audience size and clients churn. This paper introduces two novel schemes that allow a trade-off between security and efficiency by allowing to dynamically vary the number of levels used in the key hierarchy. These changes are motivated by great variations in audience size, and initiated by decision of the Key Server. Additionally, a comparative study of both is presented, focusing on security and audience size. Results show that larger key hierarchies can supply bigger audiences, but offer less security against statistical attacks. The opposite happens for shorter key hierarchies.

Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

ERIC Educational Resources Information Center

Ballantine, R. Malcolm

Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

Collaborative Response and Recovery from a Foot-and-Mouth Disease Animal Health Emergency: Supporting Decision Making in a Complex Environment with Multiple Stakeholders

DTIC Science & Technology

2013-12-01

RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING IN A COMPLEX ENVIRONMENT WITH MULTIPLE...Thesis 4. TITLE AND SUBTITLE COLLABORATIVE RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING...200 words ) This thesis recommends ways to support decision makers who must operate within the multi-stakeholder complex situation of response and

SANDS: A Service-Oriented Architecture for Clinical Decision Support in a National Health Information Network

PubMed Central

Wright, Adam; Sittig, Dean F.

2008-01-01

In this paper we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. PMID:18434256

Analysis of Media Coverage on Breastfeeding Policy in Washington State.

PubMed

DeMarchis, Alessandra; Ritter, Gaelen; Otten, Jennifer; Johnson, Donna

2018-02-01

Media coverage and message framing about breastfeeding polices can influence important policy decisions in institutional and governmental settings. Research aim: This study aimed to describe the media coverage of breastfeeding policies and the message frames that are found in print newspapers and web-only news publications in Washington State between 2000 and 2014. For this retrospective media analysis study, 131 news articles published from January 2000 through June 2014 in Washington State that specifically discussed breastfeeding policy were identified, coded, and analyzed to explore the content of the sample and examine how arguments supporting or opposing breastfeeding policy were framed. The coding scheme was developed cooperatively and found to be reliable across coders. The number of articles published each year about breastfeeding policy grew overall between 2000 and 2014 and peaked during periods of specific policy development. Seventy-four articles had a neutral tone, 49 supported breastfeeding policy, and 4 were in opposition. Nine distinct supporting frames and six distinct opposing frames were identified. Common supporting frames were health benefits of breastfeeding and the need for policies because of challenges of breastfeeding in public. The most common opposing frame was indecency of breastfeeding in public. There is limited but growing media coverage of breastfeeding policies. For the most part, coverage is supportive of the need for policies. Breastfeeding advocates can apply information about media message frames to craft effective policy development strategies that counteract negative perceptions and promote the benefits of breastfeeding policies.

Network-aware scalable video monitoring system for emergency situations with operator-managed fidelity control

NASA Astrophysics Data System (ADS)

Al Hadhrami, Tawfik; Nightingale, James M.; Wang, Qi; Grecos, Christos

2014-05-01

In emergency situations, the ability to remotely monitor unfolding events using high-quality video feeds will significantly improve the incident commander's understanding of the situation and thereby aids effective decision making. This paper presents a novel, adaptive video monitoring system for emergency situations where the normal communications network infrastructure has been severely impaired or is no longer operational. The proposed scheme, operating over a rapidly deployable wireless mesh network, supports real-time video feeds between first responders, forward operating bases and primary command and control centers. Video feeds captured on portable devices carried by first responders and by static visual sensors are encoded in H.264/SVC, the scalable extension to H.264/AVC, allowing efficient, standard-based temporal, spatial, and quality scalability of the video. A three-tier video delivery system is proposed, which balances the need to avoid overuse of mesh nodes with the operational requirements of the emergency management team. In the first tier, the video feeds are delivered at a low spatial and temporal resolution employing only the base layer of the H.264/SVC video stream. Routing in this mode is designed to employ all nodes across the entire mesh network. In the second tier, whenever operational considerations require that commanders or operators focus on a particular video feed, a `fidelity control' mechanism at the monitoring station sends control messages to the routing and scheduling agents in the mesh network, which increase the quality of the received picture using SNR scalability while conserving bandwidth by maintaining a low frame rate. In this mode, routing decisions are based on reliable packet delivery with the most reliable routes being used to deliver the base and lower enhancement layers; as fidelity is increased and more scalable layers are transmitted they will be assigned to routes in descending order of reliability. The third tier of video delivery transmits a high-quality video stream including all available scalable layers using the most reliable routes through the mesh network ensuring the highest possible video quality. The proposed scheme is implemented in a proven simulator, and the performance of the proposed system is numerically evaluated through extensive simulations. We further present an in-depth analysis of the proposed solutions and potential approaches towards supporting high-quality visual communications in such a demanding context.

Changing hospitals, choosing chemotherapy and deciding you've made the right choice: Understanding the role of online support groups in different health decision-making activities.

PubMed

Sillence, Elizabeth; Bussey, Lauren

2017-05-01

To investigate the ways in which people use online support groups (OSGs) in relation to their health decision-making and to identify the key features of the resource that support those activities. Eighteen participants who used OSGs for a range of health conditions participated in qualitative study in which they were interviewed about their experiences of using OSGs in relation to decision-making. Exploration of their experiences was supported by discussion of illustrative quotes. Across the health conditions OSGs supported two main decision-making activities: (i) prompting decision making and (ii) evaluating and confirming decisions already made. Depending on the activity, participants valued information about the process, the experience and the outcome of patient narratives. The importance of forum interactivity was highlighted in relation to advice-seeking and the selection of relevant personal experiences. People use OSGs in different ways to support their health related decision-making valuing the different content types of the narratives and the interactivity provided by the resource. Engaging with OSGs helps people in a number of different ways in relation to decision-making. However, it only forms one part of people's decision-making strategies and appropriate resources should be signposted where possible. Copyright © 2017 Elsevier B.V. All rights reserved.

ECG compression using non-recursive wavelet transform with quality control

NASA Astrophysics Data System (ADS)

Liu, Je-Hung; Hung, King-Chu; Wu, Tsung-Ching

2016-09-01

While wavelet-based electrocardiogram (ECG) data compression using scalar quantisation (SQ) yields excellent compression performance, a wavelet's SQ scheme, however, must select a set of multilevel quantisers for each quantisation process. As a result of the properties of multiple-to-one mapping, however, this scheme is not conducive for reconstruction error control. In order to address this problem, this paper presents a single-variable control SQ scheme able to guarantee the reconstruction quality of wavelet-based ECG data compression. Based on the reversible round-off non-recursive discrete periodised wavelet transform (RRO-NRDPWT), the SQ scheme is derived with a three-stage design process that first uses genetic algorithm (GA) for high compression ratio (CR), followed by a quadratic curve fitting for linear distortion control, and the third uses a fuzzy decision-making for minimising data dependency effect and selecting the optimal SQ. The two databases, Physikalisch-Technische Bundesanstalt (PTB) and Massachusetts Institute of Technology (MIT) arrhythmia, are used to evaluate quality control performance. Experimental results show that the design method guarantees a high compression performance SQ scheme with statistically linear distortion. This property can be independent of training data and can facilitate rapid error control.

Development of a Shared Decision Making coding system for analysis of patient-healthcare provider encounters

PubMed Central

Clayman, Marla L.; Makoul, Gregory; Harper, Maya M.; Koby, Danielle G.; Williams, Adam R.

2012-01-01

Objectives Describe the development and refinement of a scheme, Detail of Essential Elements and Participants in Shared Decision Making (DEEP-SDM), for coding Shared Decision Making (SDM) while reporting on the characteristics of decisions in a sample of patients with metastatic breast cancer. Methods The Evidence-Based Patient Choice instrument was modified to reflect Makoul and Clayman’s Integrative Model of SDM. Coding was conducted on video recordings of 20 women at the first visit with their medical oncologists after suspicion of disease progression. Noldus Observer XT v.8, a video coding software platform, was used for coding. Results The sample contained 80 decisions (range: 1-11), divided into 150 decision making segments. Most decisions were physician-led, although patients and physicians initiated similar numbers of decision-making conversations. Conclusion DEEP-SDM facilitates content analysis of encounters between women with metastatic breast cancer and their medical oncologists. Despite the fractured nature of decision making, it is possible to identify decision points and to code each of the Essential Elements of Shared Decision Making. Further work should include application of DEEP-SDM to non-cancer encounters. Practice Implications: A better understanding of how decisions unfold in the medical encounter can help inform the relationship of SDM to patient-reported outcomes. PMID:22784391

75 FR 20596 - Notice of Debarment; Schools and Libraries Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... participation in a scheme to defraud the E-Rate program.\\6\\ You held yourself out as an E-Rate consultant and salesperson and admitted that you and others devised a scheme to defraud school districts and the E-Rate... your companies.\\7\\ You were also ordered to pay $238,609 in restitution for your role in the scheme.\\8...

The Design and Use of Decision Support Systems by Academic Departments. AIR 1987 Annual Forum Paper.

ERIC Educational Resources Information Center

Johnson, F. Craig

The design and use of a departmental decision support system at Florida State University are described from the perspective of a department head. The decisions selected for study are ones of adequacy, equitability, quality, efficiency, and consistency. The complexity of the decision is related to the complexity of the support system. The major…

A Secure and Robust User Authenticated Key Agreement Scheme for Hierarchical Multi-medical Server Environment in TMIS.

PubMed

Das, Ashok Kumar; Odelu, Vanga; Goswami, Adrijit

2015-09-01

The telecare medicine information system (TMIS) helps the patients to gain the health monitoring facility at home and access medical services over the Internet of mobile networks. Recently, Amin and Biswas presented a smart card based user authentication and key agreement security protocol usable for TMIS system using the cryptographic one-way hash function and biohashing function, and claimed that their scheme is secure against all possible attacks. Though their scheme is efficient due to usage of one-way hash function, we show that their scheme has several security pitfalls and design flaws, such as (1) it fails to protect privileged-insider attack, (2) it fails to protect strong replay attack, (3) it fails to protect strong man-in-the-middle attack, (4) it has design flaw in user registration phase, (5) it has design flaw in login phase, (6) it has design flaw in password change phase, (7) it lacks of supporting biometric update phase, and (8) it has flaws in formal security analysis. In order to withstand these security pitfalls and design flaws, we aim to propose a secure and robust user authenticated key agreement scheme for the hierarchical multi-server environment suitable in TMIS using the cryptographic one-way hash function and fuzzy extractor. Through the rigorous security analysis including the formal security analysis using the widely-accepted Burrows-Abadi-Needham (BAN) logic, the formal security analysis under the random oracle model and the informal security analysis, we show that our scheme is secure against possible known attacks. Furthermore, we simulate our scheme using the most-widely accepted and used Automated Validation of Internet Security Protocols and Applications (AVISPA) tool. The simulation results show that our scheme is also secure. Our scheme is more efficient in computation and communication as compared to Amin-Biswas's scheme and other related schemes. In addition, our scheme supports extra functionality features as compared to other related schemes. As a result, our scheme is very appropriate for practical applications in TMIS.

Decision Performance Using Spatial Decision Support Systems: A Geospatial Reasoning Ability Perspective

ERIC Educational Resources Information Center

Erskine, Michael A.

2013-01-01

As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…

The Task and Relational Dimensions of Online Social Support.

PubMed

Beck, Stephenson J; Paskewitz, Emily A; Anderson, Whitney A; Bourdeaux, Renee; Currie-Mueller, Jenna

2017-03-01

Online support groups are attractive to individuals suffering from various types of mental and physical illness due to their accessibility, convenience, and comfort level. Individuals coping with depression, in particular, may seek social support online to avoid the stigma that accompanies face-to-face support groups. We explored how task and relational messages created social support in online depression support groups using Cutrona and Suhr's social support coding scheme and Bales's Interaction Process Analysis coding scheme. A content analysis revealed emotional support as the most common type of social support within the group, although the majority of messages were task rather than relational. Informational support consisted primarily of task messages, whereas network and esteem support were primarily relational messages. Specific types of task and relational messages were associated with different support types. Results indicate task messages dominated online depression support groups, suggesting the individuals who participate in these groups are interested in solving problems but may also experience emotional support when their uncertainty is reduced via task messages.

Scattering-free optical levitation of a cavity mirror.

PubMed

Guccione, G; Hosseini, M; Adlong, S; Johnsson, M T; Hope, J; Buchler, B C; Lam, P K

2013-11-01

We demonstrate the feasibility of levitating a small mirror using only radiation pressure. In our scheme, the mirror is supported by a tripod where each leg of the tripod is a Fabry-Perot cavity. The macroscopic state of the mirror is coherently coupled to the supporting cavity modes allowing coherent interrogation and manipulation of the mirror motion. The proposed scheme is an extreme example of the optical spring, where a mechanical oscillator is isolated from the environment and its mechanical frequency and macroscopic state can be manipulated solely through optical fields. We model the stability of the system and find a three-dimensional lattice of trapping points where cavity resonances allow for buildup of optical field sufficient to support the weight of the mirror. Our scheme offers a unique platform for studying quantum and classical optomechanics and can potentially be used for precision gravitational field sensing and quantum state generation.

Searching for solutions to mitigate greenhouse gas emissions by agricultural policy decisions--Application of system dynamics modeling for the case of Latvia.

PubMed

Dace, Elina; Muizniece, Indra; Blumberga, Andra; Kaczala, Fabio

2015-09-15

European Union (EU) Member States have agreed to limit their greenhouse gas (GHG) emissions from sectors not covered by the EU Emissions Trading Scheme (non-ETS). That includes also emissions from agricultural sector. Although the Intergovernmental Panel on Climate Change (IPCC) has established a methodology for assessment of GHG emissions from agriculture, the forecasting options are limited, especially when policies and their interaction with the agricultural system are tested. Therefore, an advanced tool, a system dynamics model, was developed that enables assessment of effects various decisions and measures have on agricultural GHG emissions. The model is based on the IPCC guidelines and includes the main elements of an agricultural system, i.e. land management, livestock farming, soil fertilization and crop production, as well as feedback mechanisms between the elements. The case of Latvia is selected for simulations, as agriculture generates 22% of the total anthropogenic GHG emissions in the country. The results demonstrate that there are very limited options for GHG mitigation in the agricultural sector. Thereby, reaching the non-ETS GHG emission targets will be very challenging for Latvia, as the level of agricultural GHG emissions will be exceeded considerably above the target levels. Thus, other non-ETS sectors will have to reduce their emissions drastically to "neutralize" the agricultural sector's emissions for reaching the EU's common ambition to move towards low-carbon economy. The developed model may serve as a decision support tool for impact assessment of various measures and decisions on the agricultural system's GHG emissions. Although the model is applied to the case of Latvia, the elements and structure of the model developed are similar to agricultural systems in many countries. By changing numeric values of certain parameters, the model can be applied to analyze decisions and measures in other countries. Copyright © 2015 Elsevier B.V. All rights reserved.

The role of economic evaluation in the pricing and reimbursement of medicines.

PubMed

Drummond, M; Jönsson, B; Rutten, F

1997-06-01

In most countries, governments or health insurers have taken initiatives to influence the price and utilization of medicines. One stated objective of these schemes is to encourage efficiency, or cost-effectiveness. In principle, economic evaluation should to be relevant to decisions about the pricing and reimbursement of health technologies, since it offers a way of estimating the additional value to society of a new intervention (e.g. medicine) relative to current therapy. However, the application of economic evaluation in drug pricing and reimbursement schemes is variable. Therefore, this paper reviews the actual and potential role of economic evaluation in different drug pricing and reimbursement schemes, such as 'free pricing' systems (United Kingdom, United States), two-stage administered systems (France), reference pricing systems (Germany, Netherlands, Sweden) and economic evaluation systems (Australia, Canada). It is concluded that, other than in the case of Australia and Canada, the potential role of economic evaluation could be greatly developed, especially in the case of new medicines, for which there is no close substitute. Comments are also given on the practical problems of using this approach. However, it is noted that economic evaluation alone cannot set a price for a medicine, since a decision has to be made about the proportion of added value going to society and the proportion going to the pharmaceutical company as a reward for innovation.

Reversible wavelet filter banks with side informationless spatially adaptive low-pass filters

NASA Astrophysics Data System (ADS)

Abhayaratne, Charith

2011-07-01

Wavelet transforms that have an adaptive low-pass filter are useful in applications that require the signal singularities, sharp transitions, and image edges to be left intact in the low-pass signal. In scalable image coding, the spatial resolution scalability is achieved by reconstructing the low-pass signal subband, which corresponds to the desired resolution level, and discarding other high-frequency wavelet subbands. In such applications, it is vital to have low-pass subbands that are not affected by smoothing artifacts associated with low-pass filtering. We present the mathematical framework for achieving 1-D wavelet transforms that have a spatially adaptive low-pass filter (SALP) using the prediction-first lifting scheme. The adaptivity decisions are computed using the wavelet coefficients, and no bookkeeping is required for the perfect reconstruction. Then, 2-D wavelet transforms that have a spatially adaptive low-pass filter are designed by extending the 1-D SALP framework. Because the 2-D polyphase decompositions are used in this case, the 2-D adaptivity decisions are made nonseparable as opposed to the separable 2-D realization using 1-D transforms. We present examples using the 2-D 5/3 wavelet transform and their lossless image coding and scalable decoding performances in terms of quality and resolution scalability. The proposed 2-D-SALP scheme results in better performance compared to the existing adaptive update lifting schemes.

Introducing a buddying scheme for first year pre-registration students.

PubMed

Campbell, Anne

Student buddying schemes have been found to be helpful for a variety of different university students. This article describes a scheme where first year pre-registration child nursing students are buddied with second-year students, which was first initiated in the academic year 2012/2013. The first year students were aware that peer support was available but contact was only maintained by a minority of students. At present it is uncertain what impact the scheme has had on attrition figures, particularly in the first year. Initial evaluation indicates that students found the scheme helpful and would like it to continue to be available to first-year students.

Supporting public involvement in research design and grant development: a case study of a public involvement award scheme managed by a National Institute for Health Research (NIHR) Research Design Service (RDS).

PubMed

Boote, Jonathan D; Twiddy, Maureen; Baird, Wendy; Birks, Yvonne; Clarke, Clare; Beever, Daniel

2015-10-01

It is good practice for the public to be involved in developing health research. Resources should be available for researchers to fund the involvement of the public in the development of their grants. To describe a funding award scheme to support public involvement in grant development, managed by an NIHR Research Design Service (RDS). Case examples of how the award contributed to successful grant applications and findings from a recent evaluation of the scheme are presented. A case study of resource provision to support public involvement activities in one region of England. University and NHS-based researchers, and members of the public. Between 2009 and 2012, the RDS approved 45 public involvement funding awards (totalling nearly £19,000). These awards contributed to 27 submitted applications at the time of writing, of which 11 were successful (totalling over £7.5 million). The evaluation revealed difficulties encountered by some researchers when involving the public in grant development, which led to suggestions about how the scheme could be improved. This award scheme represents an efficient method of providing researchers with resources to involve the public in grant development and would appear to represent good value for money. © 2013 John Wiley & Sons Ltd.

Gene-Based Multiclass Cancer Diagnosis with Class-Selective Rejections

PubMed Central

Jrad, Nisrine; Grall-Maës, Edith; Beauseroy, Pierre

2009-01-01

Supervised learning of microarray data is receiving much attention in recent years. Multiclass cancer diagnosis, based on selected gene profiles, are used as adjunct of clinical diagnosis. However, supervised diagnosis may hinder patient care, add expense or confound a result. To avoid this misleading, a multiclass cancer diagnosis with class-selective rejection is proposed. It rejects some patients from one, some, or all classes in order to ensure a higher reliability while reducing time and expense costs. Moreover, this classifier takes into account asymmetric penalties dependant on each class and on each wrong or partially correct decision. It is based on ν-1-SVM coupled with its regularization path and minimizes a general loss function defined in the class-selective rejection scheme. The state of art multiclass algorithms can be considered as a particular case of the proposed algorithm where the number of decisions is given by the classes and the loss function is defined by the Bayesian risk. Two experiments are carried out in the Bayesian and the class selective rejection frameworks. Five genes selected datasets are used to assess the performance of the proposed method. Results are discussed and accuracies are compared with those computed by the Naive Bayes, Nearest Neighbor, Linear Perceptron, Multilayer Perceptron, and Support Vector Machines classifiers. PMID:19584932

A General Water Resources Regulation Software System in China

NASA Astrophysics Data System (ADS)

LEI, X.

2017-12-01

To avoid iterative development of core modules in water resource normal regulation and emergency regulation and improve the capability of maintenance and optimization upgrading of regulation models and business logics, a general water resources regulation software framework was developed based on the collection and analysis of common demands for water resources regulation and emergency management. It can provide a customizable, secondary developed and extensible software framework for the three-level platform "MWR-Basin-Province". Meanwhile, this general software system can realize business collaboration and information sharing of water resources regulation schemes among the three-level platforms, so as to improve the decision-making ability of national water resources regulation. There are four main modules involved in the general software system: 1) A complete set of general water resources regulation modules allows secondary developer to custom-develop water resources regulation decision-making systems; 2) A complete set of model base and model computing software released in the form of Cloud services; 3) A complete set of tools to build the concept map and model system of basin water resources regulation, as well as a model management system to calibrate and configure model parameters; 4) A database which satisfies business functions and functional requirements of general water resources regulation software can finally provide technical support for building basin or regional water resources regulation models.

Combining Interactive Infrastructure Modeling and Evolutionary Algorithm Optimization for Sustainable Water Resources Design

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Zagona, E. A.

2013-12-01

Population growth and climate change, combined with difficulties in building new infrastructure, motivate portfolio-based solutions to ensuring sufficient water supply. Powerful simulation models with graphical user interfaces (GUI) are often used to evaluate infrastructure portfolios; these GUI based models require manual modification of the system parameters, such as reservoir operation rules, water transfer schemes, or system capacities. Multiobjective evolutionary algorithm (MOEA) based optimization can be employed to balance multiple objectives and automatically suggest designs for infrastructure systems, but MOEA based decision support typically uses a fixed problem formulation (i.e., a single set of objectives, decisions, and constraints). This presentation suggests a dynamic framework for linking GUI-based infrastructure models with MOEA search. The framework begins with an initial formulation which is solved using a MOEA. Then, stakeholders can interact with candidate solutions, viewing their properties in the GUI model. This is followed by changes in the formulation which represent users' evolving understanding of exigent system properties. Our case study is built using RiverWare, an object-oriented, data-centered model that facilitates the representation of a diverse array of water resources systems. Results suggest that assumptions within the initial MOEA search are violated after investigating tradeoffs and reveal how formulations should be modified to better capture stakeholders' preferences.

A Hybrid Interval-Robust Optimization Model for Water Quality Management.

PubMed

Xu, Jieyu; Li, Yongping; Huang, Guohe

2013-05-01

In water quality management problems, uncertainties may exist in many system components and pollution-related processes ( i.e. , random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval-robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements.

Comparison of Several Dissipation Algorithms for Central Difference Schemes

NASA Technical Reports Server (NTRS)

Swanson, R. C.; Radespiel, R.; Turkel, E.

1997-01-01

Several algorithms for introducing artificial dissipation into a central difference approximation to the Euler and Navier Stokes equations are considered. The focus of the paper is on the convective upwind and split pressure (CUSP) scheme, which is designed to support single interior point discrete shock waves. This scheme is analyzed and compared in detail with scalar and matrix dissipation (MATD) schemes. Resolution capability is determined by solving subsonic, transonic, and hypersonic flow problems. A finite-volume discretization and a multistage time-stepping scheme with multigrid are used to compute solutions to the flow equations. Numerical results are also compared with either theoretical solutions or experimental data. For transonic airfoil flows the best accuracy on coarse meshes for aerodynamic coefficients is obtained with a simple MATD scheme.

From guideline modeling to guideline execution: defining guideline-based decision-support services.

PubMed Central

Tu, S. W.; Musen, M. A.

2000-01-01

We describe our task-based approach to defining the guideline-based decision-support services that the EON system provides. We categorize uses of guidelines in patient-specific decision support into a set of generic tasks--making of decisions, specification of work to be performed, interpretation of data, setting of goals, and issuance of alert and reminders--that can be solved using various techniques. Our model includes constructs required for representing the knowledge used by these techniques. These constructs form a toolkit from which developers can select modeling solutions for guideline task. Based on the tasks and the guideline model, we define a guideline-execution architecture and a model of interactions between a decision-support server and clients that invoke services provided by the server. These services use generic interfaces derived from guideline tasks and their associated modeling constructs. We describe two implementations of these decision-support services and discuss how this work can be generalized. We argue that a well-defined specification of guideline-based decision-support services will facilitate sharing of tools that implement computable clinical guidelines. PMID:11080007

Tools to support GHG emissions reduction : a regional effort, part 1 - carbon footprint estimation and decision support.

DOT National Transportation Integrated Search

2010-09-01

Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...

Decision Support Framework (DSF) (Formerly Decision Support Platform)

EPA Science Inventory

The Science Advisory Board (SAB) provided several comments on the draft Ecosystem Services Research Program's (ESRP's) Multi-Year Plan (MYP). This presentation provides a response to comments related to the decision support framework (DSF) part of Long-Term Goal 1. The comments...

The Feasibility of a Decision Support System for the Determination of Source Selection Evaluation Criteria

DTIC Science & Technology

1984-09-01

is not only difficult and time consuming , but also crucial to the success of the project, the question is whether a decision support system designed...KtI I - uAujvhIMtf IENE In THE FEASIBILITY OF A DECISION SUPPORT SYSTEM FOR THE DETERMINATION OF SOURCE SELECTION EVALUATION ’CRITERIA THESIS .2...INSTITUTE OF TECHNOLOGY Wright-Patterson Air Force Base, Ohio DZM=0N STATEMENT A ,’r !’ILMILSHIM S /8 4 THE FEASIBILITY OF A DECISION SUPPORT SYSTEM FOR

Advanced life support systems in lunar and Martian environments utilizing a higher plant based engineering paradigm

NASA Technical Reports Server (NTRS)

Chamberland, Dennis

1992-01-01

The paper describes a higher-plant-based engineering paradigm for advanced life support in a Controlled Ecological Life Support System (CELSS) on the surface of the moon or Mars, called the CELSS Breadboard Project, designed at John F. Kennedy Space Center. Such a higher-plant-based system would use the plants for a direct food source, gas exchange, water reclamation, and plant residuals in a complex biological resource recovery scheme. The CELSS Breadboard Project utilizes a 'breadboard' approach of developing independent systems that are evaluated autonomously and are later interconnected. Such a scheme will enable evaluation of life support system methodologies tested for their efficiency in a life support system for habitats on the moon or Mars.

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

Numerical solution of the stochastic parabolic equation with the dependent operator coefficient

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

Ashyralyev, Allaberen; Department of Mathematics, ITTU, Ashgabat; Okur, Ulker

2015-09-18

In the present paper, a single step implicit difference scheme for the numerical solution of the stochastic parabolic equation with the dependent operator coefficient is presented. Theorem on convergence estimates for the solution of this difference scheme is established. In applications, this abstract result permits us to obtain the convergence estimates for the solution of difference schemes for the numerical solution of initial boundary value problems for parabolic equations. The theoretical statements for the solution of this difference scheme are supported by the results of numerical experiments.

Accountability in Education -- the Michigan Experience

ERIC Educational Resources Information Center

Murphy, Jerome T.; Cohen, David K.

1974-01-01

One view of accountability focuses on schemes that assume that if government can get more rational information and use it in more scientific ways, the schools' performance can be improved; the other assumes that the schools' problems are less scientific than political and that clients and constituents should influence educational decisions more…

Governance and Funding of Higher Education in Germany.

ERIC Educational Resources Information Center

Hufner, Klaus

2003-01-01

Describes the complex functioning of decision making in relation to legal, administrative, planning, and financial matters in Germany, examining the current increase of privatization of higher education and the ensuring legal and financial problem, and discussing the introduction of new funding schemes based on performance indicators which augur…

[Upon scientific accuracy scheme at clinical specialties].

PubMed

Ortega Calvo, M

2006-11-01

Will be medical specialties like sciences in the future? Yes, progressively they will. Accuracy in clinical specialties will be dissimilar in the future because formal-logic mathematics, quantum physics advances and relativity theory utilities. Evidence based medicine is now helping to clinical specialties on scientific accuracy by the way of decision theory.

Book Selection, Collection Development, and Bounded Rationality.

ERIC Educational Resources Information Center

Schwartz, Charles A.

1989-01-01

Reviews previously proposed schemes of classical rationality in book selection, describes new approaches to rational choice behavior, and presents a model of book selection based on bounded rationality in a garbage can decision process. The role of tacit knowledge and symbolic content in the selection process are also discussed. (102 references)…

Effectiveness Information and Institutional Change: An Exploratory Analysis.

ERIC Educational Resources Information Center

Ewell, Peter T.

Factors that affect the implementation of information-based improvements in college instruction and decision-making are considered, based on a conceptual scheme for comparing information-based change efforts. Based on a student outcomes project, eight brief case studies of public colleges illustrate different patterns leading to successful use of…

Surveillance system and method having an operating mode partitioned fault classification model

NASA Technical Reports Server (NTRS)

Bickford, Randall L. (Inventor)

2005-01-01

A system and method which partitions a parameter estimation model, a fault detection model, and a fault classification model for a process surveillance scheme into two or more coordinated submodels together providing improved diagnostic decision making for at least one determined operating mode of an asset.

Web-services-based spatial decision support system to facilitate nuclear waste siting

NASA Astrophysics Data System (ADS)

Huang, L. Xinglai; Sheng, Grant

2006-10-01

The availability of spatial web services enables data sharing among managers, decision and policy makers and other stakeholders in much simpler ways than before and subsequently has created completely new opportunities in the process of spatial decision making. Though generally designed for a certain problem domain, web-services-based spatial decision support systems (WSDSS) can provide a flexible problem-solving environment to explore the decision problem, understand and refine problem definition, and generate and evaluate multiple alternatives for decision. This paper presents a new framework for the development of a web-services-based spatial decision support system. The WSDSS is comprised of distributed web services that either have their own functions or provide different geospatial data and may reside in different computers and locations. WSDSS includes six key components, namely: database management system, catalog, analysis functions and models, GIS viewers and editors, report generators, and graphical user interfaces. In this study, the architecture of a web-services-based spatial decision support system to facilitate nuclear waste siting is described as an example. The theoretical, conceptual and methodological challenges and issues associated with developing web services-based spatial decision support system are described.

Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

PubMed

Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

2016-01-01

Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

Quantifying the morphodynamics of river restoration schemes using Unmanned Aerial Vehicles (UAVs)

NASA Astrophysics Data System (ADS)

Williams, Richard; Byrne, Patrick; Gilles, Eric; Hart, John; Hoey, Trevor; Maniatis, George; Moir, Hamish; Reid, Helen; Ves, Nikolas

2017-04-01

River restoration schemes are particularly sensitive to morphological adjustment during the first set of high-flow events that they are subjected to. Quantifying elevation change associated with morphological adjustment can contribute to improved adaptive decision making to ensure river restoration scheme objectives are achieved. To date the relatively high cost, technical demands and challenging logistics associated with acquiring repeat, high-resolution topographic surveys has resulted in a significant barrier to monitoring the three-dimensional morphodynamics of river restoration schemes. The availability of low-cost, consumer grade Unmanned Aerial Vehicles that are capable of acquiring imagery for processing using Structure-from-Motion Multi-View Stereo (SfM MVS) photogrammetry has the potential to transform the survey the morphodynamics of river restoration schemes. Application guidance does, however, need to be developed to fully exploit the advances of UAV technology and SfM MVS processing techniques. In particular, there is a need to quantify the effect of the number and spatial distribution of ground targets on vertical error. This is particularly significant because vertical errors propagate when mapping morphological change, and thus determine the evidence that is available for decision making. This presentation presents results from a study that investigated how the number and spatial distribution of targets influenced vertical error, and then used the findings to determine survey protocols for a monitoring campaign that has quantified morphological change across a number of restoration schemes. At the Swindale river restoration scheme, Cumbria, England, 31 targets were distributed across a 700 m long reach and the centre of each target was surveyed using RTK-GPS. Using the targets as General Control Points (GCPs) or checkpoints, they were divided into three different spatial patterns (centre, edge and random) and used for processing images acquired from a SenseFly Swinglet CAM UAV with a Canon IXUS 240 HS camera. Results indicate that if targets were distributed centrally then vertical distortions would be most notable in outer region of the processing domain; if an edge pattern was used then vertical errors were greatest in the central region of the processing domain; if targets were distributed randomly then errors were more evenly distributed. For this optimal random layout, vertical errors were lowest when 15 to 23 targets were used as GCPs. The best solution achieved planimetric (XY) errors of 0.006 m and vertical (Z) errors of 0.05 m. This result was used to determine target density and distribution for repeat surveys on two other restoration schemes, Whit Beck (Cumbria, England) and Allt Lorgy (Highlands, Scotland). These repeat surveys have been processed to produce DEMs of Difference (DoDs). The DoDs have been used to quantify the spatial distribution of erosion and deposition of these schemes due to high-flow events. Broader interpretation enables insight into patterns of morphological sensitivity that are related to scheme design.

Security enhanced anonymous multiserver authenticated key agreement scheme using smart cards and biometrics.

PubMed

Choi, Younsung; Nam, Junghyun; Lee, Donghoon; Kim, Jiye; Jung, Jaewook; Won, Dongho

2014-01-01

An anonymous user authentication scheme allows a user, who wants to access a remote application server, to achieve mutual authentication and session key establishment with the server in an anonymous manner. To enhance the security of such authentication schemes, recent researches combined user's biometrics with a password. However, these authentication schemes are designed for single server environment. So when a user wants to access different application servers, the user has to register many times. To solve this problem, Chuang and Chen proposed an anonymous multiserver authenticated key agreement scheme using smart cards together with passwords and biometrics. Chuang and Chen claimed that their scheme not only supports multiple servers but also achieves various security requirements. However, we show that this scheme is vulnerable to a masquerade attack, a smart card attack, a user impersonation attack, and a DoS attack and does not achieve perfect forward secrecy. We also propose a security enhanced anonymous multiserver authenticated key agreement scheme which addresses all the weaknesses identified in Chuang and Chen's scheme.

An Improvement of Robust Biometrics-Based Authentication and Key Agreement Scheme for Multi-Server Environments Using Smart Cards.

PubMed

Moon, Jongho; Choi, Younsung; Jung, Jaewook; Won, Dongho

2015-01-01

In multi-server environments, user authentication is a very important issue because it provides the authorization that enables users to access their data and services; furthermore, remote user authentication schemes for multi-server environments have solved the problem that has arisen from user's management of different identities and passwords. For this reason, numerous user authentication schemes that are designed for multi-server environments have been proposed over recent years. In 2015, Lu et al. improved upon Mishra et al.'s scheme, claiming that their remote user authentication scheme is more secure and practical; however, we found that Lu et al.'s scheme is still insecure and incorrect. In this paper, we demonstrate that Lu et al.'s scheme is vulnerable to outsider attack and user impersonation attack, and we propose a new biometrics-based scheme for authentication and key agreement that can be used in multi-server environments; then, we show that our proposed scheme is more secure and supports the required security properties.

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

ERIC Educational Resources Information Center

Klein, Joseph; Ronen, Herman

2003-01-01

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

Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

PubMed

Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

2018-07-01

We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

EPA Science Inventory

A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

Decision support systems in water and wastewater treatment process selection and design: a review.

PubMed

Hamouda, M A; Anderson, W B; Huck, P M

2009-01-01

The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

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

PubMed

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

2016-01-01

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

A decision-supported outpatient practice system.

PubMed Central

Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

1996-01-01

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

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

PubMed Central

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

2016-01-01

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

An energy-efficient and compact clustering scheme with temporary support nodes for cognitive radio sensor networks.

PubMed

Salim, Shelly; Moh, Sangman; Choi, Dongmin; Chung, Ilyong

2014-08-11

A cognitive radio sensor network (CRSN) is a wireless sensor network whose sensor nodes are equipped with cognitive radio capability. Clustering is one of the most challenging issues in CRSNs, as all sensor nodes, including the cluster head, have to use the same frequency band in order to form a cluster. However, due to the nature of heterogeneous channels in cognitive radio, it is difficult for sensor nodes to find a cluster head. This paper proposes a novel energy-efficient and compact clustering scheme named clustering with temporary support nodes (CENTRE). CENTRE efficiently achieves a compact cluster formation by adopting two-phase cluster formation with fixed duration. By introducing a novel concept of temporary support nodes to improve the cluster formation, the proposed scheme enables sensor nodes in a network to find a cluster head efficiently. The performance study shows that not only is the clustering process efficient and compact but it also results in remarkable energy savings that prolong the overall network lifetime. In addition, the proposed scheme decreases both the clustering overhead and the average distance between cluster heads and their members.

An Energy-Efficient and Compact Clustering Scheme with Temporary Support Nodes for Cognitive Radio Sensor Networks

PubMed Central

Salim, Shelly; Moh, Sangman; Choi, Dongmin; Chung, Ilyong

2014-01-01

A cognitive radio sensor network (CRSN) is a wireless sensor network whose sensor nodes are equipped with cognitive radio capability. Clustering is one of the most challenging issues in CRSNs, as all sensor nodes, including the cluster head, have to use the same frequency band in order to form a cluster. However, due to the nature of heterogeneous channels in cognitive radio, it is difficult for sensor nodes to find a cluster head. This paper proposes a novel energy-efficient and compact clustering scheme named clustering with temporary support nodes (CENTRE). CENTRE efficiently achieves a compact cluster formation by adopting two-phase cluster formation with fixed duration. By introducing a novel concept of temporary support nodes to improve the cluster formation, the proposed scheme enables sensor nodes in a network to find a cluster head efficiently. The performance study shows that not only is the clustering process efficient and compact but it also results in remarkable energy savings that prolong the overall network lifetime. In addition, the proposed scheme decreases both the clustering overhead and the average distance between cluster heads and their members. PMID:25116905

What are the emerging features of community health insurance schemes in East Africa?

PubMed Central

Basaza, Robert; Pariyo, George; Criel, Bart

2009-01-01

Background The three East African countries of Uganda, Tanzania, and Kenya are characterized by high poverty levels, population growth rates, prevalence of HIV/AIDS, under-funding of the health sector, poor access to quality health care, and small health insurance coverage. Tanzania and Kenya have user-fees whereas Uganda abolished user-fees in public-owned health units. Objective To provide comparative description of community health insurance (CHI) schemes in three East African countries of Uganda, Tanzania, and Kenya and thereafter provide a basis for future policy research for development of CHI schemes. Methods An analytical grid of 10 distinctive items pertaining to the nature of CHI schemes was developed so as to have a uniform lens of comparing country situations of CHI. Results and conclusions The majority of the schemes have been in existence for a relatively short time of less than 10 years and their number remains small. There is need for further research to identify what is the mix and weight of factors that cause people to refrain from joining schemes. Specific issues that could also be addressed in subsequent studies are whether the current schemes provide financial protection, increase access to quality of care and impact on the equity of health services financing and delivery. On the basis of this knowledge, rational policy decisions can be taken. The governments thereafter could consider an option of playing more roles in advocacy, paying for the poorest, and developing an enabling policy and legal framework. PMID:22312207

The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

PubMed Central

Miller, Randolph A.; Waitman, Lemuel R.; Chen, Sutin; Rosenbloom, S. Trent

2006-01-01

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt’s inpatient “WizOrder” care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model’s utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user’s workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users’ workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise. PMID:16290243

Home care decision support using an Arden engine--merging smart home and vital signs data.

PubMed

Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold

2009-01-01

The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.