Sample records for decisions and orders

  1. 49 CFR 821.43 - Effect of law judge's initial decision or appealable order and appeal therefrom.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Initial Decision § 821.43 Effect of law judge's initial decision or appealable order and appeal therefrom. If no appeal from the law judge's initial decision or appealable order is timely filed, the initial... law judge's initial decision or order, unless the basis for the decision or order is that the Board...

  2. 49 CFR 821.43 - Effect of law judge's initial decision or appealable order and appeal therefrom.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Initial Decision § 821.43 Effect of law judge's initial decision or appealable order and appeal therefrom. If no appeal from the law judge's initial decision or appealable order is timely filed, the initial... law judge's initial decision or order, unless the basis for the decision or order is that the Board...

  3. 49 CFR 821.43 - Effect of law judge's initial decision or appealable order and appeal therefrom.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Initial Decision § 821.43 Effect of law judge's initial decision or appealable order and appeal therefrom. If no appeal from the law judge's initial decision or appealable order is timely filed, the initial... law judge's initial decision or order, unless the basis for the decision or order is that the Board...

  4. 49 CFR 821.43 - Effect of law judge's initial decision or appealable order and appeal therefrom.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Initial Decision § 821.43 Effect of law judge's initial decision or appealable order and appeal therefrom. If no appeal from the law judge's initial decision or appealable order is timely filed, the initial... law judge's initial decision or order, unless the basis for the decision or order is that the Board...

  5. 49 CFR 821.43 - Effect of law judge's initial decision or appealable order and appeal therefrom.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Initial Decision § 821.43 Effect of law judge's initial decision or appealable order and appeal therefrom. If no appeal from the law judge's initial decision or appealable order is timely filed, the initial... law judge's initial decision or order, unless the basis for the decision or order is that the Board...

  6. 49 CFR 821.56 - Hearing and initial decision or appealable order of law judge.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... initial decision or appealable order of law judge. (a) Notice of hearing. Within 3 days after the date on... and effect of initial decision or appealable order. The law judge's initial decision shall be made... 49 Transportation 7 2012-10-01 2012-10-01 false Hearing and initial decision or appealable order...

  7. 49 CFR 821.56 - Hearing and initial decision or appealable order of law judge.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... initial decision or appealable order of law judge. (a) Notice of hearing. Within 3 days after the date on... and effect of initial decision or appealable order. The law judge's initial decision shall be made... 49 Transportation 7 2011-10-01 2011-10-01 false Hearing and initial decision or appealable order...

  8. 49 CFR 821.56 - Hearing and initial decision or appealable order of law judge.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... initial decision or appealable order of law judge. (a) Notice of hearing. Within 3 days after the date on... and effect of initial decision or appealable order. The law judge's initial decision shall be made... 49 Transportation 7 2010-10-01 2010-10-01 false Hearing and initial decision or appealable order...

  9. 49 CFR 821.56 - Hearing and initial decision or appealable order of law judge.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... initial decision or appealable order of law judge. (a) Notice of hearing. Within 3 days after the date on... and effect of initial decision or appealable order. The law judge's initial decision shall be made... 49 Transportation 7 2014-10-01 2014-10-01 false Hearing and initial decision or appealable order...

  10. 49 CFR 821.56 - Hearing and initial decision or appealable order of law judge.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... initial decision or appealable order of law judge. (a) Notice of hearing. Within 3 days after the date on... and effect of initial decision or appealable order. The law judge's initial decision shall be made... 49 Transportation 7 2013-10-01 2013-10-01 false Hearing and initial decision or appealable order...

  11. 29 CFR 1978.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Decision and orders of the administrative law judge. 1978... Decision and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... ALJ concludes that the respondent has violated the law, the order must order the respondent to take...

  12. 10 CFR 1003.56 - Decision and Order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... relevant information received or obtained during the proceeding, the OHA shall issue a Decision and Order... forth the relevant facts and the legal basis of the Decision and Order. When appropriate, the Decision...

  13. 20 CFR 501.6 - Decisions and orders.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decisions and orders. 501.6 Section 501.6 Employees' Benefits EMPLOYEES' COMPENSATION APPEALS BOARD, DEPARTMENT OF LABOR RULES OF PROCEDURE § 501.6 Decisions and orders. (a) Decisions. A decision of the Board will contain a written opinion setting forth...

  14. 10 CFR 1003.26 - Decision and Order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... § 1003.26 Decision and Order. (a) Upon consideration of the application and other relevant information... the relevant facts and the legal basis of the order. The Decision and Order shall provide that any...

  15. 28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  16. 28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  17. 28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  18. 28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  19. 29 CFR 1979.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Decision and orders of the administrative law judge. 1979... § 1979.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order pertaining to the remedies...

  20. 29 CFR 500.262 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

  1. 29 CFR 1980.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Decision and orders of the administrative law judge. 1980...-OXLEY ACT OF 2002 Litigation § 1980.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order...

  2. 29 CFR 500.262 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

  3. 29 CFR 1979.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1979... § 1979.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order pertaining to the remedies...

  4. 29 CFR 1979.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Decision and orders of the administrative law judge. 1979... § 1979.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order pertaining to the remedies...

  5. 29 CFR 500.262 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

  6. 29 CFR 500.262 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

  7. 29 CFR 1979.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Decision and orders of the administrative law judge. 1979... § 1979.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order pertaining to the remedies...

  8. 20 CFR 655.75 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Decision and order of administrative law... administrative law judge shall be inoperative unless and until the Board issues an order affirming the decision... Nursing in the United States (H-2B Workers) Integrity Measures § 655.75 Decision and order of...

  9. 29 CFR 500.262 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 500.262...-Hearing Procedures § 500.262 Decision and order of Administrative Law Judge. (a) The Administrative Law... Act, modifies or vacates the decision and order of the Administrative Law Judge. (h) Except as...

  10. 29 CFR 1979.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decision and orders of the administrative law judge. 1979... § 1979.109 Decision and orders of the administrative law judge. (a) The decision of the administrative law judge will contain appropriate findings, conclusions, and an order pertaining to the remedies...

  11. 49 CFR 511.25 - Summary decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Summary decision and order. 511.25 Section 511.25...; Interlocutory Appeals; Summary Judgment; Settlement § 511.25 Summary decision and order. (a) Motion. Any party may move, with a supporting memorandum, for a Summary Decision and Order in its favor upon all or any...

  12. 29 CFR 580.12 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Decision and Order of Administrative Law Judge. 580.12....12 Decision and Order of Administrative Law Judge. (a) The Administrative Law Judge shall render a... of the parties. (e) The decision of the Administrative Law Judge shall constitute the final order of...

  13. 29 CFR 801.67 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and Order of Administrative Law Judge. 801.67... Procedures Before Administrative Law Judge § 801.67 Decision and Order of Administrative Law Judge. (a) The...) The decision of the Administrative Law Judge shall constitute the final order of the Secretary unless...

  14. 29 CFR 580.12 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Decision and Order of Administrative Law Judge. 580.12....12 Decision and Order of Administrative Law Judge. (a) The Administrative Law Judge shall render a... of the parties. (e) The decision of the Administrative Law Judge shall constitute the final order of...

  15. 29 CFR 801.67 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and Order of Administrative Law Judge. 801.67... Procedures Before Administrative Law Judge § 801.67 Decision and Order of Administrative Law Judge. (a) The...) The decision of the Administrative Law Judge shall constitute the final order of the Secretary unless...

  16. 20 CFR 655.440 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decision and order of administrative law... § 655.440 Decision and order of administrative law judge. (a) Within 90 days after receipt of the...; the reason or reasons for such order shall be stated in the decision. The administrative law judge...

  17. 29 CFR 580.12 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and Order of Administrative Law Judge. 580.12....12 Decision and Order of Administrative Law Judge. (a) The Administrative Law Judge shall render a... of the parties. (e) The decision of the Administrative Law Judge shall constitute the final order of...

  18. 20 CFR 655.440 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false Decision and order of administrative law... § 655.440 Decision and order of administrative law judge. (a) Within 90 days after receipt of the...; the reason or reasons for such order shall be stated in the decision. The administrative law judge...

  19. 29 CFR 580.12 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and Order of Administrative Law Judge. 580.12....12 Decision and Order of Administrative Law Judge. (a) The Administrative Law Judge shall render a... of the parties. (e) The decision of the Administrative Law Judge shall constitute the final order of...

  20. 20 CFR 655.440 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Decision and order of administrative law... § 655.440 Decision and order of administrative law judge. (a) Within 90 days after receipt of the...; the reason or reasons for such order shall be stated in the decision. The administrative law judge...

  1. 29 CFR 801.67 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and Order of Administrative Law Judge. 801.67... Procedures Before Administrative Law Judge § 801.67 Decision and Order of Administrative Law Judge. (a) The...) The decision of the Administrative Law Judge shall constitute the final order of the Secretary unless...

  2. 20 CFR 655.440 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision and order of administrative law... § 655.440 Decision and order of administrative law judge. (a) Within 90 days after receipt of the...; the reason or reasons for such order shall be stated in the decision. The administrative law judge...

  3. 29 CFR 580.12 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and Order of Administrative Law Judge. 580.12....12 Decision and Order of Administrative Law Judge. (a) The Administrative Law Judge shall render a... of the parties. (e) The decision of the Administrative Law Judge shall constitute the final order of...

  4. 43 CFR 4.1128 - Effect of initial order or decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Effect of initial order or decision. 4... AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals Evidentiary Hearings § 4.1128 Effect of initial order or decision. An initial order or decision shall become...

  5. 49 CFR 1503.659 - Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  6. 29 CFR 1986.109 - Decisions and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decisions and orders of the administrative law judge. 1986... Decisions and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... ALJ concludes that the respondent has violated the law, the ALJ will issue an order that will require...

  7. 29 CFR 1986.109 - Decisions and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decisions and orders of the administrative law judge. 1986... Decisions and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... ALJ concludes that the respondent has violated the law, the ALJ will issue an order that will require...

  8. 20 CFR 655.75 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision and order of administrative law... Nursing in the United States (H-2B Workers) § 655.75 Decision and order of administrative law judge. (a) The administrative law judge shall issue a decision. If any party desires review of the decision...

  9. 29 CFR 1978.109 - Decisions and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decisions and orders of the administrative law judge. 1978... Litigation § 1978.109 Decisions and orders of the administrative law judge. (a) The decision of the ALJ will... the ALJ determines that the respondent has not violated the law, an order will be issued denying the...

  10. 29 CFR 1978.109 - Decisions and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decisions and orders of the administrative law judge. 1978... Litigation § 1978.109 Decisions and orders of the administrative law judge. (a) The decision of the ALJ will... the ALJ determines that the respondent has not violated the law, an order will be issued denying the...

  11. 17 CFR 201.140 - Commission orders and decisions: Signature and availability.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Commission orders and decisions: Signature and availability. 201.140 Section 201.140 Commodity and Securities Exchanges SECURITIES... and decisions: Signature and availability. (a) Signature required. All orders and decisions of the...

  12. 76 FR 21406 - Michael J. Aruta, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-40] Michael J. Aruta, M.D.; Decision and Order ACTION: Correction. On Thursday, April 7, 2011, the Drug Enforcement Administration published the above-titled Decision and Order, as well as the Decision of the Administrative Law Judge (76...

  13. 76 FR 21406 - Roni Dreszer, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-37] Roni Dreszer, M.D.; Decision and Order ACTION: Correction. On Thursday, April 7, 2011, the Drug Enforcement Administration published the above-titled Decision and Order, as well as the Decision of the Administrative Law Judge (76...

  14. 76 FR 21406 - Beau Boshers, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-35] Beau Boshers, M.D.; Decision and Order ACTION: Correction. On Thursday, April 7, 2011, the Drug Enforcement Administration published the above-titled Decision and Order, as well as the Decision of the Administrative Law Judge (76...

  15. 76 FR 21406 - Jacobo Dreszer, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-36] Jacobo Dreszer, M.D.; Decision and Order ACTION: Correction. On Thursday, April 7, 2011, the Drug Enforcement Administration published the above-titled Decision and Order, as well as the Decision of the Administrative Law Judge (76...

  16. 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

  17. 10 CFR 1003.77 - Decision and Order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... relevant information received or obtained during the proceeding, the OHA will issue a Decision and Order... a written statement setting forth the relevant facts and legal basis for the Decision and Order...

  18. 31 CFR 501.745 - Orders and decisions: signature, date and public availability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Orders and decisions: signature, date and public availability. 501.745 Section 501.745 Money and Finance: Treasury Regulations Relating to... decisions: signature, date and public availability. (a) Signature required. All orders and decisions of the...

  19. EPA Administrative Law Judge Legal Documents

    EPA Pesticide Factsheets

    This dataset contains Decisions and Orders originating from EPAs Office of Administrative Law Judges (OALJ), which is an independent office in the Office of the Administrator of the EPA. The Administrative Law Judges conduct hearings and render decisions in proceedings between the EPA and persons, businesses, government entities, and other organizations which are or are alleged to be regulated under environmental laws. Administrative Law Judges preside in enforcement and permit proceedings in accordance with the Administrative Procedure Act. Most enforcement actions initiated by the EPA are for the assessment of civil penalties. The Decisions and Orders are organized into three categories: (1) alphabetical listing by the respondent involved, (2) reverse chronological listing by date, and (3) Decisions and Orders under FIFRA Section 6. This dataset includes Decisions and Orders dating back to 1989 in the Reverse Chronological list, Decisions and Orders dating back to 1997 in the Alphabetical list, and a few Decisions and Orders dating back to 1974 under FIFRA Section 6.

  20. 76 FR 11440 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Electrolux From the... described in this notice. Today's decision prohibits Electrolux from making representations concerning the... Renewable Energy, Department of Energy. ACTION: Decision and Order. SUMMARY: The U.S. Department of Energy...

  1. 20 CFR 655.650 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Decision and order of administrative law... order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of the hearing, the administrative law judge shall issue a decision. If any party desires review of the decision...

  2. 20 CFR 655.650 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false Decision and order of administrative law... order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of the hearing, the administrative law judge shall issue a decision. If any party desires review of the decision...

  3. 20 CFR 655.650 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision and order of administrative law... order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of the hearing, the administrative law judge shall issue a decision. If any party desires review of the decision...

  4. 20 CFR 655.650 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 3 2014-04-01 2014-04-01 false Decision and order of administrative law... order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of the hearing, the administrative law judge shall issue a decision. If any party desires review of the decision...

  5. 20 CFR 655.650 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decision and order of administrative law... order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of the hearing, the administrative law judge shall issue a decision. If any party desires review of the decision...

  6. 20 CFR 726.313 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Decision and order of Administrative Law... and order, the Chief Administrative Law Judge shall promptly forward the complete hearing record to...; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Civil Money Penalties § 726.313 Decision and order of...

  7. 20 CFR 726.313 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Decision and order of Administrative Law... and order, the Chief Administrative Law Judge shall promptly forward the complete hearing record to...; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Civil Money Penalties § 726.313 Decision and order of...

  8. 20 CFR 726.313 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Decision and order of Administrative Law... and order, the Chief Administrative Law Judge shall promptly forward the complete hearing record to...; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Civil Money Penalties § 726.313 Decision and order of...

  9. 20 CFR 726.313 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision and order of Administrative Law... and order, the Chief Administrative Law Judge shall promptly forward the complete hearing record to...; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Civil Money Penalties § 726.313 Decision and order of...

  10. 10 CFR 501.124 - Decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Decision and order. 501.124 Section 501.124 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Requests for Stay § 501.124 Decision and order. (a) OFE will issue an order granting or denying the petition for a stay...

  11. 17 CFR 201.540 - Appeal and Commission review of initial decision making a temporary order permanent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of initial decision making a temporary order permanent. 201.540 Section 201.540 Commodity and... Temporary Orders and Suspensions § 201.540 Appeal and Commission review of initial decision making a... decision as to whether a temporary sanction shall be made permanent shall file a petition for review...

  12. 76 FR 21879 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to LG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-19

    ... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to LG From the Department of...: This Decision and Order is effective April 19, 2011. FOR FURTHER INFORMATION CONTACT: Dr. Michael G... described in this notice. Today's decision prohibits LG from making representations concerning the energy...

  13. Effect of clinical decision rules, patient cost and malpractice information on clinician brain CT image ordering: a randomized controlled trial.

    PubMed

    Gimbel, Ronald W; Pirrallo, Ronald G; Lowe, Steven C; Wright, David W; Zhang, Lu; Woo, Min-Jae; Fontelo, Paul; Liu, Fang; Connor, Zachary

    2018-03-12

    The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering. Understanding what type and how information may influence clinical decision making in the ordering advanced medical imaging is important in shaping the optimal design and implementation of related clinical decision support systems. Multi-center, double-blinded simulation-based randomized controlled trial. Following standardized clinical vignette presentation, clinicians made an initial imaging decision for the patient. This was followed by additional information on decision support rules, malpractice outcome review, and patient cost; each with opportunity to modify their initial order. The malpractice and cost information differed by assigned group to test the any temporal relationship. The simulation closed with a second vignette and an imaging decision. One hundred sixteen of the 167 participants (66.9%) initially ordered a brain CT scan. After CCHR presentation, the number of clinicians ordering a CT dropped to 76 (45.8%), representing a 21.1% reduction in CT ordering (P = 0.002). This reduction in CT ordering was maintained, in comparison to initial imaging orders, when presented with malpractice review information (p = 0.002) and patient cost information (p = 0.002). About 57% of clinicians changed their order during study, while 43% never modified their imaging order. This study suggests that ED clinician brain CT imaging decisions may be influenced by clinical decision support rules, patient out-of-pocket cost information and findings from malpractice case review. NCT03449862 , February 27, 2018, Retrospectively registered.

  14. 43 CFR 4.320 - Who may appeal a judge's decision or order?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Who may appeal a judge's decision or order... Board of Indian Appeals in Probate Matters § 4.320 Who may appeal a judge's decision or order? Any interested party has a right to appeal to the Board if he or she is adversely affected by a decision or order...

  15. 29 CFR 1982.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decision and orders of the administrative law judge. 1982... and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... has violated the law, the order will direct the respondent to take appropriate affirmative action to...

  16. 20 CFR 655.1040 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Decision and order of administrative law... and order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of...; the reason or reasons for such order shall be stated in the decision. (c) The administrative law judge...

  17. 29 CFR 530.406 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 530.406... Decision and order of Administrative Law Judge. (a) The Administrative Law Judge shall prepare, after... Law Judge shall constitute the final order of the Department of Labor unless the Secretary, as...

  18. 29 CFR 530.406 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Decision and order of Administrative Law Judge. 530.406... Decision and order of Administrative Law Judge. (a) The Administrative Law Judge shall prepare, after... Law Judge shall constitute the final order of the Department of Labor unless the Secretary, as...

  19. 29 CFR 1982.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Decision and orders of the administrative law judge. 1982... and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... has violated the law, the order will direct the respondent to take appropriate affirmative action to...

  20. 20 CFR 655.1040 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false Decision and order of administrative law... and order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of...; the reason or reasons for such order shall be stated in the decision. (c) The administrative law judge...

  1. 29 CFR 530.406 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 530.406... Decision and order of Administrative Law Judge. (a) The Administrative Law Judge shall prepare, after... Law Judge shall constitute the final order of the Department of Labor unless the Secretary, as...

  2. 29 CFR 530.406 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 530.406... Decision and order of Administrative Law Judge. (a) The Administrative Law Judge shall prepare, after... Law Judge shall constitute the final order of the Department of Labor unless the Secretary, as...

  3. 29 CFR 1982.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Decision and orders of the administrative law judge. 1982... and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... has violated the law, the order will direct the respondent to take appropriate affirmative action to...

  4. 29 CFR 530.406 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 530.406... Decision and order of Administrative Law Judge. (a) The Administrative Law Judge shall prepare, after... Law Judge shall constitute the final order of the Department of Labor unless the Secretary, as...

  5. 20 CFR 655.1040 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision and order of administrative law... and order of administrative law judge. (a) Within 90 calendar days after receipt of the transcript of...; the reason or reasons for such order shall be stated in the decision. (c) The administrative law judge...

  6. 29 CFR 1982.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1982... and orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate... has violated the law, the order will direct the respondent to take appropriate affirmative action to...

  7. 42 CFR 405.990 - Expedited access to judicial review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... considers material and that are not disputed; and (2) Assert that the only factor precluding a decision... accordance with § 405.1002 and a decision, dismissal order, or remand order of the ALJ has not been issued; (B) MAC review in accordance with § 405.1102 and a final decision, dismissal order, or remand order...

  8. Order of Verdict Consideration and Decision Rule Effects on Mock Jury Decision Making.

    ERIC Educational Resources Information Center

    Olaye, Imafidon M.

    A study investigated the effects of order verdict consideration and decision rule on jury verdicts. After reading the summary of an actual trial, 240 mock jurors drawn from undergraduate communications classes were randomly assigned to six-member juries. Jury assignments were made under two verdict orders (ascending and descending order of…

  9. 29 CFR 502.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

  10. 29 CFR 1980.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Decision and orders of the administrative law judge. 1980... violated the law, the order will provide all relief necessary to make the employee whole, including... SECTION 806 OF THE SARBANES-OXLEY ACT OF 2002, AS AMENDED Litigation § 1980.109 Decision and orders of the...

  11. 29 CFR 1981.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Decision and orders of the administrative law judge. 1981... charged has violated the law, the order shall direct the party charged to take appropriate affirmative... SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Litigation § 1981.109 Decision and orders of the...

  12. 29 CFR 501.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  13. 29 CFR 501.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  14. 29 CFR 1980.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decision and orders of the administrative law judge. 1980... violated the law, the order will provide all relief necessary to make the employee whole, including... SECTION 806 OF THE SARBANES-OXLEY ACT OF 2002, AS AMENDED Litigation § 1980.109 Decision and orders of the...

  15. 29 CFR 1981.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decision and orders of the administrative law judge. 1981... charged has violated the law, the order shall direct the party charged to take appropriate affirmative... SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Litigation § 1981.109 Decision and orders of the...

  16. 29 CFR 1981.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Decision and orders of the administrative law judge. 1981... charged has violated the law, the order shall direct the party charged to take appropriate affirmative... SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Litigation § 1981.109 Decision and orders of the...

  17. 29 CFR 1981.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Decision and orders of the administrative law judge. 1981... charged has violated the law, the order shall direct the party charged to take appropriate affirmative... SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Litigation § 1981.109 Decision and orders of the...

  18. 29 CFR 1981.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1981... charged has violated the law, the order shall direct the party charged to take appropriate affirmative... SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Litigation § 1981.109 Decision and orders of the...

  19. 29 CFR 503.50 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  20. 29 CFR 501.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  1. 29 CFR 1984.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1984... law judge. (a) The decision of the ALJ will contain appropriate findings, conclusions, and an order... compounded daily. (2) If the ALJ determines that the respondent has not violated the law, an order will be...

  2. 29 CFR 501.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 501.41... § 501.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare, within 60 days after... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  3. 29 CFR 503.50 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  4. 29 CFR 502.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

  5. 29 CFR 1980.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1980... violated the law, the order will provide all relief necessary to make the employee whole, including... SECTION 806 OF THE SARBANES-OXLEY ACT OF 2002, AS AMENDED Litigation § 1980.109 Decision and orders of the...

  6. 29 CFR 1984.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Decision and orders of the administrative law judge. 1984... law judge. (a) The decision of the ALJ will contain appropriate findings, conclusions, and an order... compounded daily. (2) If the ALJ determines that the respondent has not violated the law, an order will be...

  7. 29 CFR 502.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

  8. 29 CFR 502.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Decision and order of Administrative Law Judge. 502.41...-Hearing Procedures § 502.41 Decision and order of Administrative Law Judge. (a) The ALJ shall prepare... shall also include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part...

  9. 29 CFR 503.50 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Decision and order of Administrative Law Judge. 503.50... Procedures § 503.50 Decision and order of Administrative Law Judge. (a) The ALJ will prepare, within 60 days... include an appropriate order which may affirm, deny, reverse, or modify, in whole or in part, the...

  10. 46 CFR 502.227 - Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... have all the powers which it would have in making the initial decision. Whenever the Commission shall... 46 Shipping 9 2010-10-01 2010-10-01 false Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto; review of decisions or orders of dismissal by Commission; and judicial...

  11. 29 CFR 1985.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1985... orders of the administrative law judge. (a) The decision of the ALJ will contain appropriate findings.... (d)(1) If the ALJ concludes that the respondent has violated the law, the ALJ will issue an order...

  12. 16 CFR 1025.25 - Summary decisions and orders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Summary decisions and orders. 1025.25... ADJUDICATIVE PROCEEDINGS Prehearing Procedures, Motions, Interlocutory Appeals, Summary Judgments, Settlements § 1025.25 Summary decisions and orders. (a) Motion. Any party may file a motion, with a supporting...

  13. 46 CFR 502.227 - Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... administrative law judge; replies thereto; review of decisions or orders of dismissal by Commission; and judicial... Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto; review of... order of dismissal by an administrative law judge shall only be considered final for purposes of...

  14. 46 CFR 502.227 - Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... administrative law judge; replies thereto; review of decisions or orders of dismissal by Commission; and judicial... Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto; review of... order of dismissal by an administrative law judge shall only be considered final for purposes of...

  15. 46 CFR 502.227 - Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... administrative law judge; replies thereto; review of decisions or orders of dismissal by Commission; and judicial... Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto; review of... order of dismissal by an administrative law judge shall only be considered final for purposes of...

  16. 46 CFR 502.227 - Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... administrative law judge; replies thereto; review of decisions or orders of dismissal by Commission; and judicial... Exceptions to decisions or orders of dismissal of administrative law judge; replies thereto; review of... order of dismissal by an administrative law judge shall only be considered final for purposes of...

  17. 78 FR 18327 - Decision and Order Granting a Waiver to LG Electronics, Inc. From the Department of Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... and Order Granting a Waiver to LG Electronics, Inc. From the Department of Energy Residential... of the decision and order (Case No. RF-024) that grants to LG Electronics, Inc. (LG) a waiver from... and Renewable Energy. Decision and Order In the Matter of: LG Electronics, Inc. (Case No. RF-024) I...

  18. 46 CFR 201.3 - Authentication of rules, orders, determinations and decisions of the Administration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Authentication of rules, orders, determinations and decisions of the Administration. 201.3 Section 201.3 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF....3 Authentication of rules, orders, determinations and decisions of the Administration. All rules...

  19. 20 CFR 725.476 - Issuance of decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Issuance of decision and order. 725.476 Section 725.476 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL... shall issue a decision and order with respect to the claim making an award to the claimant, rejecting...

  20. 20 CFR 702.348 - Formal hearings; preparation of final decision and order; content.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Formal hearings; preparation of final decision and order; content. 702.348 Section 702.348 Employees' Benefits EMPLOYMENT STANDARDS... final decision and order; content. Within 20 days after the official termination of the hearing as...

  1. 43 CFR 4.201 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  2. Why, When, and How to Take into Account the Uncertainty Involved in Career Decisions.

    ERIC Educational Resources Information Center

    Gati, Itamar

    1990-01-01

    Theoretically analyzes career decisions under uncertainty, when career decision maker ranks options rather than choosing best one. Found that how decisions were framed affected ranking of options and quality of decisions. Analysis showed that the rank order of options in optimal ranking always coincided with the rank order of the options by their…

  3. 76 FR 65710 - Decision and Order Amending Waivers Granted to Mitsubishi Electric & Electronics USA, Inc. From...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CAC-037] Decision and Order Amending Waivers Granted to Mitsubishi Electric & Electronics USA, Inc. From the Department... Efficiency and Renewable Energy. Decision and Order In the Matter of: Mitsubishi Electric & Electronics USA...

  4. 10 CFR 501.66 - OFE evaluation of the record, decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false OFE evaluation of the record, decision and order. 501.66 Section 501.66 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and Certifications § 501.66 OFE evaluation of the record, decision and order. (a) The...

  5. 75 FR 45623 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Samsung Electronics America...-014) that grants to Samsung Electronics America, Inc. (Samsung) a waiver from the DOE electric... Energy. Decision and Order In the Matter of: Samsung Electronics America, Inc. (Case No. RF- 014...

  6. 29 CFR 458.89 - Contents of exceptions to Administrative Law Judge's recommended decision and order.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Matters § 458.89 Contents of exceptions to Administrative Law Judge's recommended decision and order. (a) Exceptions to an Administrative Law Judge's recommended decision and order shall: (1) Set forth specifically... 29 Labor 2 2013-07-01 2013-07-01 false Contents of exceptions to Administrative Law Judge's...

  7. 29 CFR 458.89 - Contents of exceptions to Administrative Law Judge's recommended decision and order.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Matters § 458.89 Contents of exceptions to Administrative Law Judge's recommended decision and order. (a) Exceptions to an Administrative Law Judge's recommended decision and order shall: (1) Set forth specifically... 29 Labor 2 2014-07-01 2014-07-01 false Contents of exceptions to Administrative Law Judge's...

  8. 29 CFR 458.89 - Contents of exceptions to Administrative Law Judge's recommended decision and order.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Matters § 458.89 Contents of exceptions to Administrative Law Judge's recommended decision and order. (a) Exceptions to an Administrative Law Judge's recommended decision and order shall: (1) Set forth specifically... 29 Labor 2 2012-07-01 2012-07-01 false Contents of exceptions to Administrative Law Judge's...

  9. 76 FR 78910 - Decision and Order Granting a Waiver to LG Electronics U.S.A., Inc. From the Department of Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... and Order Granting a Waiver to LG Electronics U.S.A., Inc. From the Department of Energy Commercial.... Department of Energy's (DOE) Decision and Order in Case No. CAC-036, which grants LG Electronics U.S.A., Inc.... Decision and Order In the Matter of: LG Electronics U.S.A., Inc. (LG) (Case No. CAC- 036). Background Title...

  10. 76 FR 17637 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Miele...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CD-005] Energy... Efficiency and Renewable Energy, Department of Energy. ACTION: Decision and order. SUMMARY: The U.S... Efficiency and Renewable Energy. Decision and Order In the Matter of: Miele, Inc. (Case No. CD-005...

  11. 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.

  12. 76 FR 13169 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Samsung Electronics America... Electronics America, Inc. (Samsung) a waiver from the DOE clothes washer test procedure for determining the.... Decision and Order In the Matter of: Samsung Electronics America, Inc. (Case No. CW- 014) I. Background and...

  13. 29 CFR 1980.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Decision and orders of the administrative law judge. 1980... SECTION 806 OF THE CORPORATE AND CRIMINAL FRAUD ACCOUNTABILITY ACT OF 2002, TITLE VIII OF THE SARBANES-OXLEY ACT OF 2002 Litigation § 1980.109 Decision and orders of the administrative law judge. (a) The...

  14. 29 CFR 458.88 - Submission of the Administrative Law Judge's recommended decision and order to the Administrative...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (b) The Administrative Law Judge shall cause his recommended decision and order to be served promptly... 29 Labor 2 2014-07-01 2014-07-01 false Submission of the Administrative Law Judge's recommended decision and order to the Administrative Review Board; exceptions. 458.88 Section 458.88 Labor Regulations...

  15. 29 CFR 458.88 - Submission of the Administrative Law Judge's recommended decision and order to the Administrative...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (b) The Administrative Law Judge shall cause his recommended decision and order to be served promptly... 29 Labor 2 2013-07-01 2013-07-01 false Submission of the Administrative Law Judge's recommended decision and order to the Administrative Review Board; exceptions. 458.88 Section 458.88 Labor Regulations...

  16. 76 FR 50207 - Decision and Order Granting a Waiver to Samsung From the Department of Energy Residential Clothes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-12

    ... Decision and Order is effective August 12, 2011. FOR FURTHER INFORMATION CONTACT: Dr. Michael G. Raymond, U... notice. Today's decision prohibits Samsung from making representations concerning the energy efficiency... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CW-019] Decision...

  17. 37 CFR 41.125 - Decision on motions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Decision on motions. (a) Order of consideration. The Board may take up motions for decisions in any order, may grant, deny, or dismiss any motion, and may take such other action appropriate to secure the just... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Decision on motions. 41.125...

  18. 37 CFR 41.125 - Decision on motions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Decision on motions. (a) Order of consideration. The Board may take up motions for decisions in any order, may grant, deny, or dismiss any motion, and may take such other action appropriate to secure the just... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Decision on motions. 41.125...

  19. 76 FR 53942 - Richard A. Herbert, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 09-33] Richard A. Herbert, M.D.; Decision and Order On June 15, 2010, Administrative Law Judge (ALJ) Mary Ellen Bittner issued the attached recommended decision. Thereafter, Respondent filed Exceptions to the ALJ's decision. Having reviewed the entire record including Respondent's...

  20. Orders of C2 Agility and Implications for Information and Decision-Making

    DTIC Science & Technology

    2013-06-01

    of agility and, in particular, in discussions of resilience. Orders of agility also invite the re-examination of conceptions of value in informing...incompatible interpretations of decision-making and information. It also gives greater confidence that different conceptions of value and assessment...examination of conceptions of value in informing decision- making, leading to the exposition of a hierarchical model of nested decision-making and decision

  1. 76 FR 38144 - Energy Conservation Program for Consumer Products; Decision and Order Granting a Waiver to BSH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... measuring energy and water consumption. DATES: This Decision and Order is effective June 29, 2011. FOR... and water based on an estimate that at least 50% of homes already have a water softening system. BSH... Conservation Program for Consumer Products; Decision and Order Granting a Waiver to BSH Corporation From the...

  2. 46 CFR 5.707 - Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant; temporary credential or endorsement. 5.707 Section 5.707... INVESTIGATION REGULATIONS-PERSONNEL ACTION Appeals § 5.707 Stay of effect of decision and order of...

  3. 29 CFR 458.88 - Submission of the Administrative Law Judge's recommended decision and order to the Assistant...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Administrative Law Judge shall cause his recommended decision and order to be served promptly on all parties to... parties. (c) Exceptions to the Administrative Law Judge's recommended decision and order may be filed by... 29 Labor 2 2011-07-01 2011-07-01 false Submission of the Administrative Law Judge's recommended...

  4. 29 CFR 458.88 - Submission of the Administrative Law Judge's recommended decision and order to the Assistant...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Administrative Law Judge shall cause his recommended decision and order to be served promptly on all parties to... parties. (c) Exceptions to the Administrative Law Judge's recommended decision and order may be filed by... 29 Labor 2 2012-07-01 2012-07-01 false Submission of the Administrative Law Judge's recommended...

  5. 46 CFR 5.707 - Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant; temporary credential or endorsement. 5.707 Section 5.707... INVESTIGATION REGULATIONS-PERSONNEL ACTION Appeals § 5.707 Stay of effect of decision and order of...

  6. 46 CFR 5.707 - Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant; temporary credential or endorsement. 5.707 Section 5.707... INVESTIGATION REGULATIONS-PERSONNEL ACTION Appeals § 5.707 Stay of effect of decision and order of...

  7. 46 CFR 5.707 - Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant; temporary credential or endorsement. 5.707 Section 5.707... INVESTIGATION REGULATIONS-PERSONNEL ACTION Appeals § 5.707 Stay of effect of decision and order of...

  8. 46 CFR 5.707 - Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Stay of effect of decision and order of Administrative Law Judge on appeal to the Commandant; temporary credential or endorsement. 5.707 Section 5.707... INVESTIGATION REGULATIONS-PERSONNEL ACTION Appeals § 5.707 Stay of effect of decision and order of...

  9. Decisions with Uncertain Consequences—A Total Ordering on Loss-Distributions

    PubMed Central

    König, Sandra; Schauer, Stefan

    2016-01-01

    Decisions are often based on imprecise, uncertain or vague information. Likewise, the consequences of an action are often equally unpredictable, thus putting the decision maker into a twofold jeopardy. Assuming that the effects of an action can be modeled by a random variable, then the decision problem boils down to comparing different effects (random variables) by comparing their distribution functions. Although the full space of probability distributions cannot be ordered, a properly restricted subset of distributions can be totally ordered in a practically meaningful way. We call these loss-distributions, since they provide a substitute for the concept of loss-functions in decision theory. This article introduces the theory behind the necessary restrictions and the hereby constructible total ordering on random loss variables, which enables decisions under uncertainty of consequences. Using data obtained from simulations, we demonstrate the practical applicability of our approach. PMID:28030572

  10. 77 FR 64131 - Zvi H. Perper, M.D., Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 11-34] Zvi H. Perper, M.D., Decision and Order On July 19, 2011, Administrative Law Judge (ALJ) Gail A. Randall issued the attached recommended decision. The Respondent did not file exceptions to the decision. Having reviewed the entire record, I have decided to adopt the ALJ's...

  11. 77 FR 49024 - Sai Wentum, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... in lieu of a hearing and issue this Decision and Final Order based on relevant evidence contained in..., the Show Cause Order alleged that Registrant is currently unlicensed to practice medicine and without...

  12. 43 CFR 30.101 - What definitions do I need to know?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  13. Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

    PubMed Central

    Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

    2013-01-01

    Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

  14. A two-level discount model for coordinating a decentralized supply chain considering stochastic price-sensitive demand

    NASA Astrophysics Data System (ADS)

    Heydari, Jafar; Norouzinasab, Yousef

    2015-12-01

    In this paper, a discount model is proposed to coordinate pricing and ordering decisions in a two-echelon supply chain (SC). Demand is stochastic and price sensitive while lead times are fixed. Decentralized decision making where downstream decides on selling price and order size is investigated. Then, joint pricing and ordering decisions are extracted where both members act as a single entity aim to maximize whole SC profit. Finally, a coordination mechanism based on quantity discount is proposed to coordinate both pricing and ordering decisions simultaneously. The proposed two-level discount policy can be characterized from two aspects: (1) marketing viewpoint: a retail price discount to increase the demand, and (2) operations management viewpoint: a wholesale price discount to induce the retailer to adjust its order quantity and selling price jointly. Results of numerical experiments demonstrate that the proposed policy is suitable to coordinate SC and improve the profitability of SC as well as all SC members in comparison with decentralized decision making.

  15. 10 CFR 430.56 - Decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Exemptions § 430.56 Decision and order. (a) Upon consideration of the application and other relevant information received or obtained, the Secretary shall issue an order granting or denying the application. (b) The order shall include a written statement setting forth the relevant facts and the legal basis of...

  16. The do-not-resuscitate order in teaching hospitals.

    PubMed

    Evans, A L; Brody, B A

    1985-04-19

    We studied the use of do-not-resuscitate (DNR) orders at three teaching hospitals that did not have official protocols for such orders to see whether their use meets the goals (decision making before a crisis and promoting patient autonomy) that have been identified for such orders. We found that 20% of all patients had or were being considered for DNR orders, that the patient and/or family was usually involved (83%) in the decision not to resuscitate, but rarely involved (25%) in decisions to resuscitate, or in cases of no decision, that a wide range of care was provided to patients with a DNR status, and that partial resuscitative efforts would be employed in some cases. Our main conclusion in light of our findings is that DNR orders are currently not fulfilling their major goals. We offer six proposals for improving future DNR protocols.

  17. 77 FR 72408 - Amy S. Benjamin, N.P.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Amy S. Benjamin, N.P.; Decision and Order On... Administration, issued an Order to Show Cause to Amy S. Benjamin, N.P. (Respondent), of Wheeler, Mississippi. The... CFR 0.100(b), I order that the Order to Show Cause issued to Amy S. Benjamin, N.P., be, and it hereby...

  18. 75 FR 7981 - Kiwifruit Grown in California; Secretary's Decision and Referendum Order on Proposed Amendments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-23

    ... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service 7 CFR Part 920 [Doc. No. AO-FV-08-0174... on Proposed Amendments to Marketing Order No. 920 AGENCY: Agricultural Marketing Service, USDA. ACTION: Proposed rule and referendum order. SUMMARY: This decision proposes amendments to Marketing Order...

  19. 76 FR 60706 - Practices and Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... publication of nonprecedential Orders will serve the goal of openness in the Board's decision-making by giving... that the Board may issue a final decision and, when appropriate, order a date for compliance with that decision. The Board received comments concerning this interim rule from two individuals. The first...

  20. Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

    PubMed

    Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

    2018-04-20

    Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

  1. 17 CFR 201.141 - Orders and decisions: Service of orders instituting proceedings and other orders and decisions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (3) Record of service. The Secretary shall maintain a record of service on parties (in hard copy or computerized format), identifying the party given notice, the method of service, the date of service, the...

  2. 77 FR 4999 - Decision and Order Granting a Waiver to LG From the Department of Energy Clothes Washer Test...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CW-022] Decision...: Office of Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Decision and Order.... Hogan, Deputy Assistant Secretary for Energy Efficiency, Energy Efficiency and Renewable Energy...

  3. 77 FR 75428 - Decision and Order Granting a Waiver to Samsung From the Department of Energy Residential...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. RF-021] Decision... Refrigerator-Freezer Test Procedures AGENCY: Office of Energy Efficiency and Renewable Energy, Department of... Assistant Secretary for Energy Efficiency, Energy Efficiency and Renewable Energy. Decision and Order In the...

  4. 20 CFR 655.840 - What are the requirements for a decision and order of the administrative law judge?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... order of the administrative law judge? 655.840 Section 655.840 Employees' Benefits EMPLOYMENT AND... requirements for a decision and order of the administrative law judge? (a) Within 60 calendar days after the... administrative law judge shall be inoperative unless and until the Secretary issues an order affirming the...

  5. 20 CFR 655.840 - What are the requirements for a decision and order of the administrative law judge?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... order of the administrative law judge? 655.840 Section 655.840 Employees' Benefits EMPLOYMENT AND... requirements for a decision and order of the administrative law judge? (a) Within 60 calendar days after the... administrative law judge shall be inoperative unless and until the Secretary issues an order affirming the...

  6. 20 CFR 655.840 - What are the requirements for a decision and order of the administrative law judge?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... order of the administrative law judge? 655.840 Section 655.840 Employees' Benefits EMPLOYMENT AND... requirements for a decision and order of the administrative law judge? (a) Within 60 calendar days after the... administrative law judge shall be inoperative unless and until the Secretary issues an order affirming the...

  7. 20 CFR 655.840 - What are the requirements for a decision and order of the administrative law judge?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... order of the administrative law judge? 655.840 Section 655.840 Employees' Benefits EMPLOYMENT AND... requirements for a decision and order of the administrative law judge? (a) Within 60 calendar days after the... administrative law judge shall be inoperative unless and until the Secretary issues an order affirming the...

  8. Focus of attention in an activity-based scheduler

    NASA Technical Reports Server (NTRS)

    Sadeh, Norman; Fox, Mark S.

    1989-01-01

    Earlier research in job shop scheduling has demonstrated the advantages of opportunistically combining order-based and resource-based scheduling techniques. An even more flexible approach is investigated where each activity is considered a decision point by itself. Heuristics to opportunistically select the next decision point on which to focus attention (i.e., variable ordering heuristics) and the next decision to be tried at this point (i.e., value ordering heuristics) are described that probabilistically account for both activity precedence and resource requirement interactions. Preliminary experimental results indicate that the variable ordering heuristic greatly increases search efficiency. While least constraining value ordering heuristics have been advocated in the literature, the experimental results suggest that other value ordering heuristics combined with our variable-ordering heuristic can produce much better schedules without significantly increasing search.

  9. 29 CFR 801.67 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... each of the parties. (f) If any party desires review of the decision of the Administrative Law Judge, a... 29 Labor 3 2010-07-01 2010-07-01 false Decision and Order of Administrative Law Judge. 801.67... OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Administrative Proceedings...

  10. 29 CFR 24.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.109 Decision and orders of the... cases arising under the Safe Drinking Water Act or the Toxic Substances Control Act, exemplary damages... brought under the Energy Reorganization Act, when an ALJ issues a decision that the complaint has merit...

  11. 29 CFR 24.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.109 Decision and orders of the... cases arising under the Safe Drinking Water Act or the Toxic Substances Control Act, exemplary damages... brought under the Energy Reorganization Act, when an ALJ issues a decision that the complaint has merit...

  12. 29 CFR 24.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.109 Decision and orders of the... cases arising under the Safe Drinking Water Act or the Toxic Substances Control Act, exemplary damages... brought under the Energy Reorganization Act, when an ALJ issues a decision that the complaint has merit...

  13. 29 CFR 24.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.109 Decision and orders of the... cases arising under the Safe Drinking Water Act or the Toxic Substances Control Act, exemplary damages... brought under the Energy Reorganization Act, when an ALJ issues a decision that the complaint has merit...

  14. Exploring the Impact of Early Decisions in Variable Ordering for Constraint Satisfaction Problems.

    PubMed

    Ortiz-Bayliss, José Carlos; Amaya, Ivan; Conant-Pablos, Santiago Enrique; Terashima-Marín, Hugo

    2018-01-01

    When solving constraint satisfaction problems (CSPs), it is a common practice to rely on heuristics to decide which variable should be instantiated at each stage of the search. But, this ordering influences the search cost. Even so, and to the best of our knowledge, no earlier work has dealt with how first variable orderings affect the overall cost. In this paper, we explore the cost of finding high-quality orderings of variables within constraint satisfaction problems. We also study differences among the orderings produced by some commonly used heuristics and the way bad first decisions affect the search cost. One of the most important findings of this work confirms the paramount importance of first decisions. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. We propose a simple method to improve early decisions of heuristics. By using it, performance of heuristics increases.

  15. Exploring the Impact of Early Decisions in Variable Ordering for Constraint Satisfaction Problems

    PubMed Central

    Amaya, Ivan

    2018-01-01

    When solving constraint satisfaction problems (CSPs), it is a common practice to rely on heuristics to decide which variable should be instantiated at each stage of the search. But, this ordering influences the search cost. Even so, and to the best of our knowledge, no earlier work has dealt with how first variable orderings affect the overall cost. In this paper, we explore the cost of finding high-quality orderings of variables within constraint satisfaction problems. We also study differences among the orderings produced by some commonly used heuristics and the way bad first decisions affect the search cost. One of the most important findings of this work confirms the paramount importance of first decisions. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. We propose a simple method to improve early decisions of heuristics. By using it, performance of heuristics increases. PMID:29681923

  16. Behavioral variability of choices versus structural inconsistency of preferences.

    PubMed

    Regenwetter, Michel; Davis-Stober, Clintin P

    2012-04-01

    Theories of rational choice often make the structural consistency assumption that every decision maker's binary strict preference among choice alternatives forms a strict weak order. Likewise, the very concept of a utility function over lotteries in normative, prescriptive, and descriptive theory is mathematically equivalent to strict weak order preferences over those lotteries, while intransitive heuristic models violate such weak orders. Using new quantitative interdisciplinary methodologies, we dissociate the variability of choices from the structural inconsistency of preferences. We show that laboratory choice behavior among stimuli of a classical "intransitivity" paradigm is, in fact, consistent with variable strict weak order preferences. We find that decision makers act in accordance with a restrictive mathematical model that, for the behavioral sciences, is extraordinarily parsimonious. Our findings suggest that the best place to invest future behavioral decision research is not in the development of new intransitive decision models but rather in the specification of parsimonious models consistent with strict weak order(s), as well as heuristics and other process models that explain why preferences appear to be weakly ordered.

  17. 29 CFR 24.110 - Decision and orders of the Administrative Review Board.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.110 Decision and orders of the... issued under the Energy Reorganization Act, other than that portion of the order awarding compensatory... employment, and compensatory damages. In cases arising under the Safe Drinking Water Act or the Toxic...

  18. 29 CFR 24.110 - Decision and orders of the Administrative Review Board.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.110 Decision and orders of the... issued under the Energy Reorganization Act, other than that portion of the order awarding compensatory... employment, and compensatory damages. In cases arising under the Safe Drinking Water Act or the Toxic...

  19. 29 CFR 24.110 - Decision and orders of the Administrative Review Board.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.110 Decision and orders of the... issued under the Energy Reorganization Act, other than that portion of the order awarding compensatory... employment, and compensatory damages. In cases arising under the Safe Drinking Water Act or the Toxic...

  20. 29 CFR 24.110 - Decision and orders of the Administrative Review Board.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ENERGY REORGANIZATION ACT OF 1974, AS AMENDED Litigation § 24.110 Decision and orders of the... issued under the Energy Reorganization Act, other than that portion of the order awarding compensatory... employment, and compensatory damages. In cases arising under the Safe Drinking Water Act or the Toxic...

  1. 76 FR 48897 - Sheryl Lavender, D.O. Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-70] Sheryl Lavender, D.O. Decision and Order On October 28, 2010, Administrative Law Judge (ALJ) Timothy D. Wing, issued the attached..., I order that DEA Certificate of Registration, BL1667596, issued to Sheryl Lavender, D.O., be, and it...

  2. The Impact of Visualizations in Promoting Informed Natural Resource Decisions

    ERIC Educational Resources Information Center

    Turner, Sheldon

    2013-01-01

    The research in this dissertation was conducted in order to understand the ways in which scientific visualizations can influence the decision process of non-scientists. A wide variety of classical and novel methods were used in order to capture and analyze the decision process. Data were collected from non-scientists through role-play interviews…

  3. 29 CFR 1987.109 - Decision and orders of the administrative law judge.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Decision and orders of the administrative law judge. 1987.... (d)(1) If the ALJ concludes that the respondent has violated the law, the ALJ will issue an order... determines that the respondent has not violated the law, an order will be issued denying the complaint. If...

  4. Temporal characteristics of decisions in hospital encounters: a threshold for shared decision making? A qualitative study.

    PubMed

    Ofstad, Eirik H; Frich, Jan C; Schei, Edvin; Frankel, Richard M; Gulbrandsen, Pål

    2014-11-01

    To identify and characterize physicians' statements that contained evidence of clinically relevant decisions in encounters with patients in different hospital settings. Qualitative analysis of 50 videotaped encounters from wards, the emergency room (ER) and outpatient clinics in a department of internal medicine at a Norwegian university hospital. Clinical decisions could be grouped in a temporal order: decisions which had already been made, and were brought into the encounter by the physician (preformed decisions), decisions made in the present (here-and-now decisions), and decisions prescribing future actions given a certain course of events (conditional decisions). Preformed decisions were a hallmark in the ward and conditional decisions a main feature of ER encounters. Clinical decisions related to a patient-physician encounter spanned a time frame exceeding the duration of the encounter. While a distribution of decisions over time and space fosters sharing and dilution of responsibility between providers, it makes the decision making process hard to access for patients. In order to plan when and how to involve patients in decisions, physicians need increased awareness of when clinical decisions are made, who usually makes them, and who should make them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. 76 FR 48898 - Robert Leigh Kale, M.D., Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Robert Leigh Kale, M.D., Decision and Order... Enforcement Administration, issued an Order to Show Cause to Robert Leigh Kale, M.D. (Registrant), of Fort... Certificate of Registration, BK9514375, issued to Robert Leigh Kale, M.D., be, and it hereby is, revoked. I...

  6. A decision tool for selecting trench cap designs

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

    Paige, G.B.; Stone, J.J.; Lane, L.J.

    1995-12-31

    A computer based prototype decision support system (PDSS) is being developed to assist the risk manager in selecting an appropriate trench cap design for waste disposal sites. The selection of the {open_quote}best{close_quote} design among feasible alternatives requires consideration of multiple and often conflicting objectives. The methodology used in the selection process consists of: selecting and parameterizing decision variables using data, simulation models, or expert opinion; selecting feasible trench cap design alternatives; ordering the decision variables and ranking the design alternatives. The decision model is based on multi-objective decision theory and uses a unique approach to order the decision variables andmore » rank the design alternatives. Trench cap designs are evaluated based on federal regulations, hydrologic performance, cover stability and cost. Four trench cap designs, which were monitored for a four year period at Hill Air Force Base in Utah, are used to demonstrate the application of the PDSS and evaluate the results of the decision model. The results of the PDSS, using both data and simulations, illustrate the relative advantages of each of the cap designs and which cap is the {open_quotes}best{close_quotes} alternative for a given set of criteria and a particular importance order of those decision criteria.« less

  7. 5 CFR 2429.17 - Reconsideration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... action of the Authority, unless so ordered by the Authority. A motion for reconsideration need not be... move for reconsideration of such final decision or order. The motion shall be filed within ten (10) days after service of the Authority's decision or order. A motion for reconsideration shall state with...

  8. 5 CFR 2429.17 - Reconsideration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... action of the Authority, unless so ordered by the Authority. A motion for reconsideration need not be... move for reconsideration of such final decision or order. The motion shall be filed within ten (10) days after service of the Authority's decision or order. A motion for reconsideration shall state with...

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

    NASA Astrophysics Data System (ADS)

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

    2012-11-01

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

  10. Evaluation of do not resuscitate orders (DNR) in a Swiss community hospital

    PubMed Central

    Junod, P; Morabia, A; de Torrente, A

    2002-01-01

    Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of DNR orders, especially with respect to the patients' involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients' involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. PMID:12468655

  11. When is diagnostic testing inappropriate or irrational? Acceptable regret approach.

    PubMed

    Hozo, Iztok; Djulbegovic, Benjamin

    2008-01-01

    The authors provide a new model within the framework of theories of bounded rationality for the observed physicians' behavior that their ordering of diagnostic tests may not be rational. Contrary to the prevailing thinking, the authors find that physicians do not act irrationally or inappropriately when they order diagnostic tests in usual clinical practice. When acceptable regret (i.e., regret that a decision maker finds tolerable upon making a wrong decision) is taken into account, the authors show that physicians tend to order diagnostic tests at a higher level of pretest probability of disease than predicted by expected utility theory. They also show why physicians tend to overtest when regret about erroneous decisions is extremely small. Finally, they explain variations in the practice of medicine. They demonstrate that in the same clinical situation, different decision makers might have different acceptable regret thresholds for withholding treatment, for ordering a diagnostic test, or for administering treatment. This in turn means that for some decision makers, the most rational strategy is to do nothing, whereas for others, it may be to order a diagnostic test, and still for others, choosing treatment may be the most rational course of action.

  12. Sure I'm Sure: Prefrontal Oscillations Support Metacognitive Monitoring of Decision Making.

    PubMed

    Wokke, Martijn E; Cleeremans, Axel; Ridderinkhof, K Richard

    2017-01-25

    Successful decision making critically involves metacognitive processes such as monitoring and control of our decision process. Metacognition enables agents to modify ongoing behavior adaptively and determine what to do next in situations in which external feedback is not (immediately) available. Despite the importance of metacognition for many aspects of life, little is known about how our metacognitive system operates or about what kind of information is used for metacognitive (second-order) judgments. In particular, it remains an open question whether metacognitive judgments are based on the same information as first-order decisions. Here, we investigated the relationship between metacognitive performance and first-order task performance by recording EEG signals while participants were asked to make a "diagnosis" after seeing a sample of fictitious patient data (a complex pattern of colored moving dots of different sizes). To assess metacognitive performance, participants provided an estimate about the quality of their diagnosis on each trial. Results demonstrate that the information that contributes to first-order decisions differs from the information that supports metacognitive judgments. Further, time-frequency analyses of EEG signals reveal that metacognitive performance is associated specifically with prefrontal theta-band activity. Together, our findings are consistent with a hierarchical model of metacognition and suggest a crucial role for prefrontal oscillations in metacognitive performance. Monitoring and control of our decision process (metacognition) is a crucial aspect of adaptive decision making. Crucially, metacognitive skills enable us to adjust ongoing behavior and determine future decision making when immediate feedback is not available. In the present study, we constructed a "diagnosis task" that allowed us to assess in what way first-order task performance and metacognition are related to each other. Results demonstrate that the contribution of sensory evidence (size, color, and motion direction) differs between first- and second-order decision making. Further, our results indicate that metacognitive performance specifically is orchestrated by means of prefrontal theta oscillations. Together, our findings suggest a hierarchical model of metacognition. Copyright © 2017 the authors 0270-6474/17/370781-09$15.00/0.

  13. 75 FR 13120 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Samsung Electronics America... (Case No. RF-011) that grants to Samsung Electronics America, Inc. (Samsung) a waiver from the DOE... and Order In the Matter of: Samsung Electronics America, Inc. (Case No. RF- 011). Background Title III...

  14. 29 CFR 801.67 - Decision and Order of Administrative Law Judge.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Administrative Law Judge shall prepare, as promptly as practicable after the expiration of the time set for... Decision and Order. [56 FR 9064, Mar. 4, 1991; 56 FR 14469, Apr. 10, 1991] Modification or Vacation of...

  15. 14 CFR 13.127 - Reports, decisions and orders.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Section 13.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Investigation § 13.127 Reports, decisions and orders. The Presiding Officer shall issue a written report based... publication as prescribed by section 313(b) of the Federal Aviation Act. ...

  16. 14 CFR 13.127 - Reports, decisions and orders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 13.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Investigation § 13.127 Reports, decisions and orders. The Presiding Officer shall issue a written report based... publication as prescribed by section 313(b) of the Federal Aviation Act. ...

  17. 14 CFR 13.127 - Reports, decisions and orders.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Section 13.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Investigation § 13.127 Reports, decisions and orders. The Presiding Officer shall issue a written report based... publication as prescribed by section 313(b) of the Federal Aviation Act. ...

  18. 14 CFR 13.127 - Reports, decisions and orders.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Section 13.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Investigation § 13.127 Reports, decisions and orders. The Presiding Officer shall issue a written report based... publication as prescribed by section 313(b) of the Federal Aviation Act. ...

  19. 14 CFR 13.127 - Reports, decisions and orders.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Section 13.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Investigation § 13.127 Reports, decisions and orders. The Presiding Officer shall issue a written report based... publication as prescribed by section 313(b) of the Federal Aviation Act. ...

  20. A Recommendation Algorithm for Automating Corollary Order Generation

    PubMed Central

    Klann, Jeffrey; Schadow, Gunther; McCoy, JM

    2009-01-01

    Manual development and maintenance of decision support content is time-consuming and expensive. We explore recommendation algorithms, e-commerce data-mining tools that use collective order history to suggest purchases, to assist with this. In particular, previous work shows corollary order suggestions are amenable to automated data-mining techniques. Here, an item-based collaborative filtering algorithm augmented with association rule interestingness measures mined suggestions from 866,445 orders made in an inpatient hospital in 2007, generating 584 potential corollary orders. Our expert physician panel evaluated the top 92 and agreed 75.3% were clinically meaningful. Also, at least one felt 47.9% would be directly relevant in guideline development. This automated generation of a rough-cut of corollary orders confirms prior indications about automated tools in building decision support content. It is an important step toward computerized augmentation to decision support development, which could increase development efficiency and content quality while automatically capturing local standards. PMID:20351875

  1. A recommendation algorithm for automating corollary order generation.

    PubMed

    Klann, Jeffrey; Schadow, Gunther; McCoy, J M

    2009-11-14

    Manual development and maintenance of decision support content is time-consuming and expensive. We explore recommendation algorithms, e-commerce data-mining tools that use collective order history to suggest purchases, to assist with this. In particular, previous work shows corollary order suggestions are amenable to automated data-mining techniques. Here, an item-based collaborative filtering algorithm augmented with association rule interestingness measures mined suggestions from 866,445 orders made in an inpatient hospital in 2007, generating 584 potential corollary orders. Our expert physician panel evaluated the top 92 and agreed 75.3% were clinically meaningful. Also, at least one felt 47.9% would be directly relevant in guideline development. This automated generation of a rough-cut of corollary orders confirms prior indications about automated tools in building decision support content. It is an important step toward computerized augmentation to decision support development, which could increase development efficiency and content quality while automatically capturing local standards.

  2. 76 FR 65707 - Decision and Order Granting a Waiver to LG Electronics, Inc. From the Department of Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... and Order Granting a Waiver to LG Electronics, Inc. From the Department of Energy Commercial Package... Energy's (DOE) Decision and Order in Case No. CAC-032, which grants LG Electronics, Inc. (LG) a waiver... Electronics, Inc. (LG) (Case No. CAC-032). Background Title III, part C of the Energy Policy and Conservation...

  3. 15 CFR Supplement No. 1 to Part 764 - Standard Terms of Orders Denying Export Privileges

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... decision following charges of violation, settlement agreement, section 11(h) of the EAA, or temporary... denial order; (2) the basis for the denial order, such as final decision following charges of violation..., transporting, financing, or otherwise servicing in any way, any transaction involving any item exported or to...

  4. 10 CFR 501.102 - OFE evaluation of the record, decision and order for modification or rescission of a rule or order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... a conference will advance its evaluation of the request. (b) Criteria. Except where modification or... rule or order. (a) OFE will consider the entire administrative record in its evaluation of the decision... request under this subpart and all interested persons will be afforded an opportunity to respond to these...

  5. Improving serum calcium test ordering according to a decision algorithm.

    PubMed

    Faria, Daniel K; Taniguchi, Leandro U; Fonseca, Luiz A M; Ferreira-Junior, Mario; Aguiar, Francisco J B; Lichtenstein, Arnaldo; Sumita, Nairo M; Duarte, Alberto J S; Sales, Maria M

    2018-05-18

    To detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm. We studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed. Adequacy of ordering was defined according to adherence to a decision algorithm implemented in 2014. Total and ionised calcium tests per patient-day of hospitalisation significantly decreased after the algorithm implementation; and duplication of tests (total and ionised calcium measured in the same blood sample) was reduced by 49%. Overall adequacy of ionised calcium determinations increased by 23% (P=0.0001) due to the increase in the adequacy of ionised calcium ordering in non-critical conditions. A decision algorithm can be a useful educational tool to improve adequacy of the process of ordering serum calcium tests. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Experimenting with C2 Applications and Federated Infrastructures for Integrated Full-Spectrum Operational Environments in Support of Collaborative Planning and Interoperable Execution

    DTIC Science & Technology

    2004-06-01

    Situation Understanding) Common Operational Pictures Planning & Decision Support Capabilities Message & Order Processing Common Operational...Pictures Planning & Decision Support Capabilities Message & Order Processing Common Languages & Data Models Modeling & Simulation Domain

  7. 77 FR 36003 - Patrick K. Chau, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Patrick K. Chau, M.D.; Decision and Order On August 8, 2011, the Deputy Assistant Administrator, Office of Diversion Control, Drug Enforcement... drug-seeking and diversion behaviors, and not requesting medical records from other providers or...

  8. Acquisition and production of skilled behavior in dynamic decision-making tasks

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex

    1992-01-01

    Currently, two main approaches exist for improving the human-machine interface component of a system in order to improve overall system performance - display enhancement and intelligent decision making. Discussed here are the characteristic issues of these two decision-making strategies. Differences in expert and novice decision making are described in order to help determine whether a particular strategy may be better for a particular type of user. Research is outlined to compare and contrast the two technologies, as well as to examine the interaction effects introduced by the different skill levels and the different methods for training operators.

  9. Self-evaluation of decision-making: A general Bayesian framework for metacognitive computation.

    PubMed

    Fleming, Stephen M; Daw, Nathaniel D

    2017-01-01

    People are often aware of their mistakes, and report levels of confidence in their choices that correlate with objective performance. These metacognitive assessments of decision quality are important for the guidance of behavior, particularly when external feedback is absent or sporadic. However, a computational framework that accounts for both confidence and error detection is lacking. In addition, accounts of dissociations between performance and metacognition have often relied on ad hoc assumptions, precluding a unified account of intact and impaired self-evaluation. Here we present a general Bayesian framework in which self-evaluation is cast as a "second-order" inference on a coupled but distinct decision system, computationally equivalent to inferring the performance of another actor. Second-order computation may ensue whenever there is a separation between internal states supporting decisions and confidence estimates over space and/or time. We contrast second-order computation against simpler first-order models in which the same internal state supports both decisions and confidence estimates. Through simulations we show that second-order computation provides a unified account of different types of self-evaluation often considered in separate literatures, such as confidence and error detection, and generates novel predictions about the contribution of one's own actions to metacognitive judgments. In addition, the model provides insight into why subjects' metacognition may sometimes be better or worse than task performance. We suggest that second-order computation may underpin self-evaluative judgments across a range of domains. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Emergency physicians' attitudes and preferences regarding computed tomography, radiation exposure, and imaging decision support.

    PubMed

    Griffey, Richard T; Jeffe, Donna B; Bailey, Thomas

    2014-07-01

    Although computerized decision support for imaging is often recommended for optimizing computed tomography (CT) use, no studies have evaluated emergency physicians' (EPs') preferences regarding computerized decision support in the emergency department (ED). In this needs assessment, the authors sought to determine if EPs view overutilization as a problem, if they want decision support, and if so, the kinds of support they prefer. A 42-item, Web-based survey of EPs was developed and used to measure EPs' attitudes, preferences, and knowledge. Key contacts at local EDs sent letters describing the study to their physicians. Exploratory principal components analysis (PCA) was used to determine the underlying factor structure of multi-item scales, Cronbach's alpha was used to measure internal consistency of items on a scale, Spearman correlations were used to describe bivariate associations, and multivariable linear regression analysis was used to identify variables independently associated with physician interest in decision support. Of 235 surveys sent, 155 (66%) EPs responded. Five factors emerged from the PCA. EPs felt that: 1) CT overutilization is a problem in the ED (α = 0.75); 2) a patient's cumulative CT study count affects decisions of whether and what type of imaging study to order only some of the time (α = 0.75); 3) knowledge that a patient has had prior CT imaging for the same indication makes EPs less likely to order a CT (α = 0.42); 4) concerns about malpractice, patient satisfaction, or insistence on CTs affect CT ordering decisions (α = 0.62); and 5) EPs want decision support before ordering CTs (α = 0.85). Performance on knowledge questions was poor, with only 18% to 39% correctly responding to each of the three multiple-choice items about effective radiation doses of chest radiograph and single-pass abdominopelvic CT, as well as estimated increased risk of cancer from a 10-mSv exposure. Although EPs wanted information on patients' cumulative exposures, they feel inadequately familiar with this information to make use of it clinically. If provided with patients' cumulative radiation exposures from CT, 87% of EPs said that they would use this information to discuss imaging options with their patients. In the multiple regression model, which included all variables associated with interest in decision support at p < 0.10 in bivariate tests, items independently associated with EPs' greater interest in all types of decision support proposed included lower total knowledge scores, greater frequency that cumulative CT study count affects EP's decision to order CTs, and greater agreement that overutilization of CT is a problem and that awareness of multiple prior CTs for a given indication affects CT ordering decisions. Emergency physicians view overutilization of CT scans as a problem with potential for improvement in the ED and would like to have more information to discuss risks with their patients. EPs are interested in all types of imaging decision support proposed to help optimize imaging ordering in the ED and to reduce radiation to their patients. Findings reveal several opportunities that could potentially affect CT utilization. © 2014 by the Society for Academic Emergency Medicine.

  11. Emergency Physicians’ Attitudes and Preferences Regarding Computed Tomography, Radiation Exposure, and Imaging Decision Support

    PubMed Central

    Griffey, Richard T.; Jeffe, Donna B.; Bailey, Thomas

    2014-01-01

    Objectives Although computerized decision support for imaging is often recommended for optimizing computed tomography (CT) use, no studies have evaluated emergency physicians’ (EPs’) preferences regarding computerized decision support in the emergency department (ED). In this needs assessment, the authors sought to determine if EPs view overutilization as a problem, if they want decision support, and if so, the kinds of support they prefer. Methods A 42-item, Web-based survey of EPs was developed and used to measure EPs’ attitudes, preferences, and knowledge. Key contacts at local EDs sent letters describing the study to their physicians. Exploratory principal components analysis (PCA) was used to determine the underlying factor structure of multi-item scales, Cronbach’s alpha was used to measure internal consistency of items on a scale, Spearman correlations were used to describe bivariate associations, and multivariable linear regression analysis was used to identify variables independently associated with physician interest in decision support. Results Of 235 surveys sent, 155 (66%) EPs responded. Five factors emerged from the PCA. EPs felt that: 1) CT overutilization is a problem in the ED (α = 0.75); 2) a patient’s cumulative CT study count affects decisions of whether and what type of imaging study to order only some of the time (α = 0.75); 3) knowledge that a patient has had prior CT imaging for the same indication makes EPs less likely to order a CT (α = 0.42); 4) concerns about malpractice, patient satisfaction, or insistence on CTs affect CT ordering decisions (α = 0.62); and 5) EPs want decision support before ordering CTs (α = 0.85). Performance on knowledge questions was poor, with only 18% to 39% correctly responding to each of the three multiple-choice items about effective radiation doses of chest radiograph and single-pass abdominopelvic CT, as well as estimated increased risk of cancer from a 10-mSv exposure. Although EPs wanted information on patients’ cumulative exposures, they feel inadequately familiar with this information to make use of it clinically. If provided with patients’ cumulative radiation exposures from CT, 87% of EPs said that they would use this information to discuss imaging options with their patients. In the multiple regression model, which included all variables associated with interest in decision support at p < 0.10 in bivariate tests, items independently associated with EPs’ greater interest in all types of decision support proposed included lower total knowledge scores, greater frequency that cumulative CT study count affects EP’s decision to order CTs, and greater agreement that overutilization of CT is a problem and that awareness of multiple prior CTs for a given indication affects CT ordering decisions. Conclusions Emergency physicians view overutilization of CT scans as a problem with potential for improvement in the ED and would like to have more information to discuss risks with their patients. EPs are interested in all types of imaging decision support proposed to help optimize imaging ordering in the ED and to reduce radiation to their patients. Findings reveal several opportunities that could potentially affect CT utilization. PMID:25125272

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

    PubMed

    Stephens, Christine; Breheny, Mary

    2008-01-01

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

  13. 76 FR 80920 - Decision and Order Granting a Waiver to Miele, Inc. From the U.S. Department of Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... certain basic models that run on a 208 volt electrical supply. Under today's decision and order, Miele... dishwasher that runs on an electrical supply voltage of 208 volts. The existing test procedure under Title 10...

  14. 77 FR 44069 - Grider Drug #1 & Grider Drug #2; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ... Vol. 77 Thursday, No. 144 July 26, 2012 Part VI Department of Justice Drug Enforcement Administration Grider Drug 1 & Grider Drug 2; Decision and Order; Notice #0;#0;Federal Register / Vol. 77 , No. 144 / Thursday, July 26, 2012 / Notices#0;#0; [[Page 44070

  15. Medical decision-making during the guardianship process for incapacitated, hospitalized adults: a descriptive cohort study.

    PubMed

    Bandy, Robin J; Helft, Paul R; Bandy, Robert W; Torke, Alexia M

    2010-10-01

    It is sometimes necessary for courts to appoint guardians for adult, incapacitated patients. There are few data describing how medical decisions are made for such patients before and during the guardianship process. To describe the process of medical decision-making for incapacitated, hospitalized adults for whom court-appointed guardians are requested. Retrospective, descriptive cohort study. Patients were identified from the legal files of a public, urban hospital. Medical and legal records were reviewed for demographic data, code status, diagnoses, code status orders and invasive procedures and person authorizing the order or procedure, dates of incapacitation and appointment of temporary guardian, reason for guardianship, and documentation of communication with a guardian. A total of 79 patients met inclusion criteria; 68.4% were male and 56.2% African-American. The median age was 65 years. Of the 71 patients with medical records available 89% of patients had a temporary guardianship petitioned because of the need for placement only. Seventeen patients had a new DNR order written during hospitalization, eight of which were ordered by physicians without consultation with a surrogate decision maker. Overall, 32 patients underwent a total of 81 documented invasive procedures, 16 of which were authorized by the patient, 15 by family or friend, and 11 by a guardian; consent was not required for 39 of the procedures because of emergency conditions or because a procedure was medically necessary and no surrogate decision maker was available. Although most of the guardianships were requested for placement purposes, important medical decisions were made while patients were awaiting appointment of a guardian. Hospitalized, incapacitated adults awaiting guardianship may lack a surrogate decision maker when serious decisions must be made about their medical care.

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

    PubMed Central

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

    2011-01-01

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

  17. Decision-Tree Formulation With Order-1 Lateral Execution

    NASA Technical Reports Server (NTRS)

    James, Mark

    2007-01-01

    A compact symbolic formulation enables mapping of an arbitrarily complex decision tree of a certain type into a highly computationally efficient multidimensional software object. The type of decision trees to which this formulation applies is that known in the art as the Boolean class of balanced decision trees. Parallel lateral slices of an object created by means of this formulation can be executed in constant time considerably less time than would otherwise be required. Decision trees of various forms are incorporated into almost all large software systems. A decision tree is a way of hierarchically solving a problem, proceeding through a set of true/false responses to a conclusion. By definition, a decision tree has a tree-like structure, wherein each internal node denotes a test on an attribute, each branch from an internal node represents an outcome of a test, and leaf nodes represent classes or class distributions that, in turn represent possible conclusions. The drawback of decision trees is that execution of them can be computationally expensive (and, hence, time-consuming) because each non-leaf node must be examined to determine whether to progress deeper into a tree structure or to examine an alternative. The present formulation was conceived as an efficient means of representing a decision tree and executing it in as little time as possible. The formulation involves the use of a set of symbolic algorithms to transform a decision tree into a multi-dimensional object, the rank of which equals the number of lateral non-leaf nodes. The tree can then be executed in constant time by means of an order-one table lookup. The sequence of operations performed by the algorithms is summarized as follows: 1. Determination of whether the tree under consideration can be encoded by means of this formulation. 2. Extraction of decision variables. 3. Symbolic optimization of the decision tree to minimize its form. 4. Expansion and transformation of all nested conjunctive-disjunctive paths to a flattened conjunctive form composed only of equality checks when possible. If each reduced conjunctive form contains only equality checks and all of these forms use the same variables, then the decision tree can be reduced to an order-one operation through a table lookup. The speedup to order one is accomplished by distributing each decision variable over a surface of a multidimensional object by mapping the equality constant to an index

  18. 31 CFR 501.705 - Service and filing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the attention of the person making the filing. (d) Service of written orders or decisions issued by... Proceedings, and other related orders and decisions, or any amendments or supplements thereto, to be served... service signed and dated by the individual making such service, stating the method of service and the...

  19. 29 CFR 502.41 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Decision and order of Administrative Law Judge. 502.41 Section 502.41 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS ENFORCEMENT OF CONTRACTUAL OBLIGATIONS FOR TEMPORARY ALIEN AGRICULTURAL WORKERS ADMITTED UNDER...

  20. 20 CFR 655.75 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and... Nursing in the United States (H-2B Workers) § 655.75 Decision and order of administrative law judge. (a... determination resulting from that process. Under no circumstances shall the administrative law judge determine...

  1. 40 CFR 164.4 - Arrangements for examining Agency records, transcripts, orders, and decisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... records, transcripts, orders, and decisions. 164.4 Section 164.4 Protection of Environment ENVIRONMENTAL..., CHANGES OF CLASSIFICATIONS, SUSPENSIONS OF REGISTRATIONS AND OTHER HEARINGS CALLED PURSUANT TO SECTION 6... signed documents required by the rules in this part, whether issued by the Environmental Appeals Board or...

  2. 40 CFR 164.4 - Arrangements for examining Agency records, transcripts, orders, and decisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... records, transcripts, orders, and decisions. 164.4 Section 164.4 Protection of Environment ENVIRONMENTAL..., CHANGES OF CLASSIFICATIONS, SUSPENSIONS OF REGISTRATIONS AND OTHER HEARINGS CALLED PURSUANT TO SECTION 6... signed documents required by the rules in this part, whether issued by the Environmental Appeals Board or...

  3. 20 CFR 726.313 - Decision and order of Administrative Law Judge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decision and order of Administrative Law Judge. 726.313 Section 726.313 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR...

  4. 77 FR 37068 - Muzaffer Aslan, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Muzaffer Aslan, M.D.; Decision and Order On... Cause and Immediate Suspension of Registration to Muzaffer Aslan, M.D. (hereinafter, Respondent), of Los....C. 824, of the CSA. Calvin Ramsey, 76 FR 20034, 20036 (2011) (other citations omitted); Brenton D...

  5. 76 FR 71370 - Silviu Ziscovici, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 11-3] Silviu Ziscovici, M.D.; Decision and Order On December 10, 2010, Administrative Law Judge (ALJ) Timothy D. Wing, issued the... Certificate of Registration, BZ4692756, issued to Silviu Ziscovici, M.D., be, and it hereby is, revoked. I...

  6. 76 FR 66969 - Aaron Gloskowski, D.O.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... this Decision and Final Order based on relevant evidence contained in the record submitted by the... of Osteopathic Examiners in Medicine and Surgery (hereinafter, the Board), Registrant is without authority to practice medicine or handle controlled substances in the State of Arizona, the State in which...

  7. 10 CFR 110.50 - Terms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... provisions of the Atomic Energy Act and to all applicable rules, regulations, decisions and orders of the... conditions when required by amendments of the Atomic Energy Act or other applicable law, or by other rules, regulations, decisions or orders issued in accordance with the terms of the Atomic Energy Act or other...

  8. 76 FR 21406 - Cynthia M. Cadet, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-34] Cynthia M. Cadet, M.D.; Decision and Order ACTION: Correction. On Thursday, April 7, 2011, the Drug Enforcement Administration... column. Dated: April 8, 2011. Michele M. Leonhart, Administrator. [FR Doc. 2011-9170 Filed 4-14-11; 8:45...

  9. 5 CFR 2638.505 - Director's decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., employee, or agent engaged in the performance of investigative or advocacy functions for the Office of... Cases Involving Individual Executive Agency Employees § 2638.505 Director's decision and order. (a) In general. Where the Director has reason to believe that an employee is violating an ethics provision, the...

  10. 77 FR 18862 - Zhiwei Lin, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-54] Zhiwei Lin, M.D.; Decision and Order On September 19, 2011, Administrative Law Judge (ALJ) Timothy D. Wing issued the....C. 824, of the CSA. Calvin Ramsey, 76 FR 20034, 20036 (2011) (other citations omitted); Brenton D...

  11. OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records

    PubMed Central

    Chen, Jonathan H; Podchiyska, Tanya

    2016-01-01

    Objective: To answer a “grand challenge” in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com’s product recommender. Materials and Methods: EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender’s ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Results: Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10−10) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10−16). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Discussion: Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from “correct” ones. Conclusions: Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. “interesting” suggestions). PMID:26198303

  12. The United States Remains Unprepared for Oil Import Disruptions. Volume I. Summary: Includes Conclusions and Recommendations.

    DTIC Science & Technology

    1981-09-29

    The Administration’s decision to stop funding rationing planning means it will not be available for emergency use. Authority for gaso- line rationing ...them. It will be a very narrow system in order to minimize adverse effects on market decision - making and efficiency. However, until such a system is...It will be a very narrow system in order to minimize adverse effects on market decision - making and efficiency. However, until such a system is

  13. 29 CFR 1921.13 - Decision of the hearing examiner.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Decision of the hearing examiner. 1921.13 Section 1921.13 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Decision and Order § 1921.13 Decision of the hearing...

  14. A qualitative exploration of the motives behind the decision to order a liver function test in primary care.

    PubMed

    Litchfield, I J; Lilford, R J; Bentham, L M; Greenfield, S M

    2014-01-01

    The number of tests ordered in primary care continues to increase influenced by a number of factors not all of which are concerned with diagnosis and management of disease. Liver function tests (LFTs) are a good example of inexpensive tests that are frequently ordered in patients with non-specific symptoms. They remain among the most frequently ordered tests despite their lack of specificity yet the full range of motives behind the decision to order an LFT remains unexplored. To gain an understanding of the family practitioner's (FP) medical and non-medical motives for ordering an LFT and the influence of various social and technical factors on this decision. We interviewed FPs across six practices who were participating in a prospective study of the efficacy of an abnormal LFT to indicate the development of a serious liver disease. Following content analysis of the data from the semi-structured interviews we used the 'attitude-social influence-efficacy' model to categorise the determinants of test ordering behaviour. Factors influencing an FP's decision to order a test were grouped into two broad categories; the first is 'internal' including expectation of efficacy and general attitude towards LFTs. The second group is 'external' and consists of themes of social influence, tests characteristics and defensive medicine. Whilst our sample acknowledged the clinical use of LFTs such as the routine monitoring of medication and liver-specific diagnostic purposes we also found that social and behavioural reasons are strong motivators to order an LFT and may take precedence over clinical factors.

  15. 7 CFR 900.64 - The Judge's decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false The Judge's decision. 900.64 Section 900.64... Judge's decision. (a) Corrections to and certification of transcript. (1) At such time as the judge may... order, based solely upon the evidence of record, and briefs in support thereof. (c) Judge's Decision...

  16. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System

    PubMed Central

    Beccaro, M. A. Del; Villanueva, R.; Knudson, K. M.; Harvey, E. M.; Langle, J. M.; Paul, W.

    2010-01-01

    Objective We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system. Measurement/Results Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors. Conclusion We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors PMID:23616845

  18. Collaborative Manufacturing for Small-Medium Enterprises

    NASA Astrophysics Data System (ADS)

    Irianto, D.

    2016-02-01

    Manufacturing systems involve decisions concerning production processes, capacity, planning, and control. In a MTO manufacturing systems, strategic decisions concerning fulfilment of customer requirement, manufacturing cost, and due date of delivery are the most important. In order to accelerate the decision making process, research on decision making structure when receiving order and sequencing activities under limited capacity is required. An effective decision making process is typically required by small-medium components and tools maker as supporting industries to large industries. On one side, metal small-medium enterprises are expected to produce parts, components or tools (i.e. jigs, fixture, mold, and dies) with high precision, low cost, and exact delivery time. On the other side, a metal small- medium enterprise may have weak bargaining position due to aspects such as low production capacity, limited budget for material procurement, and limited high precision machine and equipment. Instead of receiving order exclusively, a small-medium enterprise can collaborate with other small-medium enterprise in order to fulfill requirements high quality, low manufacturing cost, and just in time delivery. Small-medium enterprises can share their best capabilities to form effective supporting industries. Independent body such as community service at university can take a role as a collaboration manager. The Laboratory of Production Systems at Bandung Institute of Technology has implemented shared manufacturing systems for small-medium enterprise collaboration.

  19. 76 FR 11233 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to LG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Case No. CW-016] Energy... Energy Residential Clothes Washer Test Procedure AGENCY: Office of Energy Efficiency and Renewable Energy... 23, 2011. Cathy Zoi, Assistant Secretary, Energy Efficiency and Renewable Energy. Decision and Order...

  20. 10 CFR 501.68 - Decision and order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Decision and order. 501.68 Section 501.68 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS Exemptions and... Organization Act, Pub. L. 95-91, 91 Stat. 565 (42 U.S.C. 7101 et seq.); Powerplant and Industrial Fuel Use Act...

  1. Decision theory for computing variable and value ordering decisions for scheduling problems

    NASA Technical Reports Server (NTRS)

    Linden, Theodore A.

    1993-01-01

    Heuristics that guide search are critical when solving large planning and scheduling problems, but most variable and value ordering heuristics are sensitive to only one feature of the search state. One wants to combine evidence from all features of the search state into a subjective probability that a value choice is best, but there has been no solid semantics for merging evidence when it is conceived in these terms. Instead, variable and value ordering decisions should be viewed as problems in decision theory. This led to two key insights: (1) The fundamental concept that allows heuristic evidence to be merged is the net incremental utility that will be achieved by assigning a value to a variable. Probability distributions about net incremental utility can merge evidence from the utility function, binary constraints, resource constraints, and other problem features. The subjective probability that a value is the best choice is then derived from probability distributions about net incremental utility. (2) The methods used for rumor control in Bayesian Networks are the primary way to prevent cycling in the computation of probable net incremental utility. These insights lead to semantically justifiable ways to compute heuristic variable and value ordering decisions that merge evidence from all available features of the search state.

  2. 29 CFR 801.70 - Implementation by the Secretary.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Vacation of Decision and Order of Administrative Law Judge § 801.70 Implementation by the Secretary. (a... discretion of the Secretary. At any time within 30 days after the issuance of the Decision and Order of the..., the form in which submission shall be made (i.e., briefs, oral argument, etc.), and the time within...

  3. 29 CFR 801.70 - Implementation by the Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Vacation of Decision and Order of Administrative Law Judge § 801.70 Implementation by the Secretary. (a... discretion of the Secretary. At any time within 30 days after the issuance of the Decision and Order of the..., the form in which submission shall be made (i.e., briefs, oral argument, etc.), and the time within...

  4. 75 FR 51264 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to LG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... Electronics, Inc. (LG) a waiver from the DOE electric refrigerator and refrigerator- freezer test procedure... takes this technology into account when measuring energy consumption. DATES: This Decision and Order is... Energy, Building Technologies Program, Mailstop EE-2J, 1000 Independence Avenue, SW., Washington, DC...

  5. 77 FR 13104 - Decision and Order Amending a Waiver Granted to Fujitsu General America, Inc. From the Department...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-05

    ... Refrigeration Institute 1230 (AHRI) as the alternative test procedure. DATES: This Decision and Order is... testing procedures or rating procedures developed or recognized by the Air-Conditioning and Refrigeration... Refrigeration Institute (AHRI) Standard 1230-2010: Performance Rating of Variable Refrigerant Flow (VRF) Multi...

  6. 30 CFR 280.34 - How can I appeal an order or decision?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false How can I appeal an order or decision? 280.34 Section 280.34 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE PROSPECTING FOR MINERALS OTHER THAN OIL, GAS, AND SULPHUR ON THE OUTER...

  7. 77 FR 29691 - Matthew J. Kachinas, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Medicine, Registrant no longer holds authority to dispense controlled substances in Florida, the State in... lieu of a hearing. 21 CFR 1301.43(e). Accordingly, I issue this Decision and Order based on relevant evidence contained in the Investigative Record submitted by the Government. I make the following findings...

  8. 76 FR 71374 - Joseph Giacchino, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 10-54] Joseph Giacchino, M.D.; Decision and Order On July 9, 2010, Administrative Law Judge (ALJ) Timothy D. Wing, issued the attached... prevail. See, e.g., Bourne Pharmacy, 72 FR 18,273, 18,274 (2007); Agostino Carlucci, M.D., 49 FR 33,184...

  9. Self-Evaluation of Decision-Making: A General Bayesian Framework for Metacognitive Computation

    PubMed Central

    2017-01-01

    People are often aware of their mistakes, and report levels of confidence in their choices that correlate with objective performance. These metacognitive assessments of decision quality are important for the guidance of behavior, particularly when external feedback is absent or sporadic. However, a computational framework that accounts for both confidence and error detection is lacking. In addition, accounts of dissociations between performance and metacognition have often relied on ad hoc assumptions, precluding a unified account of intact and impaired self-evaluation. Here we present a general Bayesian framework in which self-evaluation is cast as a “second-order” inference on a coupled but distinct decision system, computationally equivalent to inferring the performance of another actor. Second-order computation may ensue whenever there is a separation between internal states supporting decisions and confidence estimates over space and/or time. We contrast second-order computation against simpler first-order models in which the same internal state supports both decisions and confidence estimates. Through simulations we show that second-order computation provides a unified account of different types of self-evaluation often considered in separate literatures, such as confidence and error detection, and generates novel predictions about the contribution of one’s own actions to metacognitive judgments. In addition, the model provides insight into why subjects’ metacognition may sometimes be better or worse than task performance. We suggest that second-order computation may underpin self-evaluative judgments across a range of domains. PMID:28004960

  10. 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...

  11. Mixed Frames and Risky Decision-Making.

    PubMed

    Peng, Jiaxi; Zhang, Jiaxi; Sun, Hao; Zeng, Zhicong; Mai, Yuexia; Miao, Danmin

    2017-01-01

    By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.

  12. Reduction in chemotherapy order errors with computerised physician order entry and clinical decision support systems.

    PubMed

    Aziz, Muhammad Tahir; Ur-Rehman, Tofeeq; Qureshi, Sadia; Bukhari, Nadeem Irfan

    Medication errors in chemotherapy are frequent and lead to patient morbidity and mortality, as well as increased rates of re-admission and length of stay, and considerable extra costs. Objective: This study investigated the proposition that computerised chemotherapy ordering reduces the incidence and severity of chemotherapy protocol errors. A computerised physician order entry of chemotherapy order (C-CO) with clinical decision support system was developed in-house, including standardised chemotherapy protocol definitions, automation of pharmacy distribution, clinical checks, labeling and invoicing. A prospective study was then conducted in a C-CO versus paper based chemotherapy order (P-CO) in a 30-bed chemotherapy bay of a tertiary hospital. Both C-CO and P-CO orders, including pharmacoeconomic analysis and the severity of medication errors, were checked and validated by a clinical pharmacist. A group analysis and field trial were also conducted to assess clarity, feasibility and decision making. The C-CO was very usable in terms of its clarity and feasibility. The incidence of medication errors was significantly lower in the C-CO compared with the P-CO (10/3765 [0.26%] versus 134/5514 [2.4%]). There was also a reduction in dispensing time of chemotherapy protocols in the C-CO. The chemotherapy computerisation with clinical decision support system resulted in a significant decrease in the occurrence and severity of medication errors, improvements in chemotherapy dispensing and administration times, and reduction of chemotherapy cost.

  13. 39 CFR 501.6 - Suspension and revocation of authorization.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... decision of PT shall become a final decision of the Postal Service. The appeal may be filed with the Chief Information Officer of the Postal Service and must include all supporting evidence and state with specificity... Information Officer shall constitute a final decision of the Postal Service. (f) An order or final decision...

  14. Authorship Credit: A National Study of Social Work Educators' Beliefs

    ERIC Educational Resources Information Center

    Apgar, Dawn Hall; Congress, Elaine

    2005-01-01

    This study examines decisions by social work educators about authorship order and educators' views on other authorship issues. Results indicate the writing of the manuscript was viewed as the most important task in making decisions about authorship order. The majority believed that a written agreement is helpful before beginning research to decide…

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

    DOT National Transportation Integrated Search

    2000-01-24

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

  16. 29 CFR 801.73 - Final decision of the Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Final decision of the Secretary. 801.73 Section 801.73 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS... Vacation of Decision and Order of Administrative Law Judge § 801.73 Final decision of the Secretary. The...

  17. 10 CFR 900.6 - Coordination of permitting and related environmental reviews.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... display the information utilized by the permitting entities as the basis for their decisions on the... to all permitting entities for making their agency decisions in order to ensure that each permitting... final agency decision, and all other analyses used as the basis for all decisions on a proposed...

  18. The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

    PubMed

    Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

    2016-09-01

    To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

  19. 50 CFR 25.45 - Appeals procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... appeal. Any person who is adversely affected by a refuge manager's decision or order relating to the... decision or order on a permit or application for permit, the refuge manager shall notify the permittee or... shall have twenty (20) days after notification in which to present to the refuge manager, orally or in...

  20. 49 CFR 1503.657 - Appeal from initial decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  1. 75 FR 71729 - Notice of Availability of the Record of Decision (ROD) for the Tuskegee Airmen National Historic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ...'s Order Number 12 (Conservation Planning, Environmental Impact Analysis, and Decision- making) the... DEPARTMENT OF THE INTERIOR National Park Service Notice of Availability of the Record of Decision... ROD for the project. The ROD includes a description of the project's background, a decision statement...

  2. Choice and Decision Processes and Careers. Information Series No. 7.

    ERIC Educational Resources Information Center

    Tiedeman, David V.; Miller-Tiedeman, Anna

    The state of the art review depicts comprehension of choice and decision making as knowable and demonstrates that something is already known about both processes and how to facilitate their comprehension. The assumption is made that deciding to choose, choosing to decide, deciding in order to choose, and choosing in order to decide must be…

  3. Soft context clustering for F0 modeling in HMM-based speech synthesis

    NASA Astrophysics Data System (ADS)

    Khorram, Soheil; Sameti, Hossein; King, Simon

    2015-12-01

    This paper proposes the use of a new binary decision tree, which we call a soft decision tree, to improve generalization performance compared to the conventional `hard' decision tree method that is used to cluster context-dependent model parameters in statistical parametric speech synthesis. We apply the method to improve the modeling of fundamental frequency, which is an important factor in synthesizing natural-sounding high-quality speech. Conventionally, hard decision tree-clustered hidden Markov models (HMMs) are used, in which each model parameter is assigned to a single leaf node. However, this `divide-and-conquer' approach leads to data sparsity, with the consequence that it suffers from poor generalization, meaning that it is unable to accurately predict parameters for models of unseen contexts: the hard decision tree is a weak function approximator. To alleviate this, we propose the soft decision tree, which is a binary decision tree with soft decisions at the internal nodes. In this soft clustering method, internal nodes select both their children with certain membership degrees; therefore, each node can be viewed as a fuzzy set with a context-dependent membership function. The soft decision tree improves model generalization and provides a superior function approximator because it is able to assign each context to several overlapped leaves. In order to use such a soft decision tree to predict the parameters of the HMM output probability distribution, we derive the smoothest (maximum entropy) distribution which captures all partial first-order moments and a global second-order moment of the training samples. Employing such a soft decision tree architecture with maximum entropy distributions, a novel speech synthesis system is trained using maximum likelihood (ML) parameter re-estimation and synthesis is achieved via maximum output probability parameter generation. In addition, a soft decision tree construction algorithm optimizing a log-likelihood measure is developed. Both subjective and objective evaluations were conducted and indicate a considerable improvement over the conventional method.

  4. Using intranet-based order sets to standardize clinical care and prepare for computerized physician order entry.

    PubMed

    Heffner, John E; Brower, Kathleen; Ellis, Rosemary; Brown, Shirley

    2004-07-01

    The high cost of computerized physician order entry (CPOE) and physician resistance to standardized care have delayed implementation. An intranet-based order set system can provide some of CPOE's benefits and offer opportunities to acculturate physicians toward standardized care. INTRANET CLINICIAN ORDER FORMS (COF): The COF system at the Medical University of South Carolina (MUSC) allows caregivers to enter and print orders through the intranet at points of care and to access decision support resources. Work on COF began in March 2000 with transfer of 25 MUSC paper-based order set forms to an intranet site. Physician groups developed additional order sets, which number more than 200. Web traffic increased progressively during a 24-month period, peaking at more than 6,400 hits per month to COF. Decision support tools improved compliance with Centers for Medicare & Medicaid Services core indicators. Clinicians demonstrated a willingness to develop and use order sets and decision support tools posted on the COF site. COF provides a low-cost method for preparing caregivers and institutions to adopt CPOE and standardization of care. The educational resources, relevant links to external resources, and communication alerts will all link to CPOE, thereby providing a head start in CPOE implementation.

  5. 75 FR 41845 - Energy Conservation Program for Certain Commercial and Industrial Equipment: Decision and Order...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... conditioners and heat pumps. The waiver is specific to the Sanyo variable capacity ECO-i (commercial) multi... in this notice to test and rate its ECO-i multi-split products. DATES: This Decision and Order is..., Building Technologies Program, Mailstop EE-2J, 1000 Independence Avenue, SW., Washington, DC 20585-0121...

  6. 49 CFR 511.25 - Summary decision and order.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... may move, with a supporting memorandum, for a Summary Decision and Order in its favor upon all or any of the issues in controversy. Complaint Counsel may so move at any time after thirty (30) days following issuance of a complaint, and any other party may so move at any time after issuance of a complaint...

  7. 49 CFR 107.323 - ALJ's decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false ALJ's decision. 107.323 Section 107.323 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.323 ALJ's decision. (a) After...

  8. Do-not-resuscitate orders in an extended-care study group.

    PubMed

    Meyers, R M; Lurie, N; Breitenbucher, R B; Waring, C J

    1990-09-01

    We examined the charts of 911 nursing home patients in Hennepin County, Minnesota, to determine the prevalence of written do-not-resuscitate (DNR) orders. Information regarding demographic characteristics, and whether a surrogate decisionmaker was available and participated in the decision, was also collected. Twenty-seven percent of patients had DNR orders. Ninety percent of all patients had potentially available surrogate decisionmakers. However, for 31% of patients with DNR orders, there was no documentation of patient or surrogate participation in the DNR decision. Univariate analysis identified female sex; increased age, level of care (skilled versus intermediate), presence of a potential surrogate decisionmaker, and increasing length of time since nursing home admission as factors associated with presence of DNR orders. When a logistic regression model was used, increased age, increased length of time since nursing home admission, skilled versus intermediate level of care, and presence of a surrogate decisionmaker were independently associated with presence of DNR status. Several variables are independently associated with written DNR orders; their relationship to the factors physicians use in decision making requires further study.

  9. 5 CFR 2422.31 - Application for review of a Regional Director Decision and Order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Established law or policy warrants reconsideration; or, (3) There is a genuine issue over whether the Regional... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Application for review of a Regional... REPRESENTATION PROCEEDINGS § 2422.31 Application for review of a Regional Director Decision and Order. (a) Filing...

  10. 76 FR 60873 - Jeffery M. Freesemann, M.D.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... considered the ALJ's decision and the record in light of the parties' post-hearing briefs, I have decided to...'s recommended Order. \\1\\ The ALJ made extensive findings under the public interest factors. See ALJ... ALJ Ex. 1; see also ALJ Slip op. at 32. Moreover, there was no application pending at the time of the...

  11. 78 FR 65629 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... representative of consumer behavior. For example, if the number of annual cycles results in greater than a 3-day... Conservation Program for Consumer Products: Decision and Order Granting a Waiver to Whirlpool Corporation From... Conservation Program for Consumer Products Other Than Automobiles, a program covering most major household...

  12. Dynamic Decision Making under Uncertainty and Partial Information

    DTIC Science & Technology

    2017-01-30

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

  13. 75 FR 33673 - Tart Cherries Grown in the States of Michigan, New York, Pennsylvania, Oregon, Utah, Washington...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Recommended Decision issued on May 7, 2009 and published in the May 12, 2009, issue of the Federal Register (74 FR 22112), and a Secretary's Decision and Referendum Order issued on January 6, 2010, and... Decision and Opportunity to File Written Exceptions thereto. This Recommended Decision was published in the...

  14. 75 FR 31285 - Decision-Making Authority Regarding the Denial, Suspension, or Revocation of a Federal Firearms...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

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

  15. Guided medication dosing for elderly emergency patients using real-time, computerized decision support.

    PubMed

    Griffey, Richard T; Lo, Helen G; Burdick, Elisabeth; Keohane, Carol; Bates, David W

    2012-01-01

    To evaluate the impact of a real-time computerized decision support tool in the emergency department that guides medication dosing for the elderly on physician ordering behavior and on adverse drug events (ADEs). A prospective controlled trial was conducted over 26 weeks. The status of the decision support tool alternated OFF (7/17/06-8/29/06), ON (8/29/06-10/10/06), OFF (10/10/06-11/28/06), and ON (11/28/06-1/16/07) in consecutive blocks during the study period. In patients ≥65 who were ordered certain benzodiazepines, opiates, non-steroidals, or sedative-hypnotics, the computer application either adjusted the dosing or suggested a different medication. Physicians could accept or reject recommendations. The primary outcome compared medication ordering consistent with recommendations during ON versus OFF periods. Secondary outcomes included the admission rate, emergency department length of stay for discharged patients, 10-fold dosing orders, use of a second drug to reverse the original medication, and rate of ADEs using previously validated explicit chart review. 2398 orders were placed for 1407 patients over 1548 visits. The majority (49/53; 92.5%) of recommendations for alternate medications were declined. More orders were consistent with dosing recommendations during ON (403/1283; 31.4%) than OFF (256/1115; 23%) periods (p≤0.0001). 673 (43%) visits were reviewed for ADEs. The rate of ADEs was lower during ON (8/237; 3.4%) compared with OFF (31/436; 7.1%) periods (p=0.02). The remaining secondary outcomes showed no difference. Single institution study, retrospective chart review for ADEs. Though overall agreement with recommendations was low, real-time computerized decision support resulted in greater acceptance of medication recommendations. Fewer ADEs were observed when computerized decision support was active.

  16. Food ordering for children in restaurants: multiple sources of influence on decision making.

    PubMed

    Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

    2016-09-01

    Restaurants are playing an increasingly important role in children's dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child's gender, person ordering for the child and server interactions with the dining party. Interview data included: child's age, restaurant visit frequency, timing of child's decision making, and factors influencing decision making. Ten independent, table-service restaurants in San Diego, CA, USA participated. Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3-14 years). Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children's) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children's menu. Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.

  17. 77 FR 71579 - Polyester Staple Fiber From Taiwan: Notice of Court Decision Not in Harmony With Final Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... Taiwan: Notice of Court Decision Not in Harmony With Final Results of Administrative Review and Amended Final Results of Antidumping Duty Order Administrative Review AGENCY: Import Administration...'') results of redetermination \\2\\ pursuant to the CIT's FENC Remand Order.\\3\\ \\1\\ See Far Eastern New Century...

  18. Malpractice Liability Risk and Use of Diagnostic Imaging Services: A Systematic Review of the Literature.

    PubMed

    Li, Suhui; Brantley, Erin

    2015-12-01

    A widespread concern among physicians is that fear of medical malpractice liability may affect their decisions for diagnostic imaging orders. The purpose of this article is to synthesize evidence regarding the defensive use of imaging services. A literature search was conducted using a number of databases. The review included peer-reviewed publications that studied the link between physician orders of imaging tests and malpractice liability pressure. We identified 13 peer-reviewed studies conducted in the United States. Five of the studies reported physician assessments of the role of defensive medicine in imaging-order decisions; five assessed the association between physicians' liability risk and imaging ordering, and three assessed the impact of liability risk on imaging ordering at the state level. Although the belief that medical liability risk could influence decisions is highly prevalent among physicians, findings are mixed regarding the impact of liability risk on imaging orders at both the state and physician level. Inconclusive evidence suggests that physician ordering of imaging tests is affected by malpractice liability risk. Further research is needed to disentangle defensive medicine from other reasons for inefficient use of imaging. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Understanding decision-making in cardiac imaging: determinants of appropriate use.

    PubMed

    Fonseca, Ricardo; Jose, Kim; Marwick, Thomas H

    2018-03-01

    Appropriate Use Criteria (AUC) for echocardiography were developed in 2007 to facilitate decision-making, reduce variability in test utilization, and encourage rational use of imaging. However, there is little evidence that the AUC have favourably influenced ordering behaviour. This study explores the factors that contribute to clinicians requesting echocardiograms with a focus on appropriate use. Semi-structured face-to-face interviews with cardiologists and non-cardiologists who had requested echocardiograms were conducted at an Australian tertiary hospital. The interview guide included hypothetical clinical scenarios to better understand decision-making in ordering echocardiograms and the actions they could take when receiving test reports. Interviews underwent thematic analysis. Seventeen clinicians were interviewed, ten of whom were cardiologists. All participants ordered echocardiograms to support their clinical decision-making. Awareness of the AUC was low. The categorization of tests as 'appropriate' or 'inappropriate' was considered ineffective as it failed to reflect the decision-making process. The decision to request echocardiograms was influenced by a number of personal and systemic factors as well as guidelines and protocols. Training and experience, patients' expectations, and management of uncertainty were key personal factors. Systemic factors involved the accessibility of services and health insurance status of the patient. Factors that influenced the ordering of echocardiograms by clinicians at a tertiary care hospital did not appear to be amenable to control with AUC. Alternative approaches may be more effective than the AUC in addressing the overuse of echocardiography. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  20. 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.

  1. Regret and the rationality of choices.

    PubMed

    Bourgeois-Gironde, Sacha

    2010-01-27

    Regret helps to optimize decision behaviour. It can be defined as a rational emotion. Several recent neurobiological studies have confirmed the interface between emotion and cognition at which regret is located and documented its role in decision behaviour. These data give credibility to the incorporation of regret in decision theory that had been proposed by economists in the 1980s. However, finer distinctions are required in order to get a better grasp of how regret and behaviour influence each other. Regret can be defined as a predictive error signal but this signal does not necessarily transpose into a decision-weight influencing behaviour. Clinical studies on several types of patients show that the processing of an error signal and its influence on subsequent behaviour can be dissociated. We propose a general understanding of how regret and decision-making are connected in terms of regret being modulated by rational antecedents of choice. Regret and the modification of behaviour on its basis will depend on the criteria of rationality involved in decision-making. We indicate current and prospective lines of research in order to refine our views on how regret contributes to optimal decision-making.

  2. Communicating with the coroner: how religion, culture, and family concerns may influence autopsy decision making.

    PubMed

    Carpenter, Belinda; Adkins, Glenda; Barnes, Michael; Naylor, Charles; Begum, Nelufa

    2011-04-01

    Based on coronial data gathered in the state of Queensland in 2004, this article reviews how a change in legislation may have impacted autopsy decision making by coroners. More specifically, the authors evaluated whether the requirement that coronial autopsy orders specify the level of invasiveness of an autopsy to be performed by a pathologist was affected by the further requirement that coroners take into consideration a known religion, culture, and/or raised family concern before making such an order. Preliminary data reveal that the cultural status of the deceased did not affect coronial autopsy decision making. However, a known religion with a proscription against autopsy and a raised family concern appeared to be taken into account by coroners when making autopsy decisions and tended to decrease the invasiveness of the autopsy ordered from a full internal examination to either a partial internal examination or an external-only examination of the body. The impact of these findings is briefly discussed.

  3. OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records.

    PubMed

    Chen, Jonathan H; Podchiyska, Tanya; Altman, Russ B

    2016-03-01

    To answer a "grand challenge" in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com's product recommender. EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender's ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10(-10)) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10(-16)). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from "correct" ones. Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. "interesting" suggestions). Published by Oxford University Press on behalf of the American Medical Informatics Association 2015. This work is written by US Government employees and is in the public domain in the US.

  4. Induced simplified neutrosophic correlated aggregation operators for multi-criteria group decision-making

    NASA Astrophysics Data System (ADS)

    Şahin, Rıdvan; Zhang, Hong-yu

    2018-03-01

    Induced Choquet integral is a powerful tool to deal with imprecise or uncertain nature. This study proposes a combination process of the induced Choquet integral and neutrosophic information. We first give the operational properties of simplified neutrosophic numbers (SNNs). Then, we develop some new information aggregation operators, including an induced simplified neutrosophic correlated averaging (I-SNCA) operator and an induced simplified neutrosophic correlated geometric (I-SNCG) operator. These operators not only consider the importance of elements or their ordered positions, but also take into account the interactions phenomena among decision criteria or their ordered positions under multiple decision-makers. Moreover, we present a detailed analysis of I-SNCA and I-SNCG operators, including the properties of idempotency, commutativity and monotonicity, and study the relationships among the proposed operators and existing simplified neutrosophic aggregation operators. In order to handle the multi-criteria group decision-making (MCGDM) situations where the weights of criteria and decision-makers usually correlative and the criterion values are considered as SNNs, an approach is established based on I-SNCA operator. Finally, a numerical example is presented to demonstrate the proposed approach and to verify its effectiveness and practicality.

  5. Improvements to Strategic Planning and Implementation through Enhanced Correlation with Decision-Making Frameworks

    ERIC Educational Resources Information Center

    McCready, John W.

    2010-01-01

    The purpose of this study was to examine use of decision-making tools and feedback in strategic planning in order to develop a rigorous process that would promote the efficiency of strategic planning for acquisitions in the United States Coast Guard (USCG). Strategic planning is critical to agencies such as the USCG in order to be effective…

  6. 49 CFR 1503.631 - Interlocutory appeals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Rules of Practice in TSA Civil Penalty Actions § 1503.631 Interlocutory appeals. (a) General. Unless otherwise provided in this subpart, a party may not appeal a ruling or decision of the ALJ to the TSA decision maker until the initial decision has been entered on the record. A decision or order of the TSA...

  7. 76 FR 65512 - Record of Decision Addendum for the Department of Homeland Security Headquarters Consolidation at...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... parts 1500-1508), GSA Order PBS P 1095.1F (Environmental considerations in decision-making, dated... Decision Addendum for the Department of Homeland Security Headquarters Consolidation at St. Elizabeths in...). ACTION: Record of Decision Addendum. SUMMARY: Pursuant to the requirements of the National Environmental...

  8. EEG feature selection method based on decision tree.

    PubMed

    Duan, Lijuan; Ge, Hui; Ma, Wei; Miao, Jun

    2015-01-01

    This paper aims to solve automated feature selection problem in brain computer interface (BCI). In order to automate feature selection process, we proposed a novel EEG feature selection method based on decision tree (DT). During the electroencephalogram (EEG) signal processing, a feature extraction method based on principle component analysis (PCA) was used, and the selection process based on decision tree was performed by searching the feature space and automatically selecting optimal features. Considering that EEG signals are a series of non-linear signals, a generalized linear classifier named support vector machine (SVM) was chosen. In order to test the validity of the proposed method, we applied the EEG feature selection method based on decision tree to BCI Competition II datasets Ia, and the experiment showed encouraging results.

  9. Applying predictive analytics to develop an intelligent risk detection application for healthcare contexts.

    PubMed

    Moghimi, Fatemeh Hoda; Cheung, Michael; Wickramasinghe, Nilmini

    2013-01-01

    Healthcare is an information rich industry where successful outcomes require the processing of multi-spectral data and sound decision making. The exponential growth of data and big data issues coupled with a rapid increase of service demands in healthcare contexts today, requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Such a context is appropriate for the application of real time intelligent risk detection decision support systems using predictive analytic techniques such as data mining. To illustrate the power and potential of data science technologies in healthcare decision making scenarios, the use of an intelligent risk detection (IRD) model is proffered for the context of Congenital Heart Disease (CHD) in children, an area which requires complex high risk decisions that need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.

  10. Testing whether decision aids introduce cognitive biases: results of a randomized trial.

    PubMed

    Ubel, Peter A; Smith, Dylan M; Zikmund-Fisher, Brian J; Derry, Holly A; McClure, Jennifer; Stark, Azadeh; Wiese, Cheryl; Greene, Sarah; Jankovic, Aleksandra; Fagerlin, Angela

    2010-08-01

    Women at high risk of breast cancer face a difficult decision whether to take medications like tamoxifen to prevent a first breast cancer diagnosis. Decision aids (DAs) offer a promising method of helping them make this decision. But concern lingers that DAs might introduce cognitive biases. We recruited 663 women at high risk of breast cancer and presented them with a DA designed to experimentally test potential methods of identifying and reducing cognitive biases that could influence this decision, by varying specific aspects of the DA across participants in a factorial design. Participants were susceptible to a cognitive bias - an order effect - such that those who learned first about the risks of tamoxifen thought more favorably of the drug than women who learned first about the benefits. This order effect was eliminated among women who received additional information about competing health risks. We discovered that the order of risk/benefit information influenced women's perceptions of tamoxifen. This bias was eliminated by providing contextual information about competing health risks. We have demonstrated the feasibility of using factorial experimental designs to test whether DAs introduce cognitive biases, and whether specific elements of DAs can reduce such biases. Published by Elsevier Ireland Ltd.

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

    NASA Astrophysics Data System (ADS)

    Hosseini, Mitra Bokaei; Tarokh, Mohammad Jafar

    2013-05-01

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

  12. Reasoning and Action: Implementation of a Decision-Making Program in Sport.

    PubMed

    Gil-Arias, Alexander; Moreno, M Perla; García-Mas, Alex; Moreno, Alberto; García-González, Luíz; Del Villar, Fernando

    2016-09-20

    The objective of this study was to apply a decision training programme, based on the use of video-feedback and questioning, in real game time, in order to improve decision-making in volleyball attack actions. A three-phase quasi-experimental design was implemented: Phase A (pre-test), Phase B (Intervention) and Phase C (Retention). The sample was made up of 8 female Under-16 volleyball players, who were divided into two groups: experimental group (n = 4) and control group (n = 4). The independent variable was the decision training program, which was applied for 11 weeks in a training context, more specifically in a 6x6 game situation. The player had to analyze the reasons and causes of the decision taken. The dependent variable was decision-making, which was assessed based on systematic observation, using the "Game Performance Assessment Instrument" (GPAI) (Oslin, Mitchell, & Griffin, 1998). Results showed that, after applying the decision training program, the experimental group showed a significantly higher average percentage of successful decisions than the control group F(1, 6) = 11.26; p = .015; η2 p = .652; 95% CI [056, 360]. These results highlight the need to complement the training process with cognitive tools such as video-feedback and questioning in order to improve athletes' decision-making.

  13. A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection.

    PubMed

    Tong, Xiayu; Wang, Zhou-Jing

    2016-09-19

    This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers' judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice.

  14. A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection

    PubMed Central

    Tong, Xiayu; Wang, Zhou-Jing

    2016-01-01

    This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers’ judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice. PMID:27657097

  15. A Chaotic Ordered Hierarchies Consistency Analysis Performance Evaluation Model

    NASA Astrophysics Data System (ADS)

    Yeh, Wei-Chang

    2013-02-01

    The Hierarchies Consistency Analysis (HCA) is proposed by Guh in-cooperated along with some case study on a Resort to reinforce the weakness of Analytical Hierarchy Process (AHP). Although the results obtained enabled aid for the Decision Maker to make more reasonable and rational verdicts, the HCA itself is flawed. In this paper, our objective is to indicate the problems of HCA, and then propose a revised method called chaotic ordered HCA (COH in short) which can avoid problems. Since the COH is based upon Guh's method, the Decision Maker establishes decisions in a way similar to that of the original method.

  16. 76 FR 13355 - Magnesium Metal From the Russian Federation: Notice of Court Decision Not in Harmony With Final...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... Russian Federation: Notice of Court Decision Not in Harmony With Final Results of Administrative Review... antidumping duty order on magnesium metal from the Russian Federation covering the period of review April 1... administrative review of the antidumping duty order on magnesium metal from the Russian Federation for the period...

  17. Approximating recreation site choice: the predictive capability of a lexicographic semi-order model

    Treesearch

    Alan E. Watson; Joseph W. Roggenbuck

    1985-01-01

    The relevancy of a lexicographic semi-order model, as a basis for development of a microcomputer-based decision aid for backcountry hikers, was investigated. In an interactive microcomputer exercise, it was found that a decision aid based upon this model may assist recreationists in reduction of an alternative set to a cognitively manageable number.

  18. Cancer patients' perceptions of do not resuscitate orders.

    PubMed

    Olver, Ian N; Eliott, Jaklin A; Blake-Mortimer, Jane

    2002-01-01

    Patients' perceptions of do not resuscitate (DNR) orders and how and when to present the information were sought to aid in framing DNR policy. Semi-structured interviews of 23 patients being treated for cancer, were conducted by a clinical psychologist. The interviews were transcribed and analysed with the aid of a qualitative software package. Discourse analysis enabled hypotheses to be formed based on consistencies and variations of the language used. Most patients understood what DNR meant and preferred DNR orders to 'good palliative care' orders. They saw it as their autonomous right and responsibility to make such decisions. They would seek information on the likely medical outcomes of resuscitation but also would use non-rational criteria based on emotional and social factors to make their decisions. Family considerations suggest that personal autonomy is not the overriding basis of the decision. Patients were unsure of the best timing of a DNR discussion and were prepared to defer to doctors' intuition. Most advocated written DNR orders but few had them. Families were construed as advocates but also seen as constraining individual autonomy. When considering DNR orders, patients recognise the diversity of preferences likely to exist that belie a one policy fits all approach. Copyright 2002 John Wiley & Sons, Ltd.

  19. Food ordering for children in restaurants: multiple sources of influence on decision making

    PubMed Central

    Castro, Iana A; Williams, Christine B; Madanat, Hala; Pickrel, Julie L; Jun, Hee-Jin; Zive, Michelle; Gahagan, Sheila; Ayala, Guadalupe X

    2017-01-01

    Objective Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants. Design A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making. Setting Ten independent, table-service restaurants in San Diego, CA, USA participated. Subjects Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years). Results Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu. Conclusions Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants. PMID:27334904

  20. 6 CFR 27.330 - Summary decision procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 6 Domestic Security 1 2012-01-01 2012-01-01 false Summary decision procedures. 27.330 Section 27.330 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Orders and Adjudications § 27.330 Summary decision procedures. (a) The Presiding Officer...

  1. 6 CFR 27.330 - Summary decision procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Summary decision procedures. 27.330 Section 27.330 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Orders and Adjudications § 27.330 Summary decision procedures. (a) The Presiding Officer...

  2. 6 CFR 27.330 - Summary decision procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 6 Domestic Security 1 2014-01-01 2014-01-01 false Summary decision procedures. 27.330 Section 27.330 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Orders and Adjudications § 27.330 Summary decision procedures. (a) The Presiding Officer...

  3. 6 CFR 27.330 - Summary decision procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 6 Domestic Security 1 2013-01-01 2013-01-01 false Summary decision procedures. 27.330 Section 27.330 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Orders and Adjudications § 27.330 Summary decision procedures. (a) The Presiding Officer...

  4. 6 CFR 27.330 - Summary decision procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Summary decision procedures. 27.330 Section 27.330 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Orders and Adjudications § 27.330 Summary decision procedures. (a) The Presiding Officer...

  5. 76 FR 55217 - Procedures for Protests and Contracts Dispute

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... revised to clarify the standard for requesting a dismissal or summary decision, and the process for... revised to clarify when such a decision is to be construed as a final agency order. Adjudicative Process... practice and dismissal or summary decision of protests. 17.21 Adjudicative Process for protests. 17.23...

  6. Problem and Dilemma Identification and Formulation As the Most Critical Element of the Decision-Making Process: Behavioral Biases and Characteristics.

    ERIC Educational Resources Information Center

    Pashiardis, Petros

    This paper presents an overview of research in the field of decision theory, with a focus on problem and identification. The goal is to make the decision-making process as rational as possible in order to maximize the rational administration of the organization. The decisions associated with educational administration can be categorized as…

  7. Life-sustaining treatment decisions in Portuguese intensive care units: a national survey of intensive care physicians.

    PubMed

    Cardoso, Teresa; Fonseca, Teresa; Pereira, Sofia; Lencastre, Luís

    2003-12-01

    The objective of the present study was to evaluate the opinion of Portuguese intensive care physicians regarding 'do-not-resuscitate' (DNR) orders and decisions to withhold/withdraw treatment. A questionnaire was sent to all physicians working on a full-time basis in all intensive care units (ICUs) registered with the Portuguese Intensive Care Society. A total of 266 questionnaires were sent and 175 (66%) were returned. Physicians from 79% of the ICUs participated. All participants stated that DNR orders are applied in their units, and 98.3% stated that decisions to withhold treatment and 95.4% stated that decisions to withdraw treatment are also applied. About three quarters indicated that only the medical group makes these decisions. Fewer than 15% of the responders stated that they involve nurses, 9% involve patients and fewer than 11% involve patients' relatives in end-of-life decisions. Physicians with more than 10 years of clinical experience more frequently indicated that they involve nurses in these decisions (P < 0.05), and agnostic/atheist doctors more frequently involve patients' relatives in decisions to withhold/withdraw treatment (P < 0.05). When asked about who they thought should be involved, more than 26% indicated nurses, more than 35% indicated the patient and more than 25% indicated patients' relatives. More experienced doctors more frequently felt that nurses should be involved (P < 0.05), and male doctors more frequently stated that patients' relatives should be involved in DNR orders (P < 0.05). When a decision to withdraw treatment is made, 76.8% of 151 respondents indicated that they would initiate palliative care; no respondent indicated that they would administer drugs to accelerate the expected outcome. The probability of survival from the acute episode and patients' wishes were the most important criteria influencing end-of-life decisions. These decisions are made only by the medical group in most of the responding ICUs, with little input from nursing staff, patients, or patients' relatives, although many respondents expressed a wish to involve them more in this process. Sex, experience and religious beliefs of the respondents influences the way in which these decisions are made.

  8. Deciding Factors: Do Factors beyond Achievement Influence Teachers' Student Placement Decisions?

    ERIC Educational Resources Information Center

    Riley, Tasha

    2014-01-01

    Since teachers' decisions potentially have consequences for learners' future educational and life opportunities, it is imperative to determine the basis of teachers' decision-making in order to determine whether it is discriminatory. This study combines qualitative and quantitative methods towards a multi-school, multi-region study of Australian…

  9. A Method to Assess Climate-Relevant Decisions: Application in the Chesapeake Bay (2010 External Review Draft)

    EPA Science Inventory

    The goal of this study is to formalize an approach to inventory and analyze management decisions in order to produce useful information targeted toward effective adaptation to climate change. The approach uses as its starting point ongoing planning processes and decisions geared ...

  10. Retirement Savings Behavior of Higher Education Employees

    ERIC Educational Resources Information Center

    Dulebohn, James H.; Murray, Brian

    2007-01-01

    Higher education employees often participate in university-sponsored defined contribution pension plans that place the investment decision responsibility upon them. In order to examine investment decision-making behavior with retirement savings plans we investigated attitude-mediated, individual difference determinants of risky decision-making…

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

    PubMed

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

    2016-02-01

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

  12. Shared Decision Making with Collective Bargaining.

    ERIC Educational Resources Information Center

    Steimel, Eric L.

    This paper examines the changing role of school leaders, in light of the current trend toward participative decision making. Executive Order 12871 mandates the formation of a partnership between unions and management, which will result in teachers playing an active role in decision making. Leaders, particularly leaders of Department of Defense…

  13. Decision theory applied to image quality control in radiology.

    PubMed

    Lessa, Patrícia S; Caous, Cristofer A; Arantes, Paula R; Amaro, Edson; de Souza, Fernando M Campello

    2008-11-13

    The present work aims at the application of the decision theory to radiological image quality control (QC) in diagnostic routine. The main problem addressed in the framework of decision theory is to accept or reject a film lot of a radiology service. The probability of each decision of a determined set of variables was obtained from the selected films. Based on a radiology service routine a decision probability function was determined for each considered group of combination characteristics. These characteristics were related to the film quality control. These parameters were also framed in a set of 8 possibilities, resulting in 256 possible decision rules. In order to determine a general utility application function to access the decision risk, we have used a simple unique parameter called r. The payoffs chosen were: diagnostic's result (correct/incorrect), cost (high/low), and patient satisfaction (yes/no) resulting in eight possible combinations. Depending on the value of r, more or less risk will occur related to the decision-making. The utility function was evaluated in order to determine the probability of a decision. The decision was made with patients or administrators' opinions from a radiology service center. The model is a formal quantitative approach to make a decision related to the medical imaging quality, providing an instrument to discriminate what is really necessary to accept or reject a film or a film lot. The method presented herein can help to access the risk level of an incorrect radiological diagnosis decision.

  14. The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature.

    PubMed

    Georgiou, Andrew; Prgomet, Mirela; Paoloni, Richard; Creswick, Nerida; Hordern, Antonia; Walter, Scott; Westbrook, Johanna

    2013-06-01

    We undertake a systematic review of the quantitative literature related to the effect of computerized provider order entry systems in the emergency department (ED). We searched MEDLINE, EMBASE, Inspec, CINAHL, and CPOE.org for English-language studies published between January 1990 and May 2011. We identified 1,063 articles, of which 22 met our inclusion criteria. Sixteen used a pre/post design; 2 were randomized controlled trials. Twelve studies reported outcomes related to patient flow/clinical work, 7 examined decision support systems, and 6 reported effects on patient safety. There were no studies that measured decision support systems and its effect on patient flow/clinical work. Computerized provider order entry was associated with an increase in time spent on computers (up to 16.2% for nurses and 11.3% for physicians), with no significant change in time spent on patient care. Computerized provider order entry with decision support systems was related to significant decreases in prescribing errors (ranging from 17 to 201 errors per 100 orders), potential adverse drug events (0.9 per 100 orders), and prescribing of excessive dosages (31% decrease for a targeted set of renal disease medications). There are tangible benefits associated with computerized provider order entry/decision support systems in the ED environment. Nevertheless, when considered as part of a framework of technical, clinical, and organizational components of the ED, the evidence base is neither consistent nor comprehensive. Multimethod research approaches (including qualitative research) can contribute to understanding of the multiple dimensions of ED care delivery, not as separate entities but as essential components of a highly integrated system of care. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  15. Evaluation of real-time clinical decision support systems for platelet and cryoprecipitate orders.

    PubMed

    Collins, Ryan A; Triulzi, Darrell J; Waters, Jonathan H; Reddy, Vivek; Yazer, Mark H

    2014-01-01

    To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines. There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders. CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.

  16. On the Quality of Collective Decisions in Sociotechnical Systems: Transparency, Fairness, and Efficiency

    NASA Astrophysics Data System (ADS)

    Porello, Daniele

    The aim of this paper is to propose a methodology for evaluating the quality of collective decisions in sociotechnical systems (STS). We propose using a foundational ontology for conceptualizing the complex hierarchy of information involved in decisions in STS (e.g., normative, conceptual, factual, perceptual). Moreover, we introduce the concept of transparency of decisions as a necessary condition in order to assess the quality of decision-making in STS. We further view transparency as an entitlement of the agent affected by the decision: i.e., the collective decision should be justified.

  17. Formative Evaluation of a Generic Decision Aid for Classroom Use.

    ERIC Educational Resources Information Center

    Freeman, Jared T.; Guillen, Julio

    Results of a formative evaluation of a decision aid for students of taxonomic domains such as statistics or biology are reported. The tool, XPT-EASE, is designed to allow a student to search a taxonomy by traversing its branches in an arbitrary order, presumably the order simplest for the student, rather than by starting from the root node and…

  18. Regret and the rationality of choices

    PubMed Central

    Bourgeois-Gironde, Sacha

    2010-01-01

    Regret helps to optimize decision behaviour. It can be defined as a rational emotion. Several recent neurobiological studies have confirmed the interface between emotion and cognition at which regret is located and documented its role in decision behaviour. These data give credibility to the incorporation of regret in decision theory that had been proposed by economists in the 1980s. However, finer distinctions are required in order to get a better grasp of how regret and behaviour influence each other. Regret can be defined as a predictive error signal but this signal does not necessarily transpose into a decision-weight influencing behaviour. Clinical studies on several types of patients show that the processing of an error signal and its influence on subsequent behaviour can be dissociated. We propose a general understanding of how regret and decision-making are connected in terms of regret being modulated by rational antecedents of choice. Regret and the modification of behaviour on its basis will depend on the criteria of rationality involved in decision-making. We indicate current and prospective lines of research in order to refine our views on how regret contributes to optimal decision-making. PMID:20026463

  19. An Investment Behavior Analysis using by Brain Computer Interface

    NASA Astrophysics Data System (ADS)

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

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

  20. 12 CFR 367.20 - Review and reconsideration of Ethics Counselor decisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Review and reconsideration of Ethics Counselor... Review and reconsideration of Ethics Counselor decisions. (a) Review. (1) A suspended and/or excluded contractor may appeal the exclusion decision to the Corporation Ethics Committee. (2) In order to avail...

  1. 12 CFR 367.20 - Review and reconsideration of Ethics Counselor decisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Review and reconsideration of Ethics Counselor... Review and reconsideration of Ethics Counselor decisions. (a) Review. (1) A suspended and/or excluded contractor may appeal the exclusion decision to the Corporation Ethics Committee. (2) In order to avail...

  2. 12 CFR 367.20 - Review and reconsideration of Ethics Counselor decisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Review and reconsideration of Ethics Counselor... Review and reconsideration of Ethics Counselor decisions. (a) Review. (1) A suspended and/or excluded contractor may appeal the exclusion decision to the Corporation Ethics Committee. (2) In order to avail...

  3. 12 CFR 367.20 - Review and reconsideration of Ethics Counselor decisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Review and reconsideration of Ethics Counselor... Review and reconsideration of Ethics Counselor decisions. (a) Review. (1) A suspended and/or excluded contractor may appeal the exclusion decision to the Corporation Ethics Committee. (2) In order to avail...

  4. 12 CFR 367.20 - Review and reconsideration of Ethics Counselor decisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Review and reconsideration of Ethics Counselor... Review and reconsideration of Ethics Counselor decisions. (a) Review. (1) A suspended and/or excluded contractor may appeal the exclusion decision to the Corporation Ethics Committee. (2) In order to avail...

  5. 75 FR 1724 - Tart Cherries Grown in the States of Michigan, New York, Pennsylvania, Oregon, Utah, Washington...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ... States of Michigan, New York, Pennsylvania, Oregon, Utah, Washington, and Wisconsin; Secretary's Decision...: Agricultural Marketing Service, USDA. ACTION: Proposed rule and referendum order. SUMMARY: This decision...), and a Recommended Decision issued on May 7, 2009 and published in the May 12, 2009, issue of the...

  6. Acute knee injuries: use of decision rules for selective radiograph ordering.

    PubMed

    Tandeter, H B; Shvartzman, P; Stevens, Max A

    1999-12-01

    Family physicians often encounter patients with acute knee trauma. Radiographs of injured knees are commonly ordered, even though fractures are found in only 6 percent of such patients and emergency department physicians can usually discriminate clinically between fracture and nonfracture. Decision rules have been developed to reduce the unnecessary use of radiologic studies in patients with acute knee injury. The Ottawa knee rules and the Pittsburgh decision rules are the latest guidelines for the selective use of radiographs in knee trauma. Application of these rules may lead to a more efficient evaluation of knee injuries and a reduction in health costs without an increase in adverse outcomes.

  7. Is it the time to rethink clinical decision-making strategies? From a single clinical outcome evaluation to a Clinical Multi-criteria Decision Assessment (CMDA).

    PubMed

    Migliore, Alberto; Integlia, Davide; Bizzi, Emanuele; Piaggio, Tomaso

    2015-10-01

    There are plenty of different clinical, organizational and economic parameters to consider in order having a complete assessment of the total impact of a pharmaceutical treatment. In the attempt to follow, a holistic approach aimed to provide an evaluation embracing all clinical parameters in order to choose the best treatments, it is necessary to compare and weight multiple criteria. Therefore, a change is required: we need to move from a decision-making context based on the assessment of one single criteria towards a transparent and systematic framework enabling decision makers to assess all relevant parameters simultaneously in order to choose the best treatment to use. In order to apply the MCDA methodology to clinical decision making the best pharmaceutical treatment (or medical devices) to use to treat a specific pathology, we suggest a specific application of the Multiple Criteria Decision Analysis for the purpose, like a Clinical Multi-criteria Decision Assessment CMDA. In CMDA, results from both meta-analysis and observational studies are used by a clinical consensus after attributing weights to specific domains and related parameters. The decision will result from a related comparison of all consequences (i.e., efficacy, safety, adherence, administration route) existing behind the choice to use a specific pharmacological treatment. The match will yield a score (in absolute value) that link each parameter with a specific intervention, and then a final score for each treatment. The higher is the final score; the most appropriate is the intervention to treat disease considering all criteria (domain an parameters). The results will allow the physician to evaluate the best clinical treatment for his patients considering at the same time all relevant criteria such as clinical effectiveness for all parameters and administration route. The use of CMDA model will yield a clear and complete indication of the best pharmaceutical treatment to use for patients, helping physicians to choose drugs with a complete set of information, imputed in the model. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Despite Best Intentions: A Critical Analysis of Social Justice Leadership and Decision Making

    ERIC Educational Resources Information Center

    DeMatthews, David E.; Mungal, Angus Shiva; Carrola, Paul A.

    2015-01-01

    The purpose of this article is to explore the relationship between social justice leadership and organizational decision making in order to make recommendations for how principals can make more socially just decisions in difficult school contexts. This article begins with a discussion of social justice leadership, facets and theories associated…

  9. 7 CFR 247.33 - Fair hearings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... benefits until a decision on the appeal is made by the hearing official, or until the end of the... conducted in an orderly manner, in accordance with due process; and (5) Making a hearing decision. (j) How... and regulations, and is based on the facts in the hearing record. In making the decision, the hearing...

  10. Developing an Interactive Data Visualization Tool to Assess the Impact of Decision Support on Clinical Operations.

    PubMed

    Huber, Timothy C; Krishnaraj, Arun; Monaghan, Dayna; Gaskin, Cree M

    2018-05-18

    Due to mandates from recent legislation, clinical decision support (CDS) software is being adopted by radiology practices across the country. This software provides imaging study decision support for referring providers at the point of order entry. CDS systems produce a large volume of data, providing opportunities for research and quality improvement. In order to better visualize and analyze trends in this data, an interactive data visualization dashboard was created using a commercially available data visualization platform. Following the integration of a commercially available clinical decision support product into the electronic health record, a dashboard was created using a commercially available data visualization platform (Tableau, Seattle, WA). Data generated by the CDS were exported from the data warehouse, where they were stored, into the platform. This allowed for real-time visualization of the data generated by the decision support software. The creation of the dashboard allowed the output from the CDS platform to be more easily analyzed and facilitated hypothesis generation. Integrating data visualization tools into clinical decision support tools allows for easier data analysis and can streamline research and quality improvement efforts.

  11. Law and Order: Conflict and Dissent in the Primary Grades

    ERIC Educational Resources Information Center

    Weaver, V. Phillips

    1971-01-01

    Participation in decision making, role playing, inquiry into community current events, and study of law and order in urban units facilitate learning concepts of law, order, conflict, and dissent. (VW)

  12. Decision Making in the Reward and Punishment Variants of the Iowa Gambling Task: Evidence of “Foresight” or “Framing”?

    PubMed Central

    Singh, Varsha; Khan, Azizuddin

    2012-01-01

    Surface-level differences in the reward and punishment variants, specifically greater long-term decision making in the punishment variant of the Iowa Gambling Task (IGT) observed in previous studies led to the present comparison of long-term decision making in the two IGT variants (n = 320, male = 160). It was contended that risk aversion triggered by a positive frame of the reward variant and risk seeking triggered by a negative frame of the punishment variant appears as long-term decision making in the two IGT variants. Apart from the frame of the variant as a within-subjects factor (variant type: reward and punishment), the order in which the frame was triggered (order type: reward–punishment or punishment–reward), and the four types of instructions that delineated motivation toward reward from that of punishment (reward, punishment, reward and punishment, and no-hint) were hypothesized to have an effect on foresighted decision making in the IGT. As expected, long-term decision making differed across the two IGT variants suggesting that the frame of the variant has an effect on long-term decision making in the IGT (p < 0.001). The order in which a variant was presented, and the type of the instructions that were used both had an effect on long-term decision making in the two IGT variants (p < 0.05). A post hoc test suggested that the instructions that differentiated between reward and punishment resulted in greater foresight than the commonly used IGT instructions that fail to distinguish between reward and punishment. As observed in previous studies, there were more number of participants (60%) who showed greater foresight in the punishment variant than in the reward variant (p < 0.001). The results suggest that foresight in IGT decision making is sensitive to reward and punishment frame in an asymmetric manner, an observation that is aligned with the behavioral decision making framework. Benefits of integrating findings from behavioral studies in decision neuroscience are discussed, and a need to investigate cultural differences in the IGT studies is pointed out. PMID:22833714

  13. Decision making in the reward and punishment variants of the iowa gambling task: evidence of "foresight" or "framing"?

    PubMed

    Singh, Varsha; Khan, Azizuddin

    2012-01-01

    Surface-level differences in the reward and punishment variants, specifically greater long-term decision making in the punishment variant of the Iowa Gambling Task (IGT) observed in previous studies led to the present comparison of long-term decision making in the two IGT variants (n = 320, male = 160). It was contended that risk aversion triggered by a positive frame of the reward variant and risk seeking triggered by a negative frame of the punishment variant appears as long-term decision making in the two IGT variants. Apart from the frame of the variant as a within-subjects factor (variant type: reward and punishment), the order in which the frame was triggered (order type: reward-punishment or punishment-reward), and the four types of instructions that delineated motivation toward reward from that of punishment (reward, punishment, reward and punishment, and no-hint) were hypothesized to have an effect on foresighted decision making in the IGT. As expected, long-term decision making differed across the two IGT variants suggesting that the frame of the variant has an effect on long-term decision making in the IGT (p < 0.001). The order in which a variant was presented, and the type of the instructions that were used both had an effect on long-term decision making in the two IGT variants (p < 0.05). A post hoc test suggested that the instructions that differentiated between reward and punishment resulted in greater foresight than the commonly used IGT instructions that fail to distinguish between reward and punishment. As observed in previous studies, there were more number of participants (60%) who showed greater foresight in the punishment variant than in the reward variant (p < 0.001). The results suggest that foresight in IGT decision making is sensitive to reward and punishment frame in an asymmetric manner, an observation that is aligned with the behavioral decision making framework. Benefits of integrating findings from behavioral studies in decision neuroscience are discussed, and a need to investigate cultural differences in the IGT studies is pointed out.

  14. 17 CFR 201.360 - Initial decision of hearing officer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... with the Secretary, as well as any other time limits established in orders issued by the hearing... include: Findings and conclusions, and the reasons or basis therefor, as to all the material issues of... decision, except for good cause shown, within which a petition for review of the initial decision may be...

  15. 21 CFR 1.405 - When does FDA have to issue a decision on an appeal?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false When does FDA have to issue a decision on an... Consumption What Is the Appeal Process for A Detention Order? § 1.405 When does FDA have to issue a decision... final decision within the 5-calendar day period after the appeal is filed. If FDA either fails to...

  16. 21 CFR 1.405 - When does FDA have to issue a decision on an appeal?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false When does FDA have to issue a decision on an... Consumption What Is the Appeal Process for A Detention Order? § 1.405 When does FDA have to issue a decision... final decision within the 5-calendar day period after the appeal is filed. If FDA either fails to...

  17. 21 CFR 1.405 - When does FDA have to issue a decision on an appeal?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false When does FDA have to issue a decision on an... Consumption What Is the Appeal Process for A Detention Order? § 1.405 When does FDA have to issue a decision... final decision within the 5-calendar day period after the appeal is filed. If FDA either fails to...

  18. 21 CFR 1.405 - When does FDA have to issue a decision on an appeal?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false When does FDA have to issue a decision on an... Consumption What Is the Appeal Process for A Detention Order? § 1.405 When does FDA have to issue a decision... final decision within the 5-calendar day period after the appeal is filed. If FDA either fails to...

  19. 21 CFR 1.405 - When does FDA have to issue a decision on an appeal?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false When does FDA have to issue a decision on an... Consumption What Is the Appeal Process for A Detention Order? § 1.405 When does FDA have to issue a decision... final decision within the 5-calendar day period after the appeal is filed. If FDA either fails to...

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

    DOEpatents

    Hodgin, C Reed [Westminster, CO

    2012-03-20

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

  1. Taking Decisions: Assessment for University Entry

    ERIC Educational Resources Information Center

    Plassmann, Sibylle; Zeidler, Beate

    2014-01-01

    Language testing means taking decisions: about the test taker's results, but also about the test construct and the measures taken in order to ensure quality. This article takes the German test "telc Deutsch C1 Hochschule" as an example to illustrate this decision-making process in an academic context. The test is used for university…

  2. When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation.

    PubMed

    Djulbegovic, Benjamin; van den Ende, Jef; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Pauker, Stephen G

    2015-05-01

    The threshold model represents an important advance in the field of medical decision-making. It is a linchpin between evidence (which exists on the continuum of credibility) and decision-making (which is a categorical exercise - we decide to act or not act). The threshold concept is closely related to the question of rational decision-making. When should the physician act, that is order a diagnostic test, or prescribe treatment? The threshold model embodies the decision theoretic rationality that says the most rational decision is to prescribe treatment when the expected treatment benefit outweighs its expected harms. However, the well-documented large variation in the way physicians order diagnostic tests or decide to administer treatments is consistent with a notion that physicians' individual action thresholds vary. We present a narrative review summarizing the existing literature on physicians' use of a threshold strategy for decision-making. We found that the observed variation in decision action thresholds is partially due to the way people integrate benefits and harms. That is, explanation of variation in clinical practice can be reduced to a consideration of thresholds. Limited evidence suggests that non-expected utility threshold (non-EUT) models, such as regret-based and dual-processing models, may explain current medical practice better. However, inclusion of costs and recognition of risk attitudes towards uncertain treatment effects and comorbidities may improve the explanatory and predictive value of the EUT-based threshold models. The decision when to act is closely related to the question of rational choice. We conclude that the medical community has not yet fully defined criteria for rational clinical decision-making. The traditional notion of rationality rooted in EUT may need to be supplemented by reflective rationality, which strives to integrate all aspects of medical practice - medical, humanistic and socio-economic - within a coherent reasoning system. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  3. The Associations Between the Religious Background, Social Supports, and Do-Not-Resuscitate Orders in Taiwan

    PubMed Central

    Lin, Kuan-Han; Chen, Yih-Sharng; Chou, Nai-Kuan; Huang, Sheng-Jean; Wu, Chau-Chung; Chen, Yen-Yuan

    2016-01-01

    Abstract Prior studies have demonstrated important implications related to religiosity and a do-not-resuscitate (DNR) decision. However, the association between patients’ religious background and DNR decisions is vague. In particular, the association between the religious background of Buddhism/Daoism and DNR decisions has never been examined. The objective of this study was to examine the association between patients’ religious background and their DNR decisions, with a particular focus on Buddhism/Daoism. The medical records of the patients who were admitted to the 3 surgical intensive care units (SICU) in a university-affiliated medical center located at Northern Taiwan from June 1, 2011 to December 31, 2013 were retrospectively collected. We compared the clinical/demographic variables of DNR patients with those of non-DNR patients using the Student t test or χ2 test depending on the scale of the variables. We used multivariate logistic regression analysis to examine the association between the religious backgrounds and DNR decisions. A sample of 1909 patients was collected: 122 patients had a DNR order; and 1787 patients did not have a DNR order. Old age (P = 0.02), unemployment (P = 0.02), admission diagnosis of “nonoperative, cardiac failure/insufficiency” (P = 0.03), and severe acute illness at SICU admission (P < 0.01) were significantly associated with signing of DNR orders. Patients’ religious background of Buddhism/Daoism (P = 0.04), married marital status (P = 0.02), and admission diagnosis of “postoperative, major surgery” (P = 0.02) were less likely to have a DNR order written during their SICU stay. Furthermore, patients with poor social support, as indicated by marital and working status, were more likely to consent to a DNR order during SICU stay. This study showed that the religious background of Buddhism/Daoism was significantly associated with a lower likelihood of consenting to a DNR, and poor social support was significantly associated with a higher likelihood of having a DNR order written during SICU stay. PMID:26817913

  4. The Associations Between the Religious Background, Social Supports, and Do-Not-Resuscitate Orders in Taiwan: An Observational Study.

    PubMed

    Lin, Kuan-Han; Chen, Yih-Sharng; Chou, Nai-Kuan; Huang, Sheng-Jean; Wu, Chau-Chung; Chen, Yen-Yuan

    2016-01-01

    Prior studies have demonstrated important implications related to religiosity and a do-not-resuscitate (DNR) decision. However, the association between patients' religious background and DNR decisions is vague. In particular, the association between the religious background of Buddhism/Daoism and DNR decisions has never been examined. The objective of this study was to examine the association between patients' religious background and their DNR decisions, with a particular focus on Buddhism/Daoism.The medical records of the patients who were admitted to the 3 surgical intensive care units (SICU) in a university-affiliated medical center located at Northern Taiwan from June 1, 2011 to December 31, 2013 were retrospectively collected. We compared the clinical/demographic variables of DNR patients with those of non-DNR patients using the Student t test or χ test depending on the scale of the variables. We used multivariate logistic regression analysis to examine the association between the religious backgrounds and DNR decisions.A sample of 1909 patients was collected: 122 patients had a DNR order; and 1787 patients did not have a DNR order. Old age (P = 0.02), unemployment (P = 0.02), admission diagnosis of "nonoperative, cardiac failure/insufficiency" (P = 0.03), and severe acute illness at SICU admission (P < 0.01) were significantly associated with signing of DNR orders. Patients' religious background of Buddhism/Daoism (P = 0.04), married marital status (P = 0.02), and admission diagnosis of "postoperative, major surgery" (P = 0.02) were less likely to have a DNR order written during their SICU stay. Furthermore, patients with poor social support, as indicated by marital and working status, were more likely to consent to a DNR order during SICU stay.This study showed that the religious background of Buddhism/Daoism was significantly associated with a lower likelihood of consenting to a DNR, and poor social support was significantly associated with a higher likelihood of having a DNR order written during SICU stay.

  5. Comparison of display enhancement with intelligent decision-aiding

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex; Markert, Wendy J.; Kossack, Merrick

    1992-01-01

    Currently, two main approaches exist for improving the human-machine interface component of a system in order to improve overall system performance, display enhancement and intelligent decision aiding. Each of these two approaches has its own set of advantages and disadvantages, as well as introduce its own set of additional performance problems. These characteristics should help identify which types of problem situations and domains are better aided by which type of strategy. The characteristic issues are described of these two decision aiding strategies. Then differences in expert and novice decision making are described in order to help determine whether a particular strategy may be better for a particular type of user. Finally, research is outlined to compare and contrast the two technologies, as well as to examine the interaction effects introduced by the different skill levels and the different methods for training operators.

  6. Integrating multi-criteria evaluation techniques with geographic information systems for landfill site selection: a case study using ordered weighted average.

    PubMed

    Gorsevski, Pece V; Donevska, Katerina R; Mitrovski, Cvetko D; Frizado, Joseph P

    2012-02-01

    This paper presents a GIS-based multi-criteria decision analysis approach for evaluating the suitability for landfill site selection in the Polog Region, Macedonia. The multi-criteria decision framework considers environmental and economic factors which are standardized by fuzzy membership functions and combined by integration of analytical hierarchy process (AHP) and ordered weighted average (OWA) techniques. The AHP is used for the elicitation of attribute weights while the OWA operator function is used to generate a wide range of decision alternatives for addressing uncertainty associated with interaction between multiple criteria. The usefulness of the approach is illustrated by different OWA scenarios that report landfill suitability on a scale between 0 and 1. The OWA scenarios are intended to quantify the level of risk taking (i.e., optimistic, pessimistic, and neutral) and to facilitate a better understanding of patterns that emerge from decision alternatives involved in the decision making process. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Value judgements in the decision-making process for the elderly patient.

    PubMed

    Ubachs-Moust, J; Houtepen, R; Vos, R; ter Meulen, R

    2008-12-01

    The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is possible to analyse the way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician's decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic "ageist" pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician-patient relationship, creating confidence and trust, which are at the heart of medical practice.

  8. A programmable rules engine to provide clinical decision support using HTML forms.

    PubMed

    Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

    1999-01-01

    The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

  9. Unified framework for triaxial accelerometer-based fall event detection and classification using cumulants and hierarchical decision tree classifier.

    PubMed

    Kambhampati, Satya Samyukta; Singh, Vishal; Manikandan, M Sabarimalai; Ramkumar, Barathram

    2015-08-01

    In this Letter, the authors present a unified framework for fall event detection and classification using the cumulants extracted from the acceleration (ACC) signals acquired using a single waist-mounted triaxial accelerometer. The main objective of this Letter is to find suitable representative cumulants and classifiers in effectively detecting and classifying different types of fall and non-fall events. It was discovered that the first level of the proposed hierarchical decision tree algorithm implements fall detection using fifth-order cumulants and support vector machine (SVM) classifier. In the second level, the fall event classification algorithm uses the fifth-order cumulants and SVM. Finally, human activity classification is performed using the second-order cumulants and SVM. The detection and classification results are compared with those of the decision tree, naive Bayes, multilayer perceptron and SVM classifiers with different types of time-domain features including the second-, third-, fourth- and fifth-order cumulants and the signal magnitude vector and signal magnitude area. The experimental results demonstrate that the second- and fifth-order cumulant features and SVM classifier can achieve optimal detection and classification rates of above 95%, as well as the lowest false alarm rate of 1.03%.

  10. Higher-order risk preferences in social settings.

    PubMed

    Heinrich, Timo; Mayrhofer, Thomas

    2018-01-01

    We study prudence and temperance (next to risk aversion) in social settings. Previous experimental studies have shown that these higher-order risk preferences affect the choices of individuals deciding privately on lotteries that only affect their own payoff. Yet, many risky and financially relevant decisions are made in the social settings of households or organizations. We elicit higher-order risk preferences of individuals and systematically vary how an individual's decision is made (alone or while communicating with a partner) and who is affected by the decision (only the individual or the partner as well). In doing so, we can isolate the effects of other-regarding concerns and communication on choices. Our results reveal that the majority of choices are risk averse, prudent, and temperate across social settings. We also observe that individuals are influenced significantly by the preferences of a partner when they are able to communicate and choices are payoff-relevant for both of them.

  11. Marine Steam Condenser Design Optimization.

    DTIC Science & Technology

    1983-12-01

    to make design decisions to obtain a feasible design. CONNIN, as do most optimizers, requires complete control in determining all iterative design...neutralize all the places where such design decisions are made. By removing the ability for CONDIP to make any design decisions it became totally passive...dependent on CONNIN for design decisions , does not have that capability. Pemeabering that CONHIN requires a complete once-through analysis in order to

  12. Stopping decisions: information order effects on nonfocal evaluations.

    PubMed

    Yu, Michael; Gonzalez, Cleotilde

    2013-08-01

    We investigated how the order in which information is presented affects when a person decides to stop performing a task. A stopping decision is a decision to stop performing a task on the basis of a sequence of cues. Previous order-effects models do not account for how these contexts limit available working memory for making such decisions. Participants decided how long to perform a task known as the Work Hazard Game that began by rewarding points but later cost points if work continued after an unannounced "emergency." An additive sequence of cues indicated the probability of an emergency. Study I involved a three-group design with cue sequences that indicated the same risk at each decision point but whose final cue presented a high, medium, or low probability. Study 2 had a 2 x 2 design with high or low final cues and an easy or a challenging task. In Study I, participants stopped sooner when the most recent cue presented a high rather than low probability (p = .09), despite the same emergency risk. In Study 2, participants stopped sooner when the most recent cue presented a high rather than low probability for the challenging task but not for the easy task (p = .08). Stopping decisions appear sensitive to the most recent cue observed while experiencing task load. Participants responded to the same risks differently only on the basis of a change in presentation. Findings may be relevant for research and training for hazardous jobs, such as subsurface coal mining, fishing, and trucking.

  13. 7 CFR 900.66 - Consideration of appeal by the Secretary and issuance of final order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts... Judge's decision as the final order of the Secretary, preserving any right of the party bringing the...

  14. Development and Validation of a Decision-Making Questionnaire

    ERIC Educational Resources Information Center

    Lizarraga, Maria Luisa Sanz De Acedo; Baquedano, Maria Teresa Sanz De Acedo; Oliver, Maria Soria; Closas, Antonio

    2009-01-01

    The "Decision-Making Questionnaire" (DMQ) was developed and validated in order to examine the factors that affect decision making. The investigation was carried out with two samples, one of 170 participants and the other of 425 of both sexes. Each sample was divided into three age ranges: young students (18-25 years), adults (26-60…

  15. An Examination of Accelerated and Basic Baccalaureate Nursing Students' Perceptions of Clinical Decision Making

    ERIC Educational Resources Information Center

    Krumwiede, Kelly A.

    2010-01-01

    Developing decision-making skills is essential in education in order to be a competent nurse. The purpose of this study was to examine and compare the perceptions of clinical decision-making skills of students enrolled in accelerated and basic baccalaureate nursing programs. A comparative descriptive research design was used for this study.…

  16. 78 FR 19424 - Service Rules for the 698-746, 747-762 and 777-792 MHz Bands; Revision of the Commission's Rules...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-01

    ... Reconsideration (MO&O) denies or dismisses petitions seeking reconsideration of certain decisions made by the Commission in the 700 MHz Second Report and Order, relating to the 698-806 MHz Band, including decisions..., public safety narrowband relocation procedures, and the decisions not to impose wholesale requirements...

  17. Decision Support from Local Data: Creating Adaptive Order Menus from Past Clinician Behavior

    PubMed Central

    Klann, Jeffrey G.; Szolovits, Peter; Downs, Stephen; Schadow, Gunther

    2014-01-01

    Objective Reducing care variability through guidelines has significantly benefited patients. Nonetheless, guideline-based clinical decision support (CDS) systems are not widely implemented or used, are frequently out-of-date, and cannot address complex care for which guidelines do not exist. Here, we develop and evaluate a complementary approach - using Bayesian network (BN) learning to generate adaptive, context-specific treatment menus based on local order-entry data. These menus can be used as a draft for expert review, in order to minimize development time for local decision support content. This is in keeping with the vision outlined in the US Health Information Technology Strategic Plan, which describes a healthcare system that learns from itself. Materials and Methods We used the Greedy Equivalence Search algorithm to learn four 50-node domain-specific BNs from 11,344 encounters: abdominal pain in the emergency department, inpatient pregnancy, hypertension in the urgent visit clinic, and altered mental state in the intensive care unit. We developed a system to produce situation-specific, rank-ordered treatment menus from these networks. We evaluated this system with a hospital-simulation methodology and computed Area Under the Receiver-Operator Curve (AUC) and average menu position at time of selection. We also compared this system with a similar association-rule-mining approach. Results A short order menu on average contained the next order (weighted average length 3.91–5.83 items). Overall predictive ability was good: average AUC above 0.9 for 25% of order types and overall average AUC .714–.844 (depending on domain). However, AUC had high variance (.50–.99). Higher AUC correlated with tighter clusters and more connections in the graphs, indicating importance of appropriate contextual data. Comparison with an association rule mining approach showed similar performance for only the most common orders with dramatic divergence as orders are less frequent. Discussion and Conclusion This study demonstrates that local clinical knowledge can be extracted from treatment data for decision support. This approach is appealing because: it reflects local standards; it uses data already being captured; and it produces human-readable treatment-diagnosis networks that could be curated by a human expert to reduce workload in developing localized CDS content. The BN methodology captured transitive associations and co-varying relationships, which existing approaches do not. It also performs better as orders become less frequent and require more context. This system is a step forward in harnessing local, empirical data to enhance decision support. PMID:24355978

  18. Decision-Making as a Struggle and a Play: On Alternative Rationalities in Schools as Organizations

    ERIC Educational Resources Information Center

    Salo, Petri

    2008-01-01

    In this article an alternative interpretation of the functions of decision-making and the inherent activities at teachers' meetings at schools are presented. The metaphor of "play" is introduced in order to make the teachers' actions during decision-making comprehensible, not only for outsiders, but more importantly for "involved insiders", such…

  19. The Effect of Wilderness Therapy on Adolescents' Cognitive Autonomy and Self-Efficacy: Results of a Non-Randomized Trial

    ERIC Educational Resources Information Center

    Margalit, Daniella; Ben-Ari, Amichai

    2014-01-01

    Background: Adolescents participate in decision-making processes involving risky behaviors. Management of these important decisions may be promoted by enhancing adolescents' self-efficacy beliefs and cognitive autonomy. Objective: In order to elucidate the value of wilderness therapy to the successful management of decision making processes among…

  20. Fear, Panic, and Injustice: Executive Order 9066--A Lesson for Grades 4-6

    ERIC Educational Resources Information Center

    McCormick, Theresa M.

    2008-01-01

    Decision making is one of the essential skills advocated by the National Council for the Social Studies for effective citizenship in a democratic society. Leaders in any society make decisions that influence many lives. In a democratic society, we expect that deductive and inductive reasoning guide decisions made for the common good. However, what…

  1. Application of the fuzzy topsis multi-attribute decision making method to determine scholarship recipients

    NASA Astrophysics Data System (ADS)

    Irvanizam, I.

    2018-03-01

    Some scholarships have been routinely offered by Ministry of Research, Technology and Higher Education of the Republic of Indonesia for students at Syiah Kuala University. In reality, the scholarship selection process is becoming subjective and highly complex problem. Multi-Attribute Decision Making (MADM) techniques can be a solution in order to solve scholarship selection problem. In this study, we demonstrated the application of a fuzzy TOPSIS as an MADM technique by using a numerical example in order to calculate a triangular fuzzy number for the fuzzy data onto a normalized weight. We then use this normalized value to construct the normalized fuzzy decision matrix. We finally use the fuzzy TOPSIS to rank alternatives in descending order based on the relative closeness to the ideal solution. The result in terms of final ranking shows slightly different from the previous work.

  2. Decision support from local data: creating adaptive order menus from past clinician behavior.

    PubMed

    Klann, Jeffrey G; Szolovits, Peter; Downs, Stephen M; Schadow, Gunther

    2014-04-01

    Reducing care variability through guidelines has significantly benefited patients. Nonetheless, guideline-based Clinical Decision Support (CDS) systems are not widely implemented or used, are frequently out-of-date, and cannot address complex care for which guidelines do not exist. Here, we develop and evaluate a complementary approach - using Bayesian Network (BN) learning to generate adaptive, context-specific treatment menus based on local order-entry data. These menus can be used as a draft for expert review, in order to minimize development time for local decision support content. This is in keeping with the vision outlined in the US Health Information Technology Strategic Plan, which describes a healthcare system that learns from itself. We used the Greedy Equivalence Search algorithm to learn four 50-node domain-specific BNs from 11,344 encounters: abdominal pain in the emergency department, inpatient pregnancy, hypertension in the Urgent Visit Clinic, and altered mental state in the intensive care unit. We developed a system to produce situation-specific, rank-ordered treatment menus from these networks. We evaluated this system with a hospital-simulation methodology and computed Area Under the Receiver-Operator Curve (AUC) and average menu position at time of selection. We also compared this system with a similar association-rule-mining approach. A short order menu on average contained the next order (weighted average length 3.91-5.83 items). Overall predictive ability was good: average AUC above 0.9 for 25% of order types and overall average AUC .714-.844 (depending on domain). However, AUC had high variance (.50-.99). Higher AUC correlated with tighter clusters and more connections in the graphs, indicating importance of appropriate contextual data. Comparison with an Association Rule Mining approach showed similar performance for only the most common orders with dramatic divergence as orders are less frequent. This study demonstrates that local clinical knowledge can be extracted from treatment data for decision support. This approach is appealing because: it reflects local standards; it uses data already being captured; and it produces human-readable treatment-diagnosis networks that could be curated by a human expert to reduce workload in developing localized CDS content. The BN methodology captured transitive associations and co-varying relationships, which existing approaches do not. It also performs better as orders become less frequent and require more context. This system is a step forward in harnessing local, empirical data to enhance decision support. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Application of TOPSIS and VIKOR improved versions in a multi criteria decision analysis to develop an optimized municipal solid waste management model.

    PubMed

    Aghajani Mir, M; Taherei Ghazvinei, P; Sulaiman, N M N; Basri, N E A; Saheri, S; Mahmood, N Z; Jahan, A; Begum, R A; Aghamohammadi, N

    2016-01-15

    Selecting a suitable Multi Criteria Decision Making (MCDM) method is a crucial stage to establish a Solid Waste Management (SWM) system. Main objective of the current study is to demonstrate and evaluate a proposed method using Multiple Criteria Decision Making methods (MCDM). An improved version of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) applied to obtain the best municipal solid waste management method by comparing and ranking the scenarios. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Besides, Viekriterijumsko Kompromisno Rangiranje (VIKOR) compromise solution method applied for sensitivity analyses. The proposed method can assist urban decision makers in prioritizing and selecting an optimized Municipal Solid Waste (MSW) treatment system. Besides, a logical and systematic scientific method was proposed to guide an appropriate decision-making. A modified TOPSIS methodology as a superior to existing methods for first time was applied for MSW problems. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Next, 11 scenarios of MSW treatment methods are defined and compared environmentally and economically based on the waste management conditions. Results show that integrating a sanitary landfill (18.1%), RDF (3.1%), composting (2%), anaerobic digestion (40.4%), and recycling (36.4%) was an optimized model of integrated waste management. An applied decision-making structure provides the opportunity for optimum decision-making. Therefore, the mix of recycling and anaerobic digestion and a sanitary landfill with Electricity Production (EP) are the preferred options for MSW management. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. 29 CFR 417.15 - Decision of the Assistant Secretary.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Adequacy of Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.15 Decision... of the constitution and bylaws for the purpose of removing officers, or shall order such further...

  5. 29 CFR 417.15 - Decision of the Assistant Secretary.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Adequacy of Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.15 Decision... of the constitution and bylaws for the purpose of removing officers, or shall order such further...

  6. 29 CFR 417.15 - Decision of the Assistant Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Adequacy of Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.15 Decision... of the constitution and bylaws for the purpose of removing officers, or shall order such further...

  7. Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

    PubMed

    Kawamoto, Kensaku; Lobach, David F

    2003-01-01

    Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.

  8. Simulated Order Verification and Medication Reconciliation during an Introductory Pharmacy Practice Experience.

    PubMed

    Metzger, Nicole L; Chesson, Melissa M; Momary, Kathryn M

    2015-09-25

    Objective. To create, implement, and assess a simulated medication reconciliation and an order verification activity using hospital training software. Design. A simulated patient with medication orders and home medications was built into existing hospital training software. Students in an institutional introductory pharmacy practice experience (IPPE) reconciled the patient's medications and determined whether or not to verify the inpatient orders based on his medical history and laboratory data. After reconciliation, students identified medication discrepancies and documented their rationale for rejecting inpatient orders. Assessment. For a 3-year period, the majority of students agreed the simulation enhanced their learning, taught valuable clinical decision-making skills, integrated material from previous courses, and stimulated their interest in institutional pharmacy. Overall feedback from student evaluations about the IPPE also was favorable. Conclusion. Use of existing hospital training software can affordably simulate the pharmacist's role in order verification and medication reconciliation, as well as improve clinical decision-making.

  9. 40 CFR 164.122 - Final order and order of suspension.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... 164.122 Section 164.122 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... Environmental Appeals Board shall issue a final decision and order. Such final order may accept or reject in...

  10. 40 CFR 164.122 - Final order and order of suspension.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 164.122 Section 164.122 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... Environmental Appeals Board shall issue a final decision and order. Such final order may accept or reject in...

  11. 29 CFR 25.7 - Fees; cost; expenses; decisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Fees; cost; expenses; decisions. 25.7 Section 25.7 Labor... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses... entirely by the agency. (b) The standard fee for the services of an arbitrator should be $100 per day...

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

    ERIC Educational Resources Information Center

    Godreau Cimma, Kelly L.

    2011-01-01

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

  13. Development of Asset Management Decision Support Tools for Power Equipment

    NASA Astrophysics Data System (ADS)

    Okamoto, Tatsuki; Takahashi, Tsuguhiro

    Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

  14. 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.

  15. Family Matters: Effects of Birth Order, Culture, and Family Dynamics on Surrogate Decision Making

    PubMed Central

    Su, Christopher T.; McMahan, Ryan D.; Williams, Brie A.; Sharma, Rashmi K.; Sudore, Rebecca L.

    2014-01-01

    Cultural attitudes about medical decision making and filial expectations may lead some surrogates to experience stress and family conflict. Thirteen focus groups with racially and ethnically diverse English- and Spanish-speakers from county and Veterans hospitals, senior centers, and cancer support groups were conducted to describe participants’ experiences making serious or end-of-life decisions for others. Filial expectations and family dynamics related to birth order and surrogate decision making were explored using qualitative, thematic content analysis and overarching themes from focus group transcripts were identified. The mean age of the 69 participants was 69 years ± 14 and 29% were African American, 26% were White, 26% were Asian/Pacific Islander, and 19% were Latino. Seventy percent of participants engaged in unprompted discussions about birth order and family dynamics. Six subthemes were identified within 3 overarching categories of communication, emotion, and conflict: Communication – (1) unspoken expectations and (2) discussion of death as taboo; Emotion – (3) emotional stress and (4) feelings of loneliness; and Conflict – (5) family conflict and (6) potential solutions to prevent conflict. These findings suggest that birth order and family dynamics can have profound effects on surrogate stress and coping. Clinicians should be aware of potential unspoken filial expectations for firstborns and help facilitate communication between the patient, surrogate, and extended family to reduce stress and conflict. PMID:24383459

  16. Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making.

    PubMed

    Su, Christopher T; McMahan, Ryan D; Williams, Brie A; Sharma, Rashmi K; Sudore, Rebecca L

    2014-01-01

    Cultural attitudes about medical decision-making and filial expectations may lead some surrogates to experience stress and family conflict. Thirteen focus groups with racially and ethnically diverse English and Spanish speakers from county and Veterans Affairs hospitals, senior centers, and cancer support groups were conducted to describe participants' experiences making serious or end-of-life decisions for others. Filial expectations and family dynamics related to birth order and surrogate decision-making were explored using qualitative, thematic content analysis, and overarching themes from focus group transcripts were identified. The mean age of the 69 participants was 69 ± 14, and 29% were African American, 26% were white, 26% were Asian or Pacific Islander, and 19% were Latino. Seventy percent of participants engaged in unprompted discussions about birth order and family dynamics. Six subthemes were identified within three overarching categories: communication (unspoken expectations and discussion of death as taboo), emotion (emotional stress and feelings of loneliness), and conflict (family conflict and potential solutions to prevent conflict). These findings suggest that birth order and family dynamics can have profound effects on surrogate stress and coping. Clinicians should be aware of potential unspoken filial expectations for firstborns and help facilitate communication between the patient, surrogate, and extended family to reduce stress and conflict. © Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

  17. An overview of bipolar qualitative decision rules

    NASA Astrophysics Data System (ADS)

    Bonnefon, Jean-Francois; Dubois, Didier; Fargier, Hélène

    Making a good decision is often a matter of listing and comparing positive and negative arguments, as studies in cognitive psychology have shown. In such cases, the evaluation scale should be considered bipolar, that is, negative and positive values are explicitly distinguished. Generally, positive and negative features are evaluated separately, as done in Cumulative Prospect Theory. However, contrary to the latter framework that presupposes genuine numerical assessments, decisions are often made on the basis of an ordinal ranking of the pros and the cons, and focusing on the most salient features, i.e., the decision process is qualitative. In this paper, we report on a project aiming at characterizing several decision rules, based on possibilistic order of magnitude reasoning, and tailored for the joint handling of positive and negative affects, and at testing their empirical validity. The simplest rules can be viewed as extensions of the maximin and maximax criteria to the bipolar case and, like them, suffer from a lack of discrimination power. More decisive rules that refine them are also proposed. They account for both the principle of Pareto-efficiency and the notion of order of magnitude reasoning. The most decisive one uses a lexicographic ranking of the pros and cons. It comes down to a special case of Cumulative Prospect Theory, and subsumes the “Take the best” heuristic.

  18. 25 CFR 584.3 - How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure, the Chair's decision to void or modify a management contract, the Commission's proposal to remove a certificate of self-regulation, the Chair's decision to approve or object to a tribal gaming regulatory...

  19. 25 CFR 585.3 - How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false How do I appeal a notice of violation, proposed civil fine assessment, order of temporary closure, the Chair's decision to void or modify a management contract, the Commission's proposal to remove a certificate of self regulation, the Chair's decision to approve or object to a tribal gaming regulatory...

  20. Does STES-Oriented Science Education Promote 10th-Grade Students' Decision-Making Capability?

    NASA Astrophysics Data System (ADS)

    Levy Nahum, Tami; Ben-Chaim, David; Azaiza, Ibtesam; Herskovitz, Orit; Zoller, Uri

    2010-07-01

    Today's society is continuously coping with sustainability-related complex issues in the Science-Technology-Environment-Society (STES) interfaces. In those contexts, the need and relevance of the development of students' higher-order cognitive skills (HOCS) such as question-asking, critical-thinking, problem-solving and decision-making capabilities within science teaching have been argued by several science educators for decades. Three main objectives guided this study: (1) to establish "base lines" for HOCS capabilities of 10th grade students (n = 264) in the Israeli educational system; (2) to delineate within this population, two different groups with respect to their decision-making capability, science-oriented (n = 142) and non-science (n = 122) students, Groups A and B, respectively; and (3) to assess the pre-post development/change of students' decision-making capabilities via STES-oriented HOCS-promoting curricular modules entitled Science, Technology and Environment in Modern Society (STEMS). A specially developed and validated decision-making questionnaire was used for obtaining a research-based response to the guiding research questions. Our findings suggest that a long-term persistent application of purposed decision-making, promoting teaching strategies, is needed in order to succeed in affecting, positively, high-school students' decision-making ability. The need for science teachers' involvement in the development of their students' HOCS capabilities is thus apparent.

  1. Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms.

    PubMed

    Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João

    2017-10-01

    Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.

  2. Analysis of the decision-making process of nurse managers: a collective reflection.

    PubMed

    Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

    2015-01-01

    to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

  3. Clinical Decision Making of Rural Novice Nurses

    ERIC Educational Resources Information Center

    Seright, Teresa J.

    2010-01-01

    The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent…

  4. Effects of Direct and Indirect Instruction on Fostering Decision-Making Competence in Socioscientific Issues

    NASA Astrophysics Data System (ADS)

    Böttcher, Florian; Meisert, Anke

    2013-04-01

    In this study the effects of different learning environments on the promotion of decision-making competence for the socioscientific issue of genetically modified crops is investigated. The comparison focuses on direct vs. indirect instructions. Therefore on the one hand a sophisticated decision-making strategy was presented to the directly instructed experimental group (1) and had to be applied correctly. On the other hand indirectly instructed students had to invent an appropriate strategy by themselves (2) based on the given information and the structure of the problem context. Group discussions are analysed qualitatively in order (1) to outline how the given strategy was understood and its results were reflected on by the students and (2) to explore the characteristics of invented strategies and their degree of complexity. Results indicate that the direct instruction of complex decision-making strategies may lead to a lack of understanding of the decision process when the given strategy is applied and therefore may cause rejection of the final decision. Indirectly instructed students were able to invent sophisticated decision-making strategies containing compensatory trade-offs. It is concluded that when directly instructing complex decision-making strategies, essential parts of reflection have to be integrated in order to gain greater transparency. Accordingly, empirical evidence has been found to consider indirect instruction as a possible way to foster decision-making strategies for complex socioscientific issues even if compensatory procedures are considered to be necessary.

  5. Information order and outcome framing: an assesment of judgment bias in a naturalistic decision-making context.

    PubMed

    Perrin, B M; Barnett, B J; Walrath, L; Grossman, J D

    2001-01-01

    Findings that decision makers can come to different conclusions depending on the order in which they receive information have been termed the "information order bias." When trained, experienced individuals exhibit similar behaviors; however, it has been argued that this result is not a bias, but rather, a pattern-matching process. This study provides a critical examination of this claim. It also assesses both experts' susceptibility to an outcome framing bias and the effects of varying task loads on judgment. Using a simulation of state-of-the-art ship defensive systems operated by experienced, active-duty U.S. Navy officers, we found no evidence of a framing bias, while task load had a minor, but systematic effect. The order in which information was received had a significant impact, with the effect being consistent with a judgment bias. Nonetheless, we note that pattern-matching processes, similar to those that produce inferential and reconstructive effects on memory, could also explain our results. Actual or potential applications of this research include decision support system interfaces or training programs that might be developed to reduce judgment bias.

  6. 78 FR 101 - Guidance for Industry and Food and Drug Administration Staff; Acceptance and Filing Reviews for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ... element(s). In order to enhance the consistency of our acceptance and filing decisions and to help..., thereby assuring the consistency of our acceptance and filing decisions. This guidance is applicable to... issues that need to be addressed in a PMA and the key decisions to be made during the filing process. The...

  7. Grand Challenges in Clinical Decision Support v10

    PubMed Central

    Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

    2008-01-01

    There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232

  8. Mental Disorders and Decision-Making Capacity: What Is the Role of Law?

    PubMed

    Rommelaere, Claire

    2015-03-01

    When a patient appears to have a mental disorder, doubts may arise about his or her decision-making capacity. Health professionals must then assess the patient's capacity in order to make sure of the validity of his or her consent or refusal. Incapacity has indeed legal consequences, as law provides for the appointment of a surrogate decision-maker in case of incapacity. With Belgian law as a point of departure, this contribution is aiming at identifying the role of law in capacity assessment itself, prior to the decision about (in)capacity. In order to protect the patient's rights and to support the task of those carrying out the assessment, law should provide for a global definition of decigion-making capacity and for a frame-procedure guiding this assessment. In my opinion, it is possible for law to contribute to the complex task of capacity assessment without interfering embarrassingly with healthcare practice.

  9. What Do Trainers Need to Know to Train Higher-Order Thinking Skills

    DTIC Science & Technology

    2017-11-01

    decision - making , perceptual processing , and information processing (U.S. Department of the Army, TRADOC, 2011; 2014). Current Army training...counteract this risk, we may offload aspects of the evaluative process using techniques—like the Military Decision Making Process — that tend to frame... decision -makers collect information and the influences of internal and external factors on the

  10. A Model for Developing and Assessing Tactical Decision-Making Competency in Game Play

    ERIC Educational Resources Information Center

    Pagnano-Richardson, Karen; Henninger, Mary L.

    2008-01-01

    All teachers want their students to become better game players who are motivated to participate in and outside of class. Students need to learn how to make good tactical decisions, in addition to being skilled movers, in order to become competent game players. When students make better tactical decisions, they experience more success and therefore…

  11. Communicating to Influence Drug Development and Regulatory Decisions: A Tutorial

    PubMed Central

    Mehrotra, S

    2016-01-01

    Pharmacometricians require three skills to be influential: technical, business (e.g., drug development), and soft skills (e.g., communication). Effective communication is required to translate technical and often complicated quantitative findings to interdisciplinary team members in order to influence drug development or regulatory decisions. In this tutorial, we highlight important aspects related to communicating pharmacometric analysis to influence decisions. PMID:27299706

  12. A boost of confidence: The role of the ventromedial prefrontal cortex in memory, decision-making, and schemas.

    PubMed

    Hebscher, Melissa; Gilboa, Asaf

    2016-09-01

    The ventromedial prefrontal cortex (vmPFC) has been implicated in a wide array of functions across multiple domains. In this review, we focus on the vmPFC's involvement in mediating strategic aspects of memory retrieval, memory-related schema functions, and decision-making. We suggest that vmPFC generates a confidence signal that informs decisions and memory-guided behaviour. Confidence is central to these seemingly diverse functions: (1) Strategic retrieval: lesions to the vmPFC impair an early, automatic, and intuitive monitoring process ("feeling of rightness"; FOR) often associated with confabulation (spontaneous reporting of erroneous memories). Critically, confabulators typically demonstrate high levels of confidence in their false memories, suggesting that faulty monitoring following vmPFC damage may lead to indiscriminate confidence signals. (2) Memory schemas: the vmPFC is critically involved in instantiating and maintaining contextually relevant schemas, broadly defined as higher level knowledge structures that encapsulate lower level representational elements. The correspondence between memory retrieval cues and these activated schemas leads to FOR monitoring. Stronger, more elaborate schemas produce stronger FOR and influence confidence in the veracity of memory candidates. (3) Finally, we review evidence on the vmPFC's role in decision-making, extending this role to decision-making during memory retrieval. During non-mnemonic and mnemonic decision-making the vmPFC automatically encodes confidence. Confidence signal in the vmPFC is revealed as a non-linear relationship between a first-order monitoring assessment and second-order action or choice. Attempting to integrate the multiple functions of the vmPFC, we propose a posterior-anterior organizational principle for this region. More posterior vmPFC regions are involved in earlier, automatic, subjective, and contextually sensitive functions, while more anterior regions are involved in controlled actions based on these earlier functions. Confidence signals reflect the non-linear relationship between first-order, posterior-mediated and second-order, anterior-mediated processes and are represented along the entire axis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Use of the Physician Orders for Life-Sustaining Treatment program for patients being discharged from the hospital to the nursing facility.

    PubMed

    Hickman, Susan E; Nelson, Christine A; Smith-Howell, Esther; Hammes, Bernard J

    2014-01-01

    The Physician Orders for Life-Sustaining Treatment (POLST) documents patient preferences as medical orders that transfer across settings with patients. The objectives were to pilot test methods and gather preliminary data about POLST including (1) use at time of hospital discharge, (2) transfers across settings, and (3) consistency with prior decisions. Descriptive with chart abstraction and interviews. Participants were hospitalized patients discharged to a nursing facility and/or their surrogates in La Crosse County, Wisconsin. POLST forms were abstracted from hospital records for 151 patients. Hospital and nursing facility chart data were abstracted and interviews were conducted with an additional 39 patients/surrogates. Overall, 176 patients had valid POLST forms at the time of discharge from the hospital, and many (38.6%; 68/176) only documented code status. When the whole POLST was completed, orders were more often marked as based on a discussion with the patient and/or surrogate than when the form was used just for code status (95.1% versus 13.8%, p<.001). In the follow-up and interview sample, a majority (90.6%; 29/32) of POLST forms written in the hospital were unchanged up to three weeks after nursing facility admission. Most (71.9%; 23/32) appeared consistent with patient or surrogate recall of prior treatment decisions. POLST forms generated in the hospital do transfer with patients across settings, but are often used only to document code status. POLST orders appeared largely consistent with prior treatment decisions. Further research is needed to assess the quality of POLST decisions.

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

    EPA Pesticide Factsheets

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

  15. 20 CFR 655.445 - Secretary's review of administrative law judge's decision.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Enforcement of H-1A... interested party desiring review of the decision and order of an administrative law judge shall petition the...

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

    Treesearch

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

    2010-01-01

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

  17. School-Based Management: An Approach to Decision-Making Quality in Egyptian General Secondary Schools

    ERIC Educational Resources Information Center

    Elmelegy, Reda Ibrahim

    2015-01-01

    The current research aims at clarifying how school-based management (SBM) can contribute to achieve the decision-making quality in Egyptian general secondary schools and determine the requirements of quality decision-making. It depends on the descriptive method in order to acknowledge the basics of the SBM and its relationship with the quality of…

  18. A programmable rules engine to provide clinical decision support using HTML forms.

    PubMed Central

    Heusinkveld, J.; Geissbuhler, A.; Sheshelidze, D.; Miller, R.

    1999-01-01

    The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser. Images Figure 1 PMID:10566470

  19. Enlisting qualitative methods to improve environmental monitoring

    EPA Science Inventory

    Environmental monitoring tracks ecological changes in order to support environmental management decisions. Monitoring design is driven by natural scientists, usually lacking a formal social science basis. However, human perspectives drive environmental resource decisions, with ...

  20. 25 CFR 214.26 - Fine; notice and hearing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... day for each and every day the terms of the lease or of the regulations are violated, or the orders of... Secretary of the Interior within 30 days after notice of the superintendent's decision, and the decision of...

  1. Transit Operations Decision Support System (TODSS) core requirements evaluation and update recommendations.

    DOT National Transportation Integrated Search

    2009-10-01

    Transit Operations Decision Support Systems (TODSS) are systems designed to support dispatchers and others in real-time operations : management in response to incidents, special events, and other changing conditions in order to improve operating spee...

  2. The Development of Social Perspective Taking and Leadership Decision-Making in City Government Managers

    ERIC Educational Resources Information Center

    Van Rossum, Zachary Johannes

    2013-01-01

    I examined the role of social perspective taking in leadership decision-making by investigating how a group of 70 leaders made sense of a hypothetical workplace dilemma in order to understand how they used their capacity for social perspective taking as part of their decision-making process. The majority of these leaders work in North America, are…

  3. An Application of Multidimensional Scaling to the Prioritization of Decision Aids in the S-3A.

    DTIC Science & Technology

    1980-09-01

    subjects at once and recent research by Burton (1975] suggests that most people can do a single sorting of sixty(60) stimuli in fifteen to thirty...implicit ordering of areas in which TACCOs think decision aids would be useful. a. Gain Attack Criteria The Gain Attack Criteria decision function was...will provide you with better, more intelligent support from machines and will give you time to do what you do best - think and make decision. The whole

  4. Applications of Formal Methods to Specification and Safety of Avionics Software

    NASA Technical Reports Server (NTRS)

    Hoover, D. N.; Guaspari, David; Humenn, Polar

    1996-01-01

    This report treats several topics in applications of formal methods to avionics software development. Most of these topics concern decision tables, an orderly, easy-to-understand format for formally specifying complex choices among alternative courses of action. The topics relating to decision tables include: generalizations fo decision tables that are more concise and support the use of decision tables in a refinement-based formal software development process; a formalism for systems of decision tables with behaviors; an exposition of Parnas tables for users of decision tables; and test coverage criteria and decision tables. We outline features of a revised version of ORA's decision table tool, Tablewise, which will support many of the new ideas described in this report. We also survey formal safety analysis of specifications and software.

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

    PubMed

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

    2017-01-01

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

  6. Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

    PubMed

    Subramanian, Sujha; Hoover, Sonja; Wagner, Joann L; Donovan, Jennifer L; Kanaan, Abir O; Rochon, Paula A; Gurwitz, Jerry H; Field, Terry S

    2012-01-01

    In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.

  7. 7 CFR 1200.13 - Administrator's recommended decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1200.13 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE RULES OF... decision shall include: (1) a preliminary statement containing a description of the history of the...

  8. 28 CFR 45.3 - Disciplinary proceedings under 18 U.S.C. 207(j).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... proceedings. (f) A decision adverse to the former departmental employee must be sustained by substantial... officer. (i) If a former departmental employee fails to appeal from an adverse initial decision within the... decision that the former departmental employee violated 18 U.S.C. 207 (a), (b) or (c), may issue an order...

  9. 78 FR 27462 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... making routing, quotation, price and size decisions regarding where they should send orders and quotes... more transparent and accessible to market participants making routing decisions concerning their... participants additional information in [[Page 27464

  10. Synthesis of safety for traffic operations

    DOT National Transportation Integrated Search

    2003-03-01

    Traffic operations practitioners are continually making decisions that impact on the safety performance of the transportation network. In order to make the best possible decisions the practitioner must be aware of the best available evidence on safet...

  11. Technology in Our Schools.

    ERIC Educational Resources Information Center

    Rukeyser, William L.; Kuersten, Joan

    1998-01-01

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

  12. Defining Victory: Three Case Studies of Strategic Guidance and Decision Making

    DTIC Science & Technology

    2004-06-18

    options to formulate guidance? Finally, did the decision makers adequately revisit their decisions in order to adapt to changing situations? The U.S...to leave guidance unchanged in the face of changing political circumstances. Both military and civilian leaders generally discounted the...unpredictable impact of military actions themselves on the strategic goals and therefore failed to adapt to changing situations. iv ACKNOWLEDGMENTS This

  13. The known unknowns: neural representation of second-order uncertainty, and ambiguity

    PubMed Central

    Bach, Dominik R.; Hulme, Oliver; Penny, William D.; Dolan, Raymond J.

    2011-01-01

    Predictions provided by action-outcome probabilities entail a degree of (first-order) uncertainty. However, these probabilities themselves can be imprecise and embody second-order uncertainty. Tracking second-order uncertainty is important for optimal decision making and reinforcement learning. Previous functional magnetic resonance imaging investigations of second-order uncertainty in humans have drawn on an economic concept of ambiguity, where action-outcome associations in a gamble are either known (unambiguous) or completely unknown (ambiguous). Here, we relaxed the constraints associated with a purely categorical concept of ambiguity and varied the second-order uncertainty of gambles continuously, quantified as entropy over second-order probabilities. We show that second-order uncertainty influences decisions in a pessimistic way by biasing second-order probabilities, and that second-order uncertainty is negatively correlated with posterior cingulate cortex activity. The category of ambiguous (compared to non-ambiguous) gambles also biased choice in a similar direction, but was associated with distinct activation of a posterior parietal cortical area; an activation that we show reflects a different computational mechanism. Our findings indicate that behavioural and neural responses to second-order uncertainty are distinct from those associated with ambiguity and may call for a reappraisal of previous data. PMID:21451019

  14. Duplicate laboratory test reduction using a clinical decision support tool.

    PubMed

    Procop, Gary W; Yerian, Lisa M; Wyllie, Robert; Harrison, A Marc; Kottke-Marchant, Kandice

    2014-05-01

    Duplicate laboratory tests that are unwarranted increase unnecessary phlebotomy, which contributes to iatrogenic anemia, decreased patient satisfaction, and increased health care costs. We employed a clinical decision support tool (CDST) to block unnecessary duplicate test orders during the computerized physician order entry (CPOE) process. We assessed laboratory cost savings after 2 years and searched for untoward patient events associated with this intervention. This CDST blocked 11,790 unnecessary duplicate test orders in these 2 years, which resulted in a cost savings of $183,586. There were no untoward effects reported associated with this intervention. The movement to CPOE affords real-time interaction between the laboratory and the physician through CDSTs that signal duplicate orders. These interactions save health care dollars and should also increase patient satisfaction and well-being.

  15. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    PubMed

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program. Project HOPE—The People-to-People Health Foundation, Inc.

  16. 43 CFR 4.826 - Discovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Special Procedural Rules Applicable to Practice and Procedure for Hearings, Decisions, and Administrative... make any order which justice requires to limit or condition discovery in order to protect a party or...

  17. 43 CFR 4.826 - Discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Special Procedural Rules Applicable to Practice and Procedure for Hearings, Decisions, and Administrative... make any order which justice requires to limit or condition discovery in order to protect a party or...

  18. 43 CFR 4.826 - Discovery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Procedural Rules Applicable to Practice and Procedure for Hearings, Decisions, and Administrative Review... make any order which justice requires to limit or condition discovery in order to protect a party or...

  19. 43 CFR 4.826 - Discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Special Procedural Rules Applicable to Practice and Procedure for Hearings, Decisions, and Administrative... make any order which justice requires to limit or condition discovery in order to protect a party or...

  20. Taking Guns to a Knife Fight: Effective Military Support to COIN

    DTIC Science & Technology

    2008-03-31

    generating superior “relative combat power” at decisive times and places in order to destroy, disrupt and dislocate the enemies they confront. Under...employ forces capable of striking targets of opportunity decisively with minimal collateral damage. When government counterinsurgency efforts are...The COIN force must seize such opportunities decisively . However, applying firepower with the precision needed to avoid non-combatant casualties is

  1. An Evaluation on Factors Influencing Decision making for Malaysia Disaster Management: The Confirmatory Factor Analysis Approach

    NASA Astrophysics Data System (ADS)

    Zubir, S. N. A.; Thiruchelvam, S.; Mustapha, K. N. M.; Che Muda, Z.; Ghazali, A.; Hakimie, H.

    2017-12-01

    For the past few years, natural disaster has been the subject of debate in disaster management especially in flood disaster. Each year, natural disaster results in significant loss of life, destruction of homes and public infrastructure, and economic hardship. Hence, an effective and efficient flood disaster management would assure non-futile efforts for life saving. The aim of this article is to examine the relationship between approach, decision maker, influence factor, result, and ethic to decision making for flood disaster management in Malaysia. The key elements of decision making in the disaster management were studied based on the literature. Questionnaire surveys were administered among lead agencies at East Coast of Malaysia in the state of Kelantan and Pahang. A total of 307 valid responses had been obtained for further analysis. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were carried out to analyse the measurement model involved in the study. The CFA for second-order reflective and first-order reflective measurement model indicates that approach, decision maker, influence factor, result, and ethic have a significant and direct effect on decision making during disaster. The results from this study showed that decision- making during disaster is an important element for disaster management to necessitate a successful collaborative decision making. The measurement model is accepted to proceed with further analysis known as Structural Equation Modeling (SEM) and can be assessed for the future research.

  2. A supplier selection and order allocation problem with stochastic demands

    NASA Astrophysics Data System (ADS)

    Zhou, Yun; Zhao, Lei; Zhao, Xiaobo; Jiang, Jianhua

    2011-08-01

    We consider a system comprising a retailer and a set of candidate suppliers that operates within a finite planning horizon of multiple periods. The retailer replenishes its inventory from the suppliers and satisfies stochastic customer demands. At the beginning of each period, the retailer makes decisions on the replenishment quantity, supplier selection and order allocation among the selected suppliers. An optimisation problem is formulated to minimise the total expected system cost, which includes an outer level stochastic dynamic program for the optimal replenishment quantity and an inner level integer program for supplier selection and order allocation with a given replenishment quantity. For the inner level subproblem, we develop a polynomial algorithm to obtain optimal decisions. For the outer level subproblem, we propose an efficient heuristic for the system with integer-valued inventory, based on the structural properties of the system with real-valued inventory. We investigate the efficiency of the proposed solution approach, as well as the impact of parameters on the optimal replenishment decision with numerical experiments.

  3. Multi-criteria, personalized route planning using quantifier-guided ordered weighted averaging operators

    NASA Astrophysics Data System (ADS)

    Nadi, S.; Delavar, M. R.

    2011-06-01

    This paper presents a generic model for using different decision strategies in multi-criteria, personalized route planning. Some researchers have considered user preferences in navigation systems. However, these prior studies typically employed a high tradeoff decision strategy, which used a weighted linear aggregation rule, and neglected other decision strategies. The proposed model integrates a pairwise comparison method and quantifier-guided ordered weighted averaging (OWA) aggregation operators to form a personalized route planning method that incorporates different decision strategies. The model can be used to calculate the impedance of each link regarding user preferences in terms of the route criteria, criteria importance and the selected decision strategy. Regarding the decision strategy, the calculated impedance lies between aggregations that use a logical "and" (which requires all the criteria to be satisfied) and a logical "or" (which requires at least one criterion to be satisfied). The calculated impedance also includes taking the average of the criteria scores. The model results in multiple alternative routes, which apply different decision strategies and provide users with the flexibility to select one of them en-route based on the real world situation. The model also defines the robust personalized route under different decision strategies. The influence of different decision strategies on the results are investigated in an illustrative example. This model is implemented in a web-based geographical information system (GIS) for Isfahan in Iran and verified in a tourist routing scenario. The results demonstrated, in real world situations, the validity of the route planning carried out in the model.

  4. 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

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

    ERIC Educational Resources Information Center

    Willis, Derek W.

    2010-01-01

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

  6. Association of Liability Concerns with Decisions to Order Echocardiography and Cardiac Stress Tests with Imaging.

    PubMed

    Kini, Vinay; Weiner, Rory B; McCarthy, Fenton H; Wiegers, Susan E; Kirkpatrick, James N

    2016-12-01

    Professional societies have made efforts to curb overuse of cardiac imaging and decrease practice variation by publishing appropriate use criteria. However, little is known about the impact of physician-level determinants such as liability concerns and risk aversion on decisions to order testing. A web-based survey was administered to cardiologists and general practice physicians affiliated with two academic institutions. The survey consisted of four clinical scenarios in which appropriate use criteria rated echocardiography or stress testing as "may be appropriate." Respondents' degree of liability concerns and risk aversion were measured using validated tools. The primary outcome variable was tendency to order imaging, calculated as the average likelihood to order an imaging test across the clinical scenarios (1 = very unlikely, 6 = very likely). Linear regression models were used to evaluate the association between tendency to order imaging and physician characteristics. From 420 physicians invited to participate, 108 complete responses were obtained (26% response rate, 54% cardiologists). There was no difference in tendency to order imaging between cardiologists and general practice physicians (3.46 [95% CI, 3.12-3.81] vs 3.15 [95% CI, 2.79-3.51], P = .22). On multivariate analysis, a higher degree of liability concerns was the only significant predictor of decisions to order imaging (mean difference in tendency to order imaging, 0.36; 95% CI, 0.09-0.62; P = .01). In clinical situations in which performance of cardiac imaging is rated as "may be appropriate" by appropriate use criteria, physicians with higher liability concerns ordered significantly more testing than physicians with lower concerns. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  7. AMBIENT AIR QUALITY MONITORING

    EPA Science Inventory

    The primary objective of this workshop is to exchange information on available scientific bases for environmental regulatory decision making to senior Chinese decision-makers in a readily understandable format in order to expedite appropriate control measures in China. The Pol...

  8. 48 CFR 16.505 - Ordering.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... factors in the selection decision. (iii) Orders exceeding $5 million. For task or delivery orders in... procedures in 5.705. (11) When using the Governmentwide commercial purchase card as a method of payment, orders at or below the micro-purchase threshold are exempt from verification in the Central Contractor...

  9. Decision-making in chronic ecstasy users: a systematic review.

    PubMed

    Betzler, Felix; Viohl, Leonard; Romanczuk-Seiferth, Nina

    2017-01-01

    Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  10. Knapsack - TOPSIS Technique for Vertical Handover in Heterogeneous Wireless Network

    PubMed Central

    2015-01-01

    In a heterogeneous wireless network, handover techniques are designed to facilitate anywhere/anytime service continuity for mobile users. Consistent best-possible access to a network with widely varying network characteristics requires seamless mobility management techniques. Hence, the vertical handover process imposes important technical challenges. Handover decisions are triggered for continuous connectivity of mobile terminals. However, bad network selection and overload conditions in the chosen network can cause fallout in the form of handover failure. In order to maintain the required Quality of Service during the handover process, decision algorithms should incorporate intelligent techniques. In this paper, a new and efficient vertical handover mechanism is implemented using a dynamic programming method from the operation research discipline. This dynamic programming approach, which is integrated with the Technique to Order Preference by Similarity to Ideal Solution (TOPSIS) method, provides the mobile user with the best handover decisions. Moreover, in this proposed handover algorithm a deterministic approach which divides the network into zones is incorporated into the network server in order to derive an optimal solution. The study revealed that this method is found to achieve better performance and QoS support to users and greatly reduce the handover failures when compared to the traditional TOPSIS method. The decision arrived at the zone gateway using this operational research analytical method (known as the dynamic programming knapsack approach together with Technique to Order Preference by Similarity to Ideal Solution) yields remarkably better results in terms of the network performance measures such as throughput and delay. PMID:26237221

  11. Knapsack--TOPSIS Technique for Vertical Handover in Heterogeneous Wireless Network.

    PubMed

    Malathy, E M; Muthuswamy, Vijayalakshmi

    2015-01-01

    In a heterogeneous wireless network, handover techniques are designed to facilitate anywhere/anytime service continuity for mobile users. Consistent best-possible access to a network with widely varying network characteristics requires seamless mobility management techniques. Hence, the vertical handover process imposes important technical challenges. Handover decisions are triggered for continuous connectivity of mobile terminals. However, bad network selection and overload conditions in the chosen network can cause fallout in the form of handover failure. In order to maintain the required Quality of Service during the handover process, decision algorithms should incorporate intelligent techniques. In this paper, a new and efficient vertical handover mechanism is implemented using a dynamic programming method from the operation research discipline. This dynamic programming approach, which is integrated with the Technique to Order Preference by Similarity to Ideal Solution (TOPSIS) method, provides the mobile user with the best handover decisions. Moreover, in this proposed handover algorithm a deterministic approach which divides the network into zones is incorporated into the network server in order to derive an optimal solution. The study revealed that this method is found to achieve better performance and QoS support to users and greatly reduce the handover failures when compared to the traditional TOPSIS method. The decision arrived at the zone gateway using this operational research analytical method (known as the dynamic programming knapsack approach together with Technique to Order Preference by Similarity to Ideal Solution) yields remarkably better results in terms of the network performance measures such as throughput and delay.

  12. DECISION-MAKING USING EXISTING DATA

    EPA Science Inventory

    Decision-makers need information on cumulative and aggregate stressors as well as clear information on where problems are likely to occur in the future in order to prioritize risk management actions. The most prevasive and difficult to assess changes are the result of regional-s...

  13. Influence of the Family in Career Decision-Making.

    ERIC Educational Resources Information Center

    Chope, Robert C.

    2001-01-01

    Two recently emerging factors are changing the role of family in career decision making: the revolutionary changes in family structure and increased emphasis on interpersonal relationships in work. Career counselors need new protocols in order to work with clients and family members. (SK)

  14. THE IMPORTANCE OF SPATIAL ACCURACY FOR CHEMICAL INFORMATION MANAGEMENT

    EPA Science Inventory

    Information about chemicals can be critical to making timely decisions. The results of these decisions may not be realized for many years. In order to increase the value of chemical information and to create and utilize meaningful environmental models, the Environmental Prote...

  15. E-DECIDER Decision Support Gateway For Earthquake Disaster Response

    NASA Astrophysics Data System (ADS)

    Glasscoe, M. T.; Stough, T. M.; Parker, J. W.; Burl, M. C.; Donnellan, A.; Blom, R. G.; Pierce, M. E.; Wang, J.; Ma, Y.; Rundle, J. B.; Yoder, M. R.

    2013-12-01

    Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing capabilities for decision-making utilizing remote sensing data and modeling software in order to provide decision support for earthquake disaster management and response. E-DECIDER incorporates earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project in order to produce standards-compliant map data products to aid in decision-making following an earthquake. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools, help provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). E-DECIDER utilizes a service-based GIS model for its cyber-infrastructure in order to produce standards-compliant products for different user types with multiple service protocols (such as KML, WMS, WFS, and WCS). The goal is to make complex GIS processing and domain-specific analysis tools more accessible to general users through software services as well as provide system sustainability through infrastructure services. The system comprises several components, which include: a GeoServer for thematic mapping and data distribution, a geospatial database for storage and spatial analysis, web service APIs, including simple-to-use REST APIs for complex GIS functionalities, and geoprocessing tools including python scripts to produce standards-compliant data products. These are then served to the E-DECIDER decision support gateway (http://e-decider.org), the E-DECIDER mobile interface, and to the Department of Homeland Security decision support middleware UICDS (Unified Incident Command and Decision Support). The E-DECIDER decision support gateway features a web interface that delivers map data products including deformation modeling results (slope change and strain magnitude) and aftershock forecasts, with remote sensing change detection results under development. These products are event triggered (from the USGS earthquake feed) and will be posted to event feeds on the E-DECIDER webpage and accessible via the mobile interface and UICDS. E-DECIDER also features a KML service that provides infrastructure information from the FEMA HAZUS database through UICDS and the mobile interface. The back-end GIS service architecture and front-end gateway components form a decision support system that is designed for ease-of-use and extensibility for end-users.

  16. 48 CFR 6101.26 - Reconsideration; amendment of decisions; new hearings [Rule 26].

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... amend a decision or order for any reason that would justify such action on motion of a party. (d) Effect... for granting a new hearing. Upon granting a motion for a new hearing, the Board will take additional... issue a new decision. (b) Procedure. Any motion under 6101.26 (Rule 26) shall comply with the provisions...

  17. 48 CFR 6101.26 - Reconsideration; amendment of decisions; new hearings [Rule 26].

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... amend a decision or order for any reason that would justify such action on motion of a party. (d) Effect... for granting a new hearing. Upon granting a motion for a new hearing, the Board will take additional... issue a new decision. (b) Procedure. Any motion under 6101.26 (Rule 26) shall comply with the provisions...

  18. Temporal reasoning for decision support in medicine.

    PubMed

    Augusto, Juan Carlos

    2005-01-01

    Handling time-related concepts is essential in medicine. During diagnosis it can make a substantial difference to know the temporal order in which some symptoms occurred or for how long they lasted. During prognosis the potential evolutions of a disease are conceived as a description of events unfolding in time. In therapy planning the different steps of treatment must be applied in a precise order, with a given frequency and for a certain span of time in order to be effective. This article offers a survey on the use of temporal reasoning for decision support-related tasks in medicine. Key publications of the area, mainly circumscribed to the latest two decades, are reviewed and classified according to three important stages of patient treatment requiring decision support: diagnosis, prognosis and therapy planning/management. Other complementary publications, like those on time-centered information storage and retrieval, are also considered as they provide valuable support to the above mentioned three stages. Key areas are highlighted and used to organize the latest contributions. The survey of previous research is followed by an analysis of what can still be improved and what is needed to make the next generation of decision support systems for medicine more effective. It can be observed that although the area has been considerably developed, there are still areas where more research is needed to make time-based systems of widespread use in decision support-related areas of medicine. Several suggestions for further exploration are proposed as a result of the survey.

  19. Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers--a qualitative study.

    PubMed

    Espeland, Ansgar; Baerheim, Anders

    2003-03-24

    General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed.

  20. Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers – a qualitative study

    PubMed Central

    Espeland, Ansgar; Baerheim, Anders

    2003-01-01

    Background General practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors. Methods Focus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group. Results The factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations. Conclusions Our findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed. PMID:12659640

  1. Decision-making process of patients with gynecological cancer regarding their cancer treatment choices using the analytic hierarchy process.

    PubMed

    Kitamura, Yuko

    2010-12-01

    In order to support patients' decision-making regarding cancer treatments, it is important to clarify which criteria that cancer patients use to set priorities in their treatment choices. Using the analytic hierarchy process (AHP), a mathematical decision-making method, this article investigates the criteria and the priorities of patients with gynecological cancer. In the AHP, multiple and hierarchical criteria in the decision-making process were organized by a repeated pairwise judgment of the participants so as to serialize the alternatives along with the rational order of the priorities. For the alternatives "to receive treatment" and "to not receive treatment," the following five criteria were set: "anxiety about relapse and metastasis", "distress about side-effects", "advice of family", "advice of medical staff", and "economic burden". The participants determined a pairwise priority scale, as well as a priority scale between the alternatives for every criterion. The logical consistency of their answers was checked by a consistency index (CI). The participants were 31 patients with ovarian or endometrial cancer who were being followed up after undergoing surgery and adjuvant chemotherapy. Of the participants who answered the questionnaire, 17 satisfied the logical consistency. Of the five criteria for the treatment choices, "anxiety about relapse and metastasis" and "advice of medical staff" were found to be the important factors for treatment choice; however, the weight attached to the priority criteria differed much among the patients. The AHP made it possible to support patients' decision-making in order to clarify their priority criteria and to quantitatively present their decision-making process. © 2010 The Author. Journal compilation © 2010 Japan Academy of Nursing Science.

  2. Research on Bidding Decision-making of International Public-Private Partnership Projects

    NASA Astrophysics Data System (ADS)

    Hu, Zhen Yu; Zhang, Shui Bo; Liu, Xin Yan

    2018-06-01

    In order to select the optimal quasi-bidding project for an investment enterprise, a bidding decision-making model for international PPP projects was established in this paper. Firstly, the literature frequency statistics method was adopted to screen out the bidding decision-making indexes, and accordingly the bidding decision-making index system for international PPP projects was constructed. Then, the group decision-making characteristic root method, the entropy weight method, and the optimization model based on least square method were used to set the decision-making index weights. The optimal quasi-bidding project was thus determined by calculating the consistent effect measure of each decision-making index value and the comprehensive effect measure of each quasi-bidding project. Finally, the bidding decision-making model for international PPP projects was further illustrated by a hypothetical case. This model can effectively serve as a theoretical foundation and technical support for the bidding decision-making of international PPP projects.

  3. New Directions for Military Decision Making Research in Combat and Operational Settings

    DTIC Science & Technology

    1991-12-01

    information; their search rules emphasize feasibility more than optimality; decisions depend on the order in which alternatives are presented...12:76-90. Easterbrook, J.A. "The effect of Emotion on Cue Utilization and the Organization of Behaviour." Psychological Review, 1959, 66:183-201...Acquisition and Affective State on Halo, Accuracy, Information Retrival , and Evaluations." Organizational Behavior and Human Decision Processes, 1988, 42:22

  4. The role of the bioethicist in family meetings about end of life care.

    PubMed

    Watkins, Liza T; Sacajiu, Galit; Karasz, Alison

    2007-12-01

    There has been little study of the content of bioethicists' communication during family meeting consultations about end of life care. In the literature, two roles for bioethicists are usually described: the "consultant" role, in which bioethicists define and support ethical principles such as those enshrined in the "rational choice" model; and the "mediator" role, which focuses on the enhancement of communication in order to reduce conflict. In this study, we use observational data to explore how bioethicists support the practice of decision making during family meetings about end of life care. In a study conducted in the Bronx, New York, USA, researchers observed and recorded 24 decision-making meetings between hospital staff and family members of elderly patients identified as being in the last stages of illness, who were unable or unwilling to make the decision for themselves. Bioethics consultants were present during five of those meetings. Although bioethicists referred to the "rational choice" decision-making hierarchy, we did not see the systematic exploration described in the literature. Rather, our data show that bioethicists tended to employ elements of the rational model at particular turning points in the decision-making process in order to achieve pragmatic goals. As mediators, bioethicists worked to create consensus between family and staff and provided invaluable sympathy and comfort to distressed family members. We also found evidence of a context-dependent approach to mediation, with bioethicists' contributions generally supporting staff views about end of life care. Bioethicists' called to consult on family meetings about end of life care do not appear to adhere to a strict interpretation of the official guidelines. In order to negotiate the difficult terrain of end of life decision making, our data show that bioethicists often add a third role, "persuader", to official roles of "consultant" and "mediator".

  5. 77 FR 35027 - Serenity Café; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... Cause Order proposed the denial of Serenity Caf[eacute]'s application for a DEA Certificate of...)). Next, the Order alleged that Applicant does not have a valid Illinois Department of Human Services... of Serenity Caf[eacute]. GX 1, at 3; GX 6. Since the date of service of the Order, thirty days have...

  6. Medical decision-making in children and adolescents: developmental and neuroscientific aspects.

    PubMed

    Grootens-Wiegers, Petronella; Hein, Irma M; van den Broek, Jos M; de Vries, Martine C

    2017-05-08

    Various international laws and guidelines stress the importance of respecting the developing autonomy of children and involving minors in decision-making regarding treatment and research participation. However, no universal agreement exists as to at what age minors should be deemed decision-making competent. Minors of the same age may show different levels of maturity. In addition, patients deemed rational conversation-partners as a child can suddenly become noncompliant as an adolescent. Age, context and development all play a role in decision-making competence. In this article we adopt a perspective on competence that specifically focuses on the impact of brain development on the child's decision-making process. We believe that the discussion on decision-making competence of minors can greatly benefit from a multidisciplinary approach. We adopted such an approach in order to contribute to the understanding on how to deal with children in decision-making situations. Evidence emerging from neuroscience research concerning the developing brain structures in minors is combined with insights from various other fields, such as psychology, decision-making science and ethics. Four capacities have been described that are required for (medical) decision-making: (1) communicating a choice; (2) understanding; (3) reasoning; and (4) appreciation. Each capacity is related to a number of specific skills and abilities that need to be sufficiently developed to support the capacity. Based on this approach it can be concluded that at the age of 12 children can have the capacity to be decision-making competent. However, this age coincides with the onset of adolescence. Early development of the brain's reward system combined with late development of the control system diminishes decision-making competence in adolescents in specific contexts. We conclude that even adolescents possessing capacities required for decision-making, may need support of facilitating environmental factors. This paper intends to offer insight in neuroscientific mechanisms underlying the medical decision-making capacities in minors and to stimulate practices for optimal involvement of minors. Developing minors become increasingly capable of decision-making, but the neurobiological development in adolescence affects competence in specific contexts. Adequate support should be offered in order to create a context in which minors can make competently make decisions.

  7. 29 CFR 1921.14 - Exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) RULES OF PRACTICE IN ENFORCEMENT PROCEEDINGS UNDER SECTION 41 OF THE LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Decision and Order § 1921.14 Exceptions. Within 20 days after the date of the decision of the...

  8. Consensus oriented fuzzified decision support for oil spill contingency management.

    PubMed

    Liu, Xin; Wirtz, Kai W

    2006-06-30

    Studies on multi-group multi-criteria decision-making problems for oil spill contingency management are in their infancy. This paper presents a second-order fuzzy comprehensive evaluation (FCE) model to resolve decision-making problems in the area of contingency management after environmental disasters such as oil spills. To assess the performance of different oil combat strategies, second-order FCE allows for the utilization of lexical information, the consideration of ecological and socio-economic criteria and the involvement of a variety of stakeholders. On the other hand, the new approach can be validated by using internal and external checks, which refer to sensitivity tests regarding its internal setups and comparisons with other methods, respectively. Through a case study, the Pallas oil spill in the German Bight in 1998, it is demonstrated that this approach can help decision makers who search for an optimal strategy in multi-thread contingency problems and has a wider application potential in the field of integrated coastal zone management.

  9. A fuzzy MCDM framework based on fuzzy measure and fuzzy integral for agile supplier evaluation

    NASA Astrophysics Data System (ADS)

    Dursun, Mehtap

    2017-06-01

    Supply chains need to be agile in order to response quickly to the changes in today's competitive environment. The success of an agile supply chain depends on the firm's ability to select the most appropriate suppliers. This study proposes a multi-criteria decision making technique for conducting an analysis based on multi-level hierarchical structure and fuzzy logic for the evaluation of agile suppliers. The ideal and anti-ideal solutions are taken into consideration simultaneously in the developed approach. The proposed decision approach enables the decision-makers to use linguistic terms, and thus, reduce their cognitive burden in the evaluation process. Furthermore, a hierarchy of evaluation criteria and their related sub-criteria is employed in the presented approach in order to conduct a more effective analysis.

  10. 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

  11. 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.

  12. SPATIAL ACCURACY: A CRITICAL FACTOR IN GIS-RELATED ACTIVITIES

    EPA Science Inventory

    Onsite analyses are critical to making timely decisions. The results of these decisions may not be realized for many years. In order to increase the value of onsite analyses and to create and utilize meaningful environmental models, the Environmental Protection Agency (EPA) dev...

  13. 32 CFR 2001.13 - Classification prohibitions and limitations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... making the decision to reclassify information that has been declassified and released to the public under... attention to the information at issue. Written notification, classified when appropriate under the Order... not agree with the decision, the information shall nonetheless be temporarily withdrawn from public...

  14. Legal Forum: Drug Testing in Public Schools.

    ERIC Educational Resources Information Center

    White, Janet M; Thomas, Stephen B.

    1987-01-01

    This article reviews court decisions concerning drug testing among prisoners, military personnel, public employees, and school employees. Fourth Amendment considerations of unreasonable search and seizure are discussed. In developing drug testing policies school districts must review these decisions in order to both protect individual rights and…

  15. Feasibility of neuro-morphic computing to emulate error-conflict based decision making.

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

    Branch, Darren W.

    2009-09-01

    A key aspect of decision making is determining when errors or conflicts exist in information and knowing whether to continue or terminate an action. Understanding the error-conflict processing is crucial in order to emulate higher brain functions in hardware and software systems. Specific brain regions, most notably the anterior cingulate cortex (ACC) are known to respond to the presence of conflicts in information by assigning a value to an action. Essentially, this conflict signal triggers strategic adjustments in cognitive control, which serve to prevent further conflict. The most probable mechanism is the ACC reports and discriminates different types of feedback,more » both positive and negative, that relate to different adaptations. Unique cells called spindle neurons that are primarily found in the ACC (layer Vb) are known to be responsible for cognitive dissonance (disambiguation between alternatives). Thus, the ACC through a specific set of cells likely plays a central role in the ability of humans to make difficult decisions and solve challenging problems in the midst of conflicting information. In addition to dealing with cognitive dissonance, decision making in high consequence scenarios also relies on the integration of multiple sets of information (sensory, reward, emotion, etc.). Thus, a second area of interest for this proposal lies in the corticostriatal networks that serve as an integration region for multiple cognitive inputs. In order to engineer neurological decision making processes in silicon devices, we will determine the key cells, inputs, and outputs of conflict/error detection in the ACC region. The second goal is understand in vitro models of corticostriatal networks and the impact of physical deficits on decision making, specifically in stressful scenarios with conflicting streams of data from multiple inputs. We will elucidate the mechanisms of cognitive data integration in order to implement a future corticostriatal-like network in silicon devices for improved decision processing.« less

  16. Toward an Extension of Decision Analysis to Competitive Situations.

    DTIC Science & Technology

    1985-12-01

    order to deal with competition may ease the use of non- von Neumann-Morgenstern utility. This leads to our secondary goal of questioning expected...While von WInterfeldt [1980] attempted a 5 (more detailed analysis using three separate decision trees, one for each side In the dispute, he felt that...rationality generally used In game theory derives from the same roots as the calculated rationality of Decision Analysis, von Neumann and

  17. Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial.

    PubMed

    Terrell, Kevin M; Perkins, Anthony J; Hui, Siu L; Callahan, Christopher M; Dexter, Paul R; Miller, Douglas K

    2010-12-01

    Emergency physicians prescribe several discharge medications that require dosage adjustment for patients with renal disease. The hypothesis for this research was that decision support in a computerized physician order entry system would reduce the rate of excessive medication dosing for patients with renal impairment. This was a randomized, controlled trial in an academic emergency department (ED), in which computerized physician order entry was used to write all prescriptions for patients being discharged from the ED. The sample included 42 physicians who were randomized to the intervention (21 physicians) or control (21 physicians) group. The intervention was decision support that provided dosing recommendations for targeted medications for patients aged 18 years and older when the patient's estimated creatinine clearance level was below the threshold for dosage adjustment. The primary outcome was the proportion of targeted medications that were excessively dosed. For 2,783 (46%) of the 6,015 patient visits, the decision support had sufficient information to estimate the patient's creatinine clearance level. The average age of these patients was 46 years, 1,768 (64%) were women, and 1,523 (55%) were black. Decision support was provided 73 times to physicians in the intervention group, who excessively dosed 31 (43%) prescriptions. In comparison, control physicians excessively dosed a significantly larger proportion of medications: 34 of 46, 74% (effect size=31%; 95% confidence interval 14% to 49%; P=.001). Emergency physicians often prescribed excessive doses of medications that require dosage adjustment for renal impairment. Computerized physician order entry with decision support significantly reduced excessive dosing of targeted medications. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  18. Cognitive Analysis of Decision Support for Antibiotic Prescribing at the Point of Ordering in a Neonatal Intensive Care Unit

    PubMed Central

    Sheehan, Barbara; Kaufman, David; Stetson, Peter; Currie, Leanne M.

    2009-01-01

    Computerized decision support systems have been used to help ensure safe medication prescribing. However, the acceptance of these types of decision support has been reported to be low. It has been suggested that decreased acceptance may be due to lack of clinical relevance. Additionally, cognitive fit between the user interface and clinical task may impact the response of clinicians as they interact with the system. In order to better understand clinician responses to such decision support, we used cognitive task analysis methods to evaluate clinical alerts for antibiotic prescribing in a neonatal intensive care unit. Two methods were used: 1) a cognitive walkthrough; and 2) usability testing with a ‘think-aloud’ protocol. Data were analyzed for impact on cognitive effort according to categories of cognitive distance. We found that responses to alerts may be context specific and that lack of screen cues often increases cognitive effort required to use a system. PMID:20351922

  19. 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.

  20. 5 CFR 1201.174 - Enforcing the Special Panel decision.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... 1201.174 Section 1201.174 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND... Special Panel, will order the agency concerned to take any action appropriate to carry out the decision of... matter. These regulations are set out in subpart F of this part. ...

  1. 5 CFR 1201.174 - Enforcing the Special Panel decision.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... 1201.174 Section 1201.174 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND... Special Panel, will order the agency concerned to take any action appropriate to carry out the decision of... matter. These regulations are set out in subpart F of this part. ...

  2. 5 CFR 1201.174 - Enforcing the Special Panel decision.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... 1201.174 Section 1201.174 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND... Special Panel, will order the agency concerned to take any action appropriate to carry out the decision of... matter. These regulations are set out in subpart F of this part. ...

  3. 5 CFR 1201.174 - Enforcing the Special Panel decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... 1201.174 Section 1201.174 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND... Special Panel, will order the agency concerned to take any action appropriate to carry out the decision of... matter. These regulations are set out in subpart F of this part. ...

  4. 12 CFR 12.7 - Securities trading policies and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... registered broker/dealers; (ii) Execute transactions in securities for customers; or (iii) Process orders for... investment recommendations or decisions for the accounts of customers; (ii) Participate in the determination of the recommendations or decisions; or (iii) In connection with their duties, obtain information...

  5. Implementing an extension of the analytical hierarchy process using ordered weighted averaging operators with fuzzy quantifiers in ArcGIS

    NASA Astrophysics Data System (ADS)

    Boroushaki, Soheil; Malczewski, Jacek

    2008-04-01

    This paper focuses on the integration of GIS and an extension of the analytical hierarchy process (AHP) using quantifier-guided ordered weighted averaging (OWA) procedure. AHP_OWA is a multicriteria combination operator. The nature of the AHP_OWA depends on some parameters, which are expressed by means of fuzzy linguistic quantifiers. By changing the linguistic terms, AHP_OWA can generate a wide range of decision strategies. We propose a GIS-multicriteria evaluation (MCE) system through implementation of AHP_OWA within ArcGIS, capable of integrating linguistic labels within conventional AHP for spatial decision making. We suggest that the proposed GIS-MCE would simplify the definition of decision strategies and facilitate an exploratory analysis of multiple criteria by incorporating qualitative information within the analysis.

  6. Will Decision Support in Medications Order Entry Save Money? A Return On Investment Analysis of the Case of the Hong Kong Hospital Authority

    PubMed Central

    Fung, Kin Wah; Vogel, Lynn Harold

    2003-01-01

    The computerized medications order entry system currently used in the public hospitals of Hong Kong does not have decision support features. Plans are underway to add decision support to this system to alert physicians on drug-allergy conflicts, drug-lab result conflicts, drug-drug interactions and atypical dosages. A return on investment analysis is done on this enhancement, both as an examination of whether there is a positive return on the investment and as a contribution to the ongoing discussion of the use of return on investment models in health care information technology investments. It is estimated that the addition of decision support will reduce adverse drug events by 4.2 – 8.4%. Based on this estimate, a total net saving of $44,000 – $586,000 is expected over five years. The breakeven period is estimated to be between two to four years. PMID:14728171

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

    PubMed Central

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

    2017-01-01

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

  8. Being Involved in Mainstreaming Decisions.

    ERIC Educational Resources Information Center

    Atterbury, Betty W.

    1989-01-01

    Urges music educators' involvement in placement decisions for exceptional students in order to avoid poor placements and to enable all learners to experience musical success. Explains that educators need to understand applications of current law to teaching situations. Describes instructional strategies and aids and services that will ensure music…

  9. Human-computer interface for the study of information fusion concepts in situation analysis and command decision support systems

    NASA Astrophysics Data System (ADS)

    Roy, Jean; Breton, Richard; Paradis, Stephane

    2001-08-01

    Situation Awareness (SAW) is essential for commanders to conduct decision-making (DM) activities. Situation Analysis (SA) is defined as a process, the examination of a situation, its elements, and their relations, to provide and maintain a product, i.e., a state of SAW for the decision maker. Operational trends in warfare put the situation analysis process under pressure. This emphasizes the need for a real-time computer-based Situation analysis Support System (SASS) to aid commanders in achieving the appropriate situation awareness, thereby supporting their response to actual or anticipated threats. Data fusion is clearly a key enabler for SA and a SASS. Since data fusion is used for SA in support of dynamic human decision-making, the exploration of the SA concepts and the design of data fusion techniques must take into account human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight integration of the human element with the SA technology is essential. Regarding these issues, this paper provides a description of CODSI (Command Decision Support Interface), and operational- like human machine interface prototype for investigations in computer-based SA and command decision support. With CODSI, one objective was to apply recent developments in SA theory and information display technology to the problem of enhancing SAW quality. It thus provides a capability to adequately convey tactical information to command decision makers. It also supports the study of human-computer interactions for SA, and methodologies for SAW measurement.

  10. Hospital do-not-resuscitate orders: why they have failed and how to fix them.

    PubMed

    Yuen, Jacqueline K; Reid, M Carrington; Fetters, Michael D

    2011-07-01

    Do-not-resuscitate (DNR) orders have been in use in hospitals nationwide for over 20 years. Nonetheless, as currently implemented, they fail to adequately fulfill their two intended purposes--to support patient autonomy and to prevent non-beneficial interventions. These failures lead to serious consequences. Patients are deprived of the opportunity to make informed decisions regarding resuscitation, and CPR is performed on patients who would have wanted it withheld or are harmed by the procedure. This article highlights the persistent problems with today's use of inpatient DNR orders, i.e., DNR discussions do not occur frequently enough and occur too late in the course of patients' illnesses to allow their participation in resuscitation decisions. Furthermore, many physicians fail to provide adequate information to allow patients or surrogates to make informed decisions and inappropriately extrapolate DNR orders to limit other treatments. Because these failings are primarily due to systemic factors that result in deficient physician behaviors, we propose strategies to target these factors including changing the hospital culture, reforming hospital policies on DNR discussions, mandating provider communication skills training, and using financial incentives. These strategies could help overcome existing barriers to proper DNR discussions and align the use of DNR orders closer to their intended purposes of supporting patient self-determination and avoiding non-beneficial interventions at the end of life.

  11. Cognitive analysis of physicians' medication ordering activity.

    PubMed

    Pelayo, Sylvia; Leroy, Nicolas; Guerlinger, Sandra; Degoulet, Patrice; Meaux, Jean-Jacques; Beuscart-Zéphir, Marie-Catherine

    2005-01-01

    Computerized Physician Order Entry (CPOE) addresses critical functions in healthcare systems. As the name clearly indicates, these systems focus on order entry. With regard to medication orders, such systems generally force physicians to enter exhaustively documented orders. But a cognitive analysis of the physician's medication ordering task shows that order entry is the last (and least) important step of the entire cognitive therapeutic decision making task. We performed a comparative analysis of these complex cognitive tasks in two working environments, computer-based and paper-based. The results showed that information gathering, selection and interpretation are critical cognitive functions to support the therapeutic decision making. Thus the most important requirement from the physician's perspective would be an efficient display of relevant information provided first in the form of a summarized view of the patient's current treatment, followed by in a more detailed focused display of those items pertinent to the current situation. The CPOE system examined obviously failed to provide the physicians this critical summarized view. Following these results, consistent with users' complaints, the Company decided to engage in a significant re-engineering process of their application.

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

    PubMed

    Simic, Vladimir

    2015-01-01

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

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

    DTIC Science & Technology

    2014-09-01

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

  14. 32 CFR 1802.26 - Notification of decision and prohibition on adverse action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... NATIONAL COUNTERINTELLIGENCE CENTER CHALLENGES TO CLASSIFICATION OF DOCUMENTS BY AUTHORIZED HOLDERS... regard to the challenge and that an appeal of the decision may be made to the Interagency Security Classification Appeals Panel (ISCAP) established pursuant to § 5.4 of this Order. ...

  15. 32 CFR 1802.26 - Notification of decision and prohibition on adverse action.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NATIONAL COUNTERINTELLIGENCE CENTER CHALLENGES TO CLASSIFICATION OF DOCUMENTS BY AUTHORIZED HOLDERS... regard to the challenge and that an appeal of the decision may be made to the Interagency Security Classification Appeals Panel (ISCAP) established pursuant to § 5.4 of this Order. ...

  16. 45 CFR 672.5 - Filing and service of rulings, orders, and decisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.5 Filing and service of rulings, orders, and..., or with any representative of such person. Any ex parte memorandum or other communication addressed...

  17. Assessment of Higher Order Thinking Skills. Current Perspectives on Cognition, Learning and Instruction

    ERIC Educational Resources Information Center

    Schraw, Gregory, Ed.; Robinson, Daniel H., Ed.

    2011-01-01

    This volume examines the assessment of higher order thinking skills from the perspectives of applied cognitive psychology and measurement theory. The volume considers a variety of higher order thinking skills, including problem solving, critical thinking, argumentation, decision making, creativity, metacognition, and self-regulation. Fourteen…

  18. 42 CFR 426.489 - Board remands.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... decision; and (2) Explains why the case is being remanded and the specific actions ordered by the Board. (b) Action by an ALJ on remand. An ALJ takes any action that is ordered by the Board and may take any additional action that is not inconsistent with the Board's remand order. ...

  19. Application of decision-making theory to the regulation of muscular work rate during self-paced competitive endurance activity.

    PubMed

    Renfree, Andrew; Martin, Louise; Micklewright, Dominic; St Clair Gibson, Alan

    2014-02-01

    Successful participation in competitive endurance activities requires continual regulation of muscular work rate in order to maximise physiological performance capacities, meaning that individuals must make numerous decisions with regards to the muscular work rate selected at any point in time. Decisions relating to the setting of appropriate goals and the overall strategic approach to be utilised are made prior to the commencement of an event, whereas tactical decisions are made during the event itself. This review examines current theories of decision-making in an attempt to explain the manner in which regulation of muscular work is achieved during athletic activity. We describe rational and heuristic theories, and relate these to current models of regulatory processes during self-paced exercise in an attempt to explain observations made in both laboratory and competitive environments. Additionally, we use rational and heuristic theories in an attempt to explain the influence of the presence of direct competitors on the quality of the decisions made during these activities. We hypothesise that although both rational and heuristic models can plausibly explain many observed behaviours in competitive endurance activities, the complexity of the environment in which such activities occur would imply that effective rational decision-making is unlikely. However, at present, many proposed models of the regulatory process share similarities with rational models. We suggest enhanced understanding of the decision-making process during self-paced activities is crucial in order to improve the ability to understand regulation of performance and performance outcomes during athletic activity.

  20. Time Management and the Military Decision Making Process

    DTIC Science & Technology

    1992-12-18

    This monograph analyzes the military decision making process in terms of time management in order to determine if a timeline will expedite the...process. The monograph begins by establishing the importance of time and time management in planning. This section provides a general discussion of time, an...Perhaps using some of the techniques that other armies use will facilitate time management .... Time management , Decision making, Timeline, Mission analysis, Wargaming, Courses of action, OPORD, Brigade OPS.

  1. 77 FR 4830 - Southwest K-9; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... Braunfels, Texas. The Show Cause Order proposed the denial of Applicant's application for a DEA Certificate..., and (5) ``institute * * * procedures for ensuring that its services will not be offered to illegal... detection services in the area where it proposes to do business. Id. The Order also notified applicant of...

  2. A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems

    PubMed Central

    Hou, Kun-Mean; Zhang, Zhan

    2017-01-01

    Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem. PMID:29120357

  3. A Decentralized Compositional Framework for Dependable Decision Process in Self-Managed Cyber Physical Systems.

    PubMed

    Zhou, Peng; Zuo, Decheng; Hou, Kun-Mean; Zhang, Zhan

    2017-11-09

    Cyber Physical Systems (CPSs) need to interact with the changeable environment under various interferences. To provide continuous and high quality services, a self-managed CPS should automatically reconstruct itself to adapt to these changes and recover from failures. Such dynamic adaptation behavior introduces systemic challenges for CPS design, advice evaluation and decision process arrangement. In this paper, a formal compositional framework is proposed to systematically improve the dependability of the decision process. To guarantee the consistent observation of event orders for causal reasoning, this work first proposes a relative time-based method to improve the composability and compositionality of the timing property of events. Based on the relative time solution, a formal reference framework is introduced for self-managed CPSs, which includes a compositional FSM-based actor model (subsystems of CPS), actor-based advice and runtime decomposable decisions. To simplify self-management, a self-similar recursive actor interface is proposed for decision (actor) composition. We provide constraints and seven patterns for the composition of reliability and process time requirements. Further, two decentralized decision process strategies are proposed based on our framework, and we compare the reliability with the static strategy and the centralized processing strategy. The simulation results show that the one-order feedback strategy has high reliability, scalability and stability against the complexity of decision and random failure. This paper also shows a way to simplify the evaluation for dynamic system by improving the composability and compositionality of the subsystem.

  4. 31 CFR 538.407 - Facilitation by a United States person.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... planning; decision making; designing, ordering or transporting goods; and financial, insurance, and other... pursuant to this part. (d) No U.S. person may refer to a foreign person purchase orders, requests for bids...

  5. Relevance Judging, Evaluation, and Decision Making in Virtual Libraries: A Descriptive Study.

    ERIC Educational Resources Information Center

    Fitzgerald, Mary Ann; Galloway, Chad

    2001-01-01

    Describes a study that investigated the cognitive processes undergraduates used to select information while using a virtual library, GALILEO (Georgia Library Learning Online). Discusses higher order thinking processes, relevance judging, evaluation (critical thinking), decision making, reasoning involving documents, relevance-related reasoning,…

  6. 75 FR 69653 - Energy Conservation Program for Consumer Products: Decision and Order Granting a Waiver to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

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

  7. Forgoing life sustaining treatments: differences and similarities between North America and Europe.

    PubMed

    Moselli, N M; Debernardi, F; Piovano, F

    2006-11-01

    As evidence exist that severe neurological damage or prolonged death after inappropriate CPR could occur, restraints and indications for CPR were perceived as necessary. The objective of this review is to examine policies and attitudes towards end-of-life decisions in Europe and North America and to outline differences and similarities. A bibliographic database search from 1990 to 2006 was performed using the following terms: do-not-resuscitate orders, end-of-life decisions, withholding/withdrawal of life-sustaining treatments, medical futility and advanced directives. Eighty-eight articles, out of 305 examined, were analyzed and their data systematically reported and compared where possible. They consisted of studies, questionnaires and surveys answering the following questions: percentage of deaths of critical patients preceded by do-not-resuscitate orders, factors affecting the decision for do-not-resuscitate orders, people involved in this decision (patient, surrogates and medical staff) and how it was performed. There is an evident gap between the North American use of standard and formal procedures compared with Europe. Second, they diverge in the role acknowledged to surrogates in the decisional process, as in Europe, restraints and reserves to accept surrogates as decision makers seem still strong and a paternalistic approach at the end-of-life is still present. Incidentally, despite the predictable differences between Europe and North America, concerns do exist about the actual extent of autonomy wished by patients and surrogates. It is important to highlight these findings, as the paternalistic attitude, too often negatively depicted, could be, according to the best medical practice, justified and more welcomed in some instances.

  8. Leadership Decision Making and the Use of Data

    ERIC Educational Resources Information Center

    Guerra-Lopez, Ingrid; Blake, Anne M.

    2011-01-01

    Intelligence gathering, or data collection, is a preliminary and critical stage of decision making. Two key approaches to intelligence gathering are "discovery" and "idea imposition." The discovery approach allows us to learn about possibilities by gathering intelligence in order to identify and weigh options. The idea imposition approach limits…

  9. GLOBAL POSITIONING SYSTEMS GPS TECHNOLOGY PRIMER, EPA POLICIES AND PROCEDURES, AND QA CONSIDERATION

    EPA Science Inventory



    Onsite analyses are critical to making timely decisions. The results of these decisions may not be realized for many years. in order to increase the value of onsite analyses and to create and utilize meaningful environmental models, the Environmental Protection Agency (EP...

  10. 78 FR 69441 - Wheatland Pharmacy; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... Order proposed the denial of Applicant's pending application for a DEA Certificate of Registration as a... adjudication in 1991 following Ms. Clark's guilty plea to a felony charge of Theft of Service in the District... the Pharmacy Buying Association (PBA), a pharmaceutical distributing company, that Applicant ordered 1...

  11. Combat Orders: An Analysis of the Tactical Orders Process

    DTIC Science & Technology

    1990-06-01

    119 How Each System was Adapted to Doctrine .................. 120 T im e, the Critical Factor...Order ............................. 127 Decision Sequencing ... .......................... .............. ........................ 134 Adapting Tactical...overcentralization slows action and leads to inertia." 15 Agility Is the ability of friendly forces to act faster than the enemy. Initiative stresses the ability

  12. 40 CFR 164.103 - Final decision or order on appeal or review.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... review. 164.103 Section 164.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... of an accelerated decision, unless otherwise stipulated by the parties, the Environmental Appeals...

  13. 40 CFR 164.103 - Final decision or order on appeal or review.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... review. 164.103 Section 164.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... of an accelerated decision, unless otherwise stipulated by the parties, the Environmental Appeals...

  14. 40 CFR 57.813 - Final decision.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Final decision. 57.813 Section 57.813 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PRIMARY NONFERROUS SMELTER ORDERS Waiver of Interim Requirement for Use of Continuous Emission Reduction Technology...

  15. Commonality in Military Equipment. A Framework to Improve Acquisition Decisions

    DTIC Science & Technology

    2008-01-01

    Improving Acquisition Decisions Chopra, Sunil , and Peter Meindl, Supply Chain Management : Strategy, Planning, Operation, Upper Saddle River, N.J...Personnel Costs in Managing Suppliers and Ordering Parts. The effort to perform these activities may be reduced and simplified through a smaller supply ...a Combined MOS on Mechanic Supply Variability

  16. Career Decision-Making: What Matters to Indigenous Australians?

    ERIC Educational Resources Information Center

    Helme, Sue

    2010-01-01

    This article brings together and discusses three research projects that examined the vocational education and career-decision making of Indigenous Australians. These studies focused on the experiences of Indigenous people themselves, in order to provide an Indigenous perspective on vocational and career development. Four main barriers that limit…

  17. Justice in and through Education? Students' Participation in Decision-Making

    ERIC Educational Resources Information Center

    Rönnlund, Maria

    2014-01-01

    Drawing on one year of ethnographic work in three Swedish lower secondary schools, this article problematizes students' participation in decision-making in everyday school life in the perspective of social justice. In order to extend the traditional liberal understanding of justice and include also relational, procedurial, social and cultural…

  18. Service users' experiences of participation in decision making in mental health services.

    PubMed

    Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

    2015-11-01

    Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

  19. Efficacy of an evidence-based clinical decision support in primary care practices: a randomized clinical trial.

    PubMed

    McGinn, Thomas G; McCullagh, Lauren; Kannry, Joseph; Knaus, Megan; Sofianou, Anastasia; Wisnivesky, Juan P; Mann, Devin M

    2013-09-23

    There is consensus that incorporating clinical decision support into electronic health records will improve quality of care, contain costs, and reduce overtreatment, but this potential has yet to be demonstrated in clinical trials. To assess the influence of a customized evidence-based clinical decision support tool on the management of respiratory tract infections and on the effectiveness of integrating evidence at the point of care. In a randomized clinical trial, we implemented 2 well-validated integrated clinical prediction rules, namely, the Walsh rule for streptococcal pharyngitis and the Heckerling rule for pneumonia. INTERVENTIONS AND MAIN OUTCOMES AND MEASURES: The intervention group had access to the integrated clinical prediction rule tool and chose whether to complete risk score calculators, order medications, and generate progress notes to assist with complex decision making at the point of care. The intervention group completed the integrated clinical prediction rule tool in 57.5% of visits. Providers in the intervention group were significantly less likely to order antibiotics than the control group (age-adjusted relative risk, 0.74; 95% CI, 0.60-0.92). The absolute risk of the intervention was 9.2%, and the number needed to treat was 10.8. The intervention group was significantly less likely to order rapid streptococcal tests compared with the control group (relative risk, 0.75; 95% CI, 0.58-0.97; P= .03). The integrated clinical prediction rule process for integrating complex evidence-based clinical decision report tools is of relevant importance for national initiatives, such as Meaningful Use. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01386047.

  20. Prioritization of water management for sustainability using hydrologic simulation model and multicriteria decision making techniques.

    PubMed

    Chung, Eun-Sung; Lee, Kil Seong

    2009-03-01

    The objective of this study is to develop an alternative evaluation index (AEI) in order to determine the priorities of a range of alternatives using both the hydrological simulation program in FORTRAN (HSPF) and multicriteria decision making (MCDM) techniques. In order to formulate the HSPF model, sensitivity analyses of water quantity (peak discharge and total volume) and quality (BOD peak concentrations and total loads) are conducted and a number of critical parameters were selected. To achieve a more precise simulation, the study watershed is divided into four regions for calibration and verification according to landuse, location, slope, and climate data. All evaluation criteria were selected using the Driver-Pressure-State-Impact-Response (DPSIR) model, a sustainability evaluation concept. The Analytic Hierarchy Process is used to estimate the weights of the criteria and the effects of water quantity and quality were quantified by HSPF simulation. In addition, AEIs that reflected residents' preferences for management objectives are proposed in order to induce the stakeholder to participate in the decision making process.

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