Science.gov

Sample records for early design decisions

  1. Early stage design decisions: the way to achieve sustainable buildings at lower costs.

    PubMed

    Bragança, Luís; Vieira, Susana M; Andrade, Joana B

    2014-01-01

    The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle.

  2. Early Stage Design Decisions: The Way to Achieve Sustainable Buildings at Lower Costs

    PubMed Central

    Bragança, Luís; Vieira, Susana M.; Andrade, Joana B.

    2014-01-01

    The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle. PMID:24578630

  3. Designing for Decision Making

    ERIC Educational Resources Information Center

    Jonassen, David H.

    2012-01-01

    Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…

  4. Enhancing Decision Topology Assessment in Engineering Design

    DTIC Science & Technology

    2014-04-10

    in engineering design decision making. References 1. Clemen , R. T., 1997, Making Hard Decisions, Second Edition, Duxbury Press. 2. Hazelrigg, G. A...United Kingdom. 6. Lewis, K., Chen, W. and L. C. Schmidt , Editors, 2006, Decision Making in Engineering Design, ASME Press, New York. 7. Myers

  5. Intertwining Risk Insights and Design Decisions

    NASA Technical Reports Server (NTRS)

    Cornford, Steven L.; Feather, Martin S.; Jenkins, J. Steven

    2006-01-01

    The state of systems engineering is such that a form of early and continued use of risk assessments is conducted (as evidenced by NASA's adoption and use of the 'Continuous Risk Management' paradigm developed by SEI). ... However, these practices fall short of theideal: (1) Integration between risk assessment techniques and other systems engineering tools is weak. (2) Risk assessment techniques and the insights they yield are only informally coupled to design decisions. (3) Individual riskassessment techniques lack the mix of breadth, fidelity and agility required to span the gamut of the design space. In this paper we present an approach that addresses these shortcomings. The hallmark of our approach is a simple representation comprising objectives (what the system is to do), risks (whose occurrence would detract from attainment of objectives) and activities (a.k.a. 'mitigations') that, if performed, will decrease those risks. These are linked to indicate by how much a risk would detract from attainment of an objective, and by how much an activity would reduce a risk. The simplicity of our representational framework gives it the breadth to encompass the gamut of the design space concerns, the agility to be utilized in even the earliest phases of designs, and the capability to connect to system engineering models and higher-fidelity risk tools. It is through this integration that we address the shortcomings listed above, and so achieve the intertwining between risk insights and design decisions needed to guide systems engineering towards superior final designs while avoiding costly rework to achieve them. The paper will use an example, constructed to be representative of space mission design, to illustrate our approach.

  6. Integrating post-manufacturing issues into design and manufacturing decisions

    NASA Technical Reports Server (NTRS)

    Eubanks, Charles F.

    1996-01-01

    An investigation is conducted on research into some of the fundamental issues underlying the design for manufacturing, service and recycling that affect engineering decisions early in the conceptual design phase of mechanical systems. The investigation focuses on a system-based approach to material selection, manufacturing methods and assembly processes related to overall product requirements, performance and life-cycle costs. Particular emphasis is placed on concurrent engineering decision support for post-manufacturing issues such as serviceability, recyclability, and product retirement.

  7. Recycling Decisions and Green Design.

    ERIC Educational Resources Information Center

    Lave, Lester B.; And Others

    1994-01-01

    Explores the facts and perceptions regarding recycling, what can be done to make products more environmentally compatible, and how to think about recycling decisions in a more helpful way. (Contains 39 references.) (MDH)

  8. The Early Years: Integrating Design

    ERIC Educational Resources Information Center

    Ashbrook, Peggy; Nellor, Sue

    2015-01-01

    Engineering is such a common part of children's work in early childhood programs that teachers can simply look around the room to identify examples where students have engaged in engineering practices. This article presents a classroom activity that integrates engineering design by building on the everyday problems that young children encounter in…

  9. Naturalistic Decision Making: Implications for Design

    DTIC Science & Technology

    1993-04-01

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

  10. Globally optimal trial design for local decision making.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2009-02-01

    Value of information methods allows decision makers to identify efficient trial design following a principle of maximizing the expected value to decision makers of information from potential trial designs relative to their expected cost. However, in health technology assessment (HTA) the restrictive assumption has been made that, prospectively, there is only expected value of sample information from research commissioned within jurisdiction. This paper extends the framework for optimal trial design and decision making within jurisdiction to allow for optimal trial design across jurisdictions. This is illustrated in identifying an optimal trial design for decision making across the US, the UK and Australia for early versus late external cephalic version for pregnant women presenting in the breech position. The expected net gain from locally optimal trial designs of US$0.72M is shown to increase to US$1.14M with a globally optimal trial design. In general, the proposed method of globally optimal trial design improves on optimal trial design within jurisdictions by: (i) reflecting the global value of non-rival information; (ii) allowing optimal allocation of trial sample across jurisdictions; (iii) avoiding market failure associated with free-rider effects, sub-optimal spreading of fixed costs and heterogeneity of trial information with multiple trials. Copyright (c) 2008 John Wiley & Sons, Ltd.

  11. "Dosage" Decisions for Early Intervention Services

    ERIC Educational Resources Information Center

    Kuhn, Miriam; Marvin, Christine A.

    2016-01-01

    Part C of the Individuals With Disabilities Education Improvement Act (IDEA) of 2004 requires early intervention teams craft individualized and effective plans to meet the needs of young children with special needs and their families (Küpper, 2012). Many early intervention teams, however, may struggle to follow a process that results in…

  12. A quantitative risk model for early lifecycle decision making

    NASA Technical Reports Server (NTRS)

    Feather, M. S.; Cornford, S. L.; Dunphy, J.; Hicks, K.

    2002-01-01

    Decisions made in the earliest phases of system development have the most leverage to influence the success of the entire development effort, and yet must be made when information is incomplete and uncertain. We have developed a scalable cost-benefit model to support this critical phase of early-lifecycle decision-making.

  13. A Design Pattern for Decentralised Decision Making

    PubMed Central

    Valentini, Gabriele; Fernández-Oto, Cristian; Dorigo, Marco

    2015-01-01

    The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera). The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling. PMID:26496359

  14. Decomposition-Based Decision Making for Aerospace Vehicle Design

    NASA Technical Reports Server (NTRS)

    Borer, Nicholas K.; Mavris, DImitri N.

    2005-01-01

    Most practical engineering systems design problems have multiple and conflicting objectives. Furthermore, the satisfactory attainment level for each objective ( requirement ) is likely uncertain early in the design process. Systems with long design cycle times will exhibit more of this uncertainty throughout the design process. This is further complicated if the system is expected to perform for a relatively long period of time, as now it will need to grow as new requirements are identified and new technologies are introduced. These points identify a need for a systems design technique that enables decision making amongst multiple objectives in the presence of uncertainty. Traditional design techniques deal with a single objective or a small number of objectives that are often aggregates of the overarching goals sought through the generation of a new system. Other requirements, although uncertain, are viewed as static constraints to this single or multiple objective optimization problem. With either of these formulations, enabling tradeoffs between the requirements, objectives, or combinations thereof is a slow, serial process that becomes increasingly complex as more criteria are added. This research proposal outlines a technique that attempts to address these and other idiosyncrasies associated with modern aerospace systems design. The proposed formulation first recasts systems design into a multiple criteria decision making problem. The now multiple objectives are decomposed to discover the critical characteristics of the objective space. Tradeoffs between the objectives are considered amongst these critical characteristics by comparison to a probabilistic ideal tradeoff solution. The proposed formulation represents a radical departure from traditional methods. A pitfall of this technique is in the validation of the solution: in a multi-objective sense, how can a decision maker justify a choice between non-dominated alternatives? A series of examples help the

  15. Design decisions from the history of the EUVE science payload

    NASA Astrophysics Data System (ADS)

    Marchant, W.

    1993-09-01

    Some of the design issues that arose during the development of the EUVE science payload and solutions to the problems involved are examined. In particular, attention is given to the use of parallel and serial busses, the selection of the the ROM approach for software storage and execution, implementation of memory error detection and correction, and the selection of command structures. The early design decisions paid off in the timely delivery of the scientific payload and in the successful completion of the survey phase of the EUVE science mission.

  16. Design decisions from the history of the EUVE science payload

    NASA Technical Reports Server (NTRS)

    Marchant, W.

    1993-01-01

    Some of the design issues that arose during the development of the EUVE science payload and solutions to the problems involved are examined. In particular, attention is given to the use of parallel and serial busses, the selection of the the ROM approach for software storage and execution, implementation of memory error detection and correction, and the selection of command structures. The early design decisions paid off in the timely delivery of the scientific payload and in the successful completion of the survey phase of the EUVE science mission.

  17. Early Design Energy Analysis Using Building Information Modeling Technology

    DTIC Science & Technology

    2011-11-01

    building, (a) floor plan and (b) 3D image. ....................................... 50 Figure 28. Comparison of different energy estimates...when they make the biggest impact on building life-cycle costs. Traditionally, most building energy analyses have been conducted late in design, by...complete energy analysis. This method enables project teams to make energy conscious decisions early in design when they impact building life-cycle

  18. Collaborative, Sequential and Isolated Decisions in Design

    NASA Technical Reports Server (NTRS)

    Lewis, Kemper; Mistree, Farrokh

    1997-01-01

    The Massachusetts Institute of Technology (MIT) Commission on Industrial Productivity, in their report Made in America, found that six recurring weaknesses were hampering American manufacturing industries. The two weaknesses most relevant to product development were 1) technological weakness in development and production, and 2) failures in cooperation. The remedies to these weaknesses are considered the essential twin pillars of CE: 1) improved development process, and 2) closer cooperation. In the MIT report, it is recognized that total cooperation among teams in a CE environment is rare in American industry, while the majority of the design research in mathematically modeling CE has assumed total cooperation. In this paper, we present mathematical constructs, based on game theoretic principles, to model degrees of collaboration characterized by approximate cooperation, sequential decision making and isolation. The design of a pressure vessel and a passenger aircraft are included as illustrative examples.

  19. A decision-based perspective for the design of methods for systems design

    NASA Technical Reports Server (NTRS)

    Mistree, Farrokh; Muster, Douglas; Shupe, Jon A.; Allen, Janet K.

    1989-01-01

    Organization of material, a definition of decision based design, a hierarchy of decision based design, the decision support problem technique, a conceptual model design that can be manufactured and maintained, meta-design, computer-based design, action learning, and the characteristics of decisions are among the topics covered.

  20. UML Profiles for Design Decisions and Non-Functional Requirements

    SciT

    Zhu, Liming; Gorton, Ian

    2007-06-30

    A software architecture is composed of a collection of design decisions. Each design decision helps or hinders certain Non-Functional Requirements (NFR). Current software architecture views focus on expressing components and connectors in the system. Design decisions and their relationships with non-functional requirements are often captured in separate design documentation, not explicitly expressed in any views. This disassociation makes architecture comprehension and architecture evolution harder. In this paper, we propose a UML profile for modeling design decisions and an associated UML profile for modeling non-functional requirements in a generic way. The two UML profiles treat design decisions and nonfunctional requirements asmore » first-class elements. Modeled design decisions always refer to existing architectural elements and thus maintain traceability between the two. We provide a mechanism for checking consistency over this traceability. An exemplar is given as« less

  1. Corruption Early Prevention: Decision Support System for President of the Republic of Indonesia

    NASA Astrophysics Data System (ADS)

    Sasmoko; Widhoyoko, S. A.; Ariyanto, S.; Indrianti, Y.; Noerlina; Muqsith, A. M.; Alamsyah, M.

    2017-01-01

    Corruption is an extraordinary crime, and then the prevention must also be extraordinary, simultaneously (national) in the form of early warning that involves all elements; government, industry, and society. To realize it the system needs to be built which in this study is called the Corruption Early Prevention (CEP) as a Decision Support System for President of the Republic of Indonesia. This study aims to examine 1) how is the construct of the Corruption Early Prevention as a Decision Support System for President of the Republic of Indonesia?, and 2) how is the design form of the system of Corruption Early Prevention as a Decision Support System for President of Republic of Indonesia? The research method is using Neuro-Research which is the collaboration of qualitative and quantitative research methods and the model development of Information Technology (IT). The research found that: 1) the construct of CEP is theoretically feasible, valid and reliable by content to be developed in the context of the prevention of corruption in Indonesia as an early prevention system that diagnoses Indonesia simultaneously and in real time, and 2) the concept of system design and business process of CEP is predicted to be realized in the IT-based program.

  2. Flexible Early Warning Systems with Workflows and Decision Tables

    NASA Astrophysics Data System (ADS)

    Riedel, F.; Chaves, F.; Zeiner, H.

    2012-04-01

    An essential part of early warning systems and systems for crisis management are decision support systems that facilitate communication and collaboration. Often official policies specify how different organizations collaborate and what information is communicated to whom. For early warning systems it is crucial that information is exchanged dynamically in a timely manner and all participants get exactly the information they need to fulfil their role in the crisis management process. Information technology obviously lends itself to automate parts of the process. We have experienced however that in current operational systems the information logistics processes are hard-coded, even though they are subject to change. In addition, systems are tailored to the policies and requirements of a certain organization and changes can require major software refactoring. We seek to develop a system that can be deployed and adapted to multiple organizations with different dynamic runtime policies. A major requirement for such a system is that changes can be applied locally without affecting larger parts of the system. In addition to the flexibility regarding changes in policies and processes, the system needs to be able to evolve; when new information sources become available, it should be possible to integrate and use these in the decision process. In general, this kind of flexibility comes with a significant increase in complexity. This implies that only IT professionals can maintain a system that can be reconfigured and adapted; end-users are unable to utilise the provided flexibility. In the business world similar problems arise and previous work suggested using business process management systems (BPMS) or workflow management systems (WfMS) to guide and automate early warning processes or crisis management plans. However, the usability and flexibility of current WfMS are limited, because current notations and user interfaces are still not suitable for end-users, and workflows

  3. The Downside of Early Decision: Choosing Early Doesn't Always Mean Choosing Right

    ERIC Educational Resources Information Center

    Bacow, Lawrence S.

    2006-01-01

    The increasingly popular option of applying "early decision" (ED) requires a student to make a binding commitment that, if admitted to a particular college, she or he will enroll. Now offered by 184 U.S. colleges and universities, ED is a highly effective--and therefore highly seductive--tool for managing enrollment. This author argues,…

  4. Understanding Early Decisions to Withdraw Life-Sustaining Therapy in Cardiac Arrest Survivors. A Qualitative Investigation.

    PubMed

    Dale, Craig M; Sinuff, Tasnim; Morrison, Laurie J; Golan, Eyal; Scales, Damon C

    2016-07-01

    Early withdrawal of life-sustaining therapy contributes to the majority of deaths following out-of-hospital cardiac arrest (OHCA), despite current recommendations for delayed neurological prognostication (≥72 h) after treatment with targeted temperature management. Little is known about clinicians' experiences of early withdrawal of life support decisions in patients with OHCA. To explore clinicians' experiences and perceptions of early withdrawal of life support decisions and barriers to guideline-concordant neurological prognostication in comatose survivors of OHCA treated with targeted temperature management. We conducted qualitative interviews with intensive care unit (ICU) physicians and nurses following withdrawal of life support in comatose patients with OHCA treated with targeted temperature management. The study was carried out across 18 academic and community hospitals participating in a multicenter, stepped-wedge, cluster-randomized controlled trial designed to improve quality-of-care processes for patients after OHCA in Ontario, Canada. We used a focused thematic analysis to capture barriers to guideline-concordant neurological prognostication and used these barriers to identify potentially modifiable issues. The core thematic finding was a high emotional burden of ICU family-team communication in which strong feelings inhibited information transfer and delayed decision making following OHCA. Four subthemes describing sources of communication strain were identified: (1) requests from family members to provide early outcome predictions, (2) incomplete family comprehension of critical care, (3) family requests for early withdrawal of life support based on their understanding of patients' preferences and values, and (4) family-team communication gaps related to prognostic uncertainty. Participants worried that gaps in timely and clear prognostic information contributed to surrogates' perceptions of a poor outcome and to inappropriately early decisions to

  5. A decision tool for selecting trench cap designs

    SciT

    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

  6. An automated approach to the design of decision tree classifiers

    NASA Technical Reports Server (NTRS)

    Argentiero, P.; Chin, R.; Beaudet, P.

    1982-01-01

    An automated technique is presented for designing effective decision tree classifiers predicated only on a priori class statistics. The procedure relies on linear feature extractions and Bayes table look-up decision rules. Associated error matrices are computed and utilized to provide an optimal design of the decision tree at each so-called 'node'. A by-product of this procedure is a simple algorithm for computing the global probability of correct classification assuming the statistical independence of the decision rules. Attention is given to a more precise definition of decision tree classification, the mathematical details on the technique for automated decision tree design, and an example of a simple application of the procedure using class statistics acquired from an actual Landsat scene.

  7. Bayesian design of decision rules for failure detection

    NASA Technical Reports Server (NTRS)

    Chow, E. Y.; Willsky, A. S.

    1984-01-01

    The formulation of the decision making process of a failure detection algorithm as a Bayes sequential decision problem provides a simple conceptualization of the decision rule design problem. As the optimal Bayes rule is not computable, a methodology that is based on the Bayesian approach and aimed at a reduced computational requirement is developed for designing suboptimal rules. A numerical algorithm is constructed to facilitate the design and performance evaluation of these suboptimal rules. The result of applying this design methodology to an example shows that this approach is potentially a useful one.

  8. Iteration in Early-Elementary Engineering Design

    NASA Astrophysics Data System (ADS)

    McFarland Kendall, Amber Leigh

    K-12 standards and curricula are beginning to include engineering design as a key practice within Science Technology Engineering and Mathematics (STEM) education. However, there is little research on how the youngest students engage in engineering design within the elementary classroom. This dissertation focuses on iteration as an essential aspect of engineering design, and because research at the college and professional level suggests iteration improves the designer's understanding of problems and the quality of design solutions. My research presents qualitative case studies of students in kindergarten and third-grade as they engage in classroom engineering design challenges which integrate with traditional curricula standards in mathematics, science, and literature. I discuss my results through the lens of activity theory, emphasizing practices, goals, and mediating resources. Through three chapters, I provide insight into how early-elementary students iterate upon their designs by characterizing the ways in which lesson design impacts testing and revision, by analyzing the plan-driven and experimentation-driven approaches that student groups use when solving engineering design challenges, and by investigating how students attend to constraints within the challenge. I connect these findings to teacher practices and curriculum design in order to suggest methods of promoting iteration within open-ended, classroom-based engineering design challenges. This dissertation contributes to the field of engineering education by providing evidence of productive engineering practices in young students and support for the value of engineering design challenges in developing students' participation and agency in these practices.

  9. Information Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions.

    PubMed

    Wang, Shi-Yi; Kelly, Gabrielle; Gross, Cary; Killelea, Brigid K; Mougalian, Sarah; Presley, Carolyn; Fraenkel, Liana; Evans, Suzanne B

    2017-07-15

    To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. We surveyed (through face-to-face interview, telephone, or mail) women aged ≥65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers. Participants rated the importance (on a 4-point scale) of 24 statements describing the benefits, side effects, impact on daily life, and other issues of radiation therapy in relation to radiation therapy decision making. Participants also designated who was considered the key decision maker. The response rate was 56.4% (93 of 165). Mean age was 72.5 years, ranging from 65 to 93 years. More than 96% of participants indicated they were the main decision maker on receiving radiation therapy. There was wide variation in information needs regarding radiation therapy decision making. Participants rated a mean of 18 (range, 3-24) items as "essential." Participants rated items related to benefits highest, followed by side effects. Participants who were older than 75 years rated 13.9 questions as essential, whereas participants aged ≤74 years rated 18.7 as essential (P=.018). Older women desire information and have more agency and input in the decision-making process than prior literature would suggest. The variation in information needs indicates that future decision support tools should provide options to select what information would be of interest to the participants. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Compositing Visualization Tools for Improving Design Decisions

    ERIC Educational Resources Information Center

    Chung, Wayne C.

    2005-01-01

    Today's designers deal with a range of communication modes. These modes vary from hand gestures to sketches, physical models, and computer-generated images. It has been the norm to use these mediums throughout the process to visualize the intended design so that the potential users, designers, team members, and clients can understand the end…

  11. Astrophysical Supercomputing with GPUs: Critical Decisions for Early Adopters

    NASA Astrophysics Data System (ADS)

    Fluke, Christopher J.; Barnes, David G.; Barsdell, Benjamin R.; Hassan, Amr H.

    2011-01-01

    General-purpose computing on graphics processing units (GPGPU) is dramatically changing the landscape of high performance computing in astronomy. In this paper, we identify and investigate several key decision areas, with a goal of simplifying the early adoption of GPGPU in astronomy. We consider the merits of OpenCL as an open standard in order to reduce risks associated with coding in a native, vendor-specific programming environment, and present a GPU programming philosophy based on using brute force solutions. We assert that effective use of new GPU-based supercomputing facilities will require a change in approach from astronomers. This will likely include improved programming training, an increased need for software development best practice through the use of profiling and related optimisation tools, and a greater reliance on third-party code libraries. As with any new technology, those willing to take the risks and make the investment of time and effort to become early adopters of GPGPU in astronomy, stand to reap great benefits.

  12. An intelligent, knowledge-based multiple criteria decision making advisor for systems design

    NASA Astrophysics Data System (ADS)

    Li, Yongchang

    In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection

  13. Understanding Decision Making in Teachers' Curriculum Design Approaches

    ERIC Educational Resources Information Center

    Boschman, Ferry; McKenney, Susan; Voogt, Joke

    2014-01-01

    The goal of this study was to reach a better understanding of the intuitive decisions teachers make when designing a technology-rich learning environment. A multiple case-study design was employed to examine what kinds of factors (external priorities, existing orientations or practical concerns) influence design interactions of teams of…

  14. The design of aircraft using the decision support problem technique

    NASA Technical Reports Server (NTRS)

    Mistree, Farrokh; Marinopoulos, Stergios; Jackson, David M.; Shupe, Jon A.

    1988-01-01

    The Decision Support Problem Technique for unified design, manufacturing and maintenance is being developed at the Systems Design Laboratory at the University of Houston. This involves the development of a domain-independent method (and the associated software) that can be used to process domain-dependent information and thereby provide support for human judgment. In a computer assisted environment, this support is provided in the form of optimal solutions to Decision Support Problems.

  15. Remotely Piloted Vehicles Design Option Decision Trees

    DTIC Science & Technology

    1975-06-01

    of Lrade-off options available before inception of hardware design (Askren and Korkan, 1971 ; Askren, Korkan, and Watts, 1973). The purpose of the study...bouso~ENGIN LAVEIVESi SLIPSTRCA LAS? SOURCE HIGH LIFT DEVICE$ FLAPS SIGESO GRACES~~~ -AULILESOrCTER kALL T RCD TEMPERATUR EQUIPNENT COS,.UV...Method for Relating Human Resources Data to Design Parameters, AFHRL-TR-71-52, December 1971 . Barnes, B.P., Baker, L.A., and McIntosh, B.E., The

  16. Closed loop supply chain network design with fuzzy tactical decisions

    NASA Astrophysics Data System (ADS)

    Sherafati, Mahtab; Bashiri, Mahdi

    2016-09-01

    One of the most strategic and the most significant decisions in supply chain management is reconfiguration of the structure and design of the supply chain network. In this paper, a closed loop supply chain network design model is presented to select the best tactical and strategic decision levels simultaneously considering the appropriate transportation mode in activated links. The strategic decisions are made for a long term; thus, it is more satisfactory and more appropriate when the decision variables are considered uncertain and fuzzy, because it is more flexible and near to the real world. This paper is the first research which considers fuzzy decision variables in the supply chain network design model. Moreover, in this study a new fuzzy optimization approach is proposed to solve a supply chain network design problem with fuzzy tactical decision variables. Finally, the proposed approach and model are verified using several numerical examples. The comparison of the results with other existing approaches confirms efficiency of the proposed approach. Moreover the results confirms that by considering the vagueness of tactical decisions some properties of the supply chain network will be improved.

  17. Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

    PubMed Central

    Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

    2016-01-01

    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

  18. Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise.

    PubMed

    Militello, Laura G; Saleem, Jason J; Borders, Morgan R; Sushereba, Christen E; Haverkamp, Donald; Wolf, Steven P; Doebbeling, Bradley N

    2016-03-01

    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

  19. An automated approach to the design of decision tree classifiers

    NASA Technical Reports Server (NTRS)

    Argentiero, P.; Chin, P.; Beaudet, P.

    1980-01-01

    The classification of large dimensional data sets arising from the merging of remote sensing data with more traditional forms of ancillary data is considered. Decision tree classification, a popular approach to the problem, is characterized by the property that samples are subjected to a sequence of decision rules before they are assigned to a unique class. An automated technique for effective decision tree design which relies only on apriori statistics is presented. This procedure utilizes a set of two dimensional canonical transforms and Bayes table look-up decision rules. An optimal design at each node is derived based on the associated decision table. A procedure for computing the global probability of correct classfication is also provided. An example is given in which class statistics obtained from an actual LANDSAT scene are used as input to the program. The resulting decision tree design has an associated probability of correct classification of .76 compared to the theoretically optimum .79 probability of correct classification associated with a full dimensional Bayes classifier. Recommendations for future research are included.

  20. A Web-Based Tool to Support Data-Based Early Intervention Decision Making

    ERIC Educational Resources Information Center

    Buzhardt, Jay; Greenwood, Charles; Walker, Dale; Carta, Judith; Terry, Barbara; Garrett, Matthew

    2010-01-01

    Progress monitoring and data-based intervention decision making have become key components of providing evidence-based early childhood special education services. Unfortunately, there is a lack of tools to support early childhood service providers' decision-making efforts. The authors describe a Web-based system that guides service providers…

  1. A Preliminary Investigation of Factors Affecting Appraisal of the Decision to Take Early Retirement.

    ERIC Educational Resources Information Center

    Gowan, Mary A.

    1998-01-01

    Examines why individuals elect to take the early retirement package offered by their employer, as well as factors affecting their appraisal of that decision. Results suggest that all early retirement decisions are not voluntary. Individuals who do not wish to retire and who had lower self-esteem, fewer financial resources, and plans to continue…

  2. 39 CFR 3007.33 - Standard for decision for early termination of non-public status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Standard for decision for early termination of non-public status. 3007.33 Section 3007.33 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.33 Standard for decision for early...

  3. 39 CFR 3007.33 - Standard for decision for early termination of non-public status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Standard for decision for early termination of non-public status. 3007.33 Section 3007.33 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL TREATMENT OF NON-PUBLIC MATERIALS PROVIDED BY THE POSTAL SERVICE § 3007.33 Standard for decision for early...

  4. Early decision-analytic modeling - a case study on vascular closure devices.

    PubMed

    Brandes, Alina; Sinner, Moritz F; Kääb, Stefan; Rogowski, Wolf H

    2015-10-27

    As economic considerations become more important in healthcare reimbursement, decisions about the further development of medical innovations need to take into account not only medical need and potential clinical effectiveness, but also cost-effectiveness. Already early in the innovation process economic evaluations can support decisions on development in specific indications or patient groups by anticipating future reimbursement and implementation decisions. One potential concept for early assessment is value-based pricing. The objective is to assess the feasibility of value-based pricing and product design for a hypothetical vascular closure device in the pre-clinical stage which aims at decreasing bleeding events. A deterministic decision-analytic model was developed to estimate the cost-effectiveness of established vascular closure devices from the perspective of the Statutory Health Insurance system. To identify early benchmarks for pricing and product design, three strategies of determining the product's value are explored: 1) savings from complications avoided by the new device; 2) valuation of the avoided complications based on an assumed willingness-to-pay-threshold (the efficiency frontier approach); 3) value associated with modifying the care pathways within which the device would be applied. Use of established vascular closure devices is dominated by manual compression. The hypothetical vascular closure device reduces overall complication rates at higher costs than manual compression. Maximum cost savings of only about €4 per catheterization could be realized by applying the hypothetical device. Extrapolation of an efficiency frontier is only possible for one subgroup where vascular closure devices are not a dominated strategy. Modifying care in terms of same-day discharge of patients treated with vascular closure devices could result in cost savings of €400-600 per catheterization. It was partially feasible to calculate value-based prices for the

  5. Designing Computerized Decision Support That Works for Clinicians and Families

    PubMed Central

    Fiks, Alexander G.

    2011-01-01

    Evidence-based decision-making is central to the practice of pediatrics. Clinical trials and other biomedical research provide a foundation for this process, and practice guidelines, drawing from their results, inform the optimal management of an increasing number of childhood health problems. However, many clinicians fail to adhere to guidelines. Clinical decision support delivered using health information technology, often in the form of electronic health records, provides a tool to deliver evidence-based information to the point of care and has the potential to overcome barriers to evidence-based practice. An increasing literature now informs how these systems should be designed and implemented to most effectively improve outcomes in pediatrics. Through the examples of computerized physician order entry, as well as the impact of alerts at the point of care on immunization rates, the delivery of evidence-based asthma care, and the follow-up of children with attention deficit hyperactivity disorder, the following review addresses strategies for success in using these tools. The following review argues that, as decision support evolves, the clinician should no longer be the sole target of information and alerts. Through the Internet and other technologies, families are increasingly seeking health information and gathering input to guide health decisions. By enlisting clinical decision support systems to deliver evidence-based information to both clinicians and families, help families express their preferences and goals, and connect families to the medical home, clinical decision support may ultimately be most effective in improving outcomes. PMID:21315295

  6. Rethinking Instructional Technology to Improve Pedagogy for Digital Literacy: A Design Case in a Graduate Early Childhood Education Course

    ERIC Educational Resources Information Center

    Langub, Lee Woodham; Lokey-Vega, Anissa

    2017-01-01

    Digital literacy is an important aspect to consider within teacher education as a way to address twenty-first century learner needs, particularly in early childhood contexts where developmental concerns should be paramount in making instructional design decisions. This article is a design case of a graduate level early childhood education…

  7. Design of decision support interventions for medication prescribing.

    PubMed

    Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

    2013-06-01

    Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians

  8. SLUDGE TREATMENT PROJECT KOP CONCEPTUAL DESIGN CONTROL DECISION REPORT

    SciT

    CARRO CA

    2010-03-09

    This control decision addresses the Knock-Out Pot (KOP) Disposition KOP Processing System (KPS) conceptual design. The KPS functions to (1) retrieve KOP material from canisters, (2) remove particles less than 600 {micro}m in size and low density materials from the KOP material, (3) load the KOP material into Multi-Canister Overpack (MCO) baskets, and (4) stage the MCO baskets for subsequent loading into MCOs. Hazard and accident analyses of the KPS conceptual design have been performed to incorporate safety into the design process. The hazard analysis is documented in PRC-STP-00098, Knock-Out Pot Disposition Project Conceptual Design Hazard Analysis. The accident analysismore » is documented in PRC-STP-CN-N-00167, Knock-Out Pot Disposition Sub-Project Canister Over Lift Accident Analysis. Based on the results of these analyses, and analyses performed in support of MCO transportation and MCO processing and storage activities at the Cold Vacuum Drying Facility (CVDF) and Canister Storage Building (CSB), control decision meetings were held to determine the controls required to protect onsite and offsite receptors and facility workers. At the conceptual design stage, these controls are primarily defined by their safety functions. Safety significant structures, systems, and components (SSCs) that could provide the identified safety functions have been selected for the conceptual design. It is anticipated that some safety SSCs identified herein will be reclassified based on hazard and accident analyses performed in support of preliminary and detailed design.« less

  9. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    PubMed

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  10. Multi objective decision making in hybrid energy system design

    NASA Astrophysics Data System (ADS)

    Merino, Gabriel Guillermo

    The design of grid-connected photovoltaic wind generator system supplying a farmstead in Nebraska has been undertaken in this dissertation. The design process took into account competing criteria that motivate the use of different sources of energy for electric generation. The criteria considered were 'Financial', 'Environmental', and 'User/System compatibility'. A distance based multi-objective decision making methodology was developed to rank design alternatives. The method is based upon a precedence order imposed upon the design objectives and a distance metric describing the performance of each alternative. This methodology advances previous work by combining ambiguous information about the alternatives with a decision-maker imposed precedence order in the objectives. Design alternatives, defined by the photovoltaic array and wind generator installed capacities, were analyzed using the multi-objective decision making approach. The performance of the design alternatives was determined by simulating the system using hourly data for an electric load for a farmstead and hourly averages of solar irradiation, temperature and wind speed from eight wind-solar energy monitoring sites in Nebraska. The spatial variability of the solar energy resource within the region was assessed by determining semivariogram models to krige hourly and daily solar radiation data. No significant difference was found in the predicted performance of the system when using kriged solar radiation data, with the models generated vs. using actual data. The spatial variability of the combined wind and solar energy resources was included in the design analysis by using fuzzy numbers and arithmetic. The best alternative was dependent upon the precedence order assumed for the main criteria. Alternatives with no PV array or wind generator dominated when the 'Financial' criteria preceded the others. In contrast, alternatives with a nil component of PV array but a high wind generator component

  11. Regret about surgical decisions among early-stage breast cancer patients: Effects of the congruence between patients' preferred and actual decision-making roles.

    PubMed

    Wang, Ashley Wei-Ting; Chang, Su-Mei; Chang, Cheng-Shyong; Chen, Shou-Tung; Chen, Dar-Ren; Fan, Fang; Antoni, Michael H; Hsu, Wen-Yau

    2018-02-01

    Early-stage breast cancer patients generally receive either a mastectomy or a lumpectomy, either by their own choice or that of their surgeon. Sometimes, there is regret about the decision afterward. To better understand regret about surgical decisions, this study examined 2 possibilities: The first is that women who take a dominant or collaborative role in decision making about the surgery express less regret afterward. The second is that congruence between preferred role and actual role predicts less regret. We also explored whether disease stage moderates the relationship between role congruence and decisional regret. In a cross-sectional design, 154 women diagnosed with breast cancer completed a survey assessing decisional role preference and actual decisional role, a measure of post-decision regret, and a measure of disturbances related to breast cancer treatment. Hierarchical regression was used to investigate prediction of decisional regret. Role congruence, not actual decisional role, was significantly associated with less decisional regret, independent of all the control variables. The interaction between disease stage and role congruence was also significant, showing that mismatch relates to regret only in women with more advanced disease. Our findings suggest that cancer patients could benefit from tailored decision support concerning their decisional role preferences in the complex scenario of medical and personal factors during the surgical decision. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Compromise decision support problems for hierarchical design involving uncertainty

    NASA Astrophysics Data System (ADS)

    Vadde, S.; Allen, J. K.; Mistree, F.

    1994-08-01

    In this paper an extension to the traditional compromise Decision Support Problem (DSP) formulation is presented. Bayesian statistics is used in the formulation to model uncertainties associated with the information being used. In an earlier paper a compromise DSP that accounts for uncertainty using fuzzy set theory was introduced. The Bayesian Decision Support Problem is described in this paper. The method for hierarchical design is demonstrated by using this formulation to design a portal frame. The results are discussed and comparisons are made with those obtained using the fuzzy DSP. Finally, the efficacy of incorporating Bayesian statistics into the traditional compromise DSP formulation is discussed and some pending research issues are described. Our emphasis in this paper is on the method rather than the results per se.

  13. Making Decisions about Service Delivery in Early Childhood Programs

    ERIC Educational Resources Information Center

    Case-Smith, Jane; Holland, Terri

    2009-01-01

    Purpose: This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. Method: The literature on occupational therapy, physical therapy, and speech-language…

  14. Study design and hierarchy of evidence for surgical decision making.

    PubMed

    Sprague, Sheila; McKay, Paula; Thoma, Achilleas

    2008-04-01

    This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

  15. Modelling Situation Awareness Information for Naval Decision Support Design

    DTIC Science & Technology

    2003-10-01

    Modelling Situation Awareness Information for Naval Decision Support Design Dr.-Ing. Bernhard Doering, Dipl.-Ing. Gert Doerfel, Dipl.-Ing... knowledge -based user interfaces. For developing such interfaces information of the three different SA levels which operators need in performing their...large scale on situation awareness of operators which is defined as the state of operator knowledge about the external environment resulting from

  16. Factors influencing mothers' decisions on whether to provide seafood during early years' feeding: A qualitative study.

    PubMed

    Carstairs, Sharon A; Craig, Leone C A; Marais, Debbi; Kiezebrink, Kirsty

    2017-01-01

    The first year of a child's life is a key period of transition from an exclusive milk diet to solid foods to meet growing nutritional demands. An increased requirement for nutrients includes the introduction of protein-rich solid foods, such as seafood, which additionally provides valuable omega-3 fatty acids. However, consumption of seafood is low in the British child population. The aim of this study was to identify maternal perceptions of the factors that can influence the decision on whether to provide seafood during early years' feeding using a multi-method qualitative study design. A total of 26 discussions posted by mothers on parenting websites; Mumknowsbest, Mumsnet and Netmums, accessed July 2013, together with discussions from six focus groups (February-July 2014) in the North East of Scotland were included for thematic qualitative analysis. Discussions on the inclusion of seafood during the early years were centred across four interrelating themes; - food-related attributes, mother-centred aspects, family-centred aspects, and external information sources. Concerns regarding safety and mothers' limited knowledge and skills on seafood were apparent from discussions; however, the practicalities of providing a cost effective family meal were also issues raised by mothers. An understanding of the numerous and sometimes contradictory influences on mothers' decisions to include seafood during early years' period could be used to develop strategies to help increase regular seafood consumption. In particular, ensuring formal information and guidance clearly addresses the safety concerns of mothers and the development of practical education schemes to encourage and teach cooking skills should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. [Early detection in prostate cancer and shared decision making].

    PubMed

    Junod, A F

    2005-09-28

    Screening of prostate cancer with PSA is a challenge for the aid to decision. Beside the rather mediocre characteristics of the screening test, there the additional problem of the peculiar biology of this cancer, with its late development and its ability to remain latent for a prolonged period. On the other hand, the treatment (surgery, irradiation) is associated with important side-effects: impotence and urinary leakage. Several studies, which appear to be a form of aid to information than aid to shared decision, have been carried out to analyse the effect of various modes of information on the behaviour of potential candidates to screening of prostate cancer, with the following results: better knowledge of the problem, lower rate of acceptance of PSA testing and trend towards watchful waiting rather than surgery in case of discovery of cancer.

  18. Envisioning the Impact of Decisions Made about Early Childhood Professional Development Systems by Different Constituent Groups

    ERIC Educational Resources Information Center

    Apple, Peggy; McMullen, Mary Benson

    2007-01-01

    In this article the authors explore the need for early childhood practitioners and scholars to engage in joint problem solving to create and support early childhood education and care (ECEC) professional development systems in which all constituents benefit. Primary constituent groups and principal decision-making bodies are defined and analyzed,…

  19. Early Childhood Program Evaluations: A Decision-Maker's Guide

    ERIC Educational Resources Information Center

    National Forum on Early Childhood Program Evaluation, 2007

    2007-01-01

    Increasing demands for evidence-based early childhood services and the need by policymakers to know whether a program is effective or whether it warrants a significant investment of public and/or private funds--coupled with the often-politicized debate around these topics--make it imperative for policymakers and civic leaders to have independent…

  20. Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

    NASA Astrophysics Data System (ADS)

    Marović, Ivan; Hanak, Tomaš

    2017-10-01

    In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

  1. Designing, Evaluating, and Deploying Automated Scoring Systems with Validity in Mind: Methodological Design Decisions

    ERIC Educational Resources Information Center

    Rupp, André A.

    2018-01-01

    This article discusses critical methodological design decisions for collecting, interpreting, and synthesizing empirical evidence during the design, deployment, and operational quality-control phases for automated scoring systems. The discussion is inspired by work on operational large-scale systems for automated essay scoring but many of the…

  2. Applying Probabilistic Decision Models to Clinical Trial Design

    PubMed Central

    Smith, Wade P; Phillips, Mark H

    2018-01-01

    Clinical trial design most often focuses on a single or several related outcomes with corresponding calculations of statistical power. We consider a clinical trial to be a decision problem, often with competing outcomes. Using a current controversy in the treatment of HPV-positive head and neck cancer, we apply several different probabilistic methods to help define the range of outcomes given different possible trial designs. Our model incorporates the uncertainties in the disease process and treatment response and the inhomogeneities in the patient population. Instead of expected utility, we have used a Markov model to calculate quality adjusted life expectancy as a maximization objective. Monte Carlo simulations over realistic ranges of parameters are used to explore different trial scenarios given the possible ranges of parameters. This modeling approach can be used to better inform the initial trial design so that it will more likely achieve clinical relevance. PMID:29888075

  3. Early-Stage Software Design for Usability

    ERIC Educational Resources Information Center

    Golden, Elspeth

    2010-01-01

    In spite of the goodwill and best efforts of software engineers and usability professionals, systems continue to be built and released with glaring usability flaws that are costly and difficult to fix after the system has been built. Although user interface (UI) designers, be they usability or design experts, communicate usability requirements to…

  4. Iteration in Early-Elementary Engineering Design

    ERIC Educational Resources Information Center

    McFarland Kendall, Amber Leigh

    2017-01-01

    K-12 standards and curricula are beginning to include engineering design as a key practice within Science Technology Engineering and Mathematics (STEM) education. However, there is little research on how the youngest students engage in engineering design within the elementary classroom. This dissertation focuses on iteration as an essential aspect…

  5. Teaching ethics to engineers: ethical decision making parallels the engineering design process.

    PubMed

    Bero, Bridget; Kuhlman, Alana

    2011-09-01

    In order to fulfill ABET requirements, Northern Arizona University's Civil and Environmental engineering programs incorporate professional ethics in several of its engineering courses. This paper discusses an ethics module in a 3rd year engineering design course that focuses on the design process and technical writing. Engineering students early in their student careers generally possess good black/white critical thinking skills on technical issues. Engineering design is the first time students are exposed to "grey" or multiple possible solution technical problems. To identify and solve these problems, the engineering design process is used. Ethical problems are also "grey" problems and present similar challenges to students. Students need a practical tool for solving these ethical problems. The step-wise engineering design process was used as a model to demonstrate a similar process for ethical situations. The ethical decision making process of Martin and Schinzinger was adapted for parallelism to the design process and presented to students as a step-wise technique for identification of the pertinent ethical issues, relevant moral theories, possible outcomes and a final decision. Students had greatest difficulty identifying the broader, global issues presented in an ethical situation, but by the end of the module, were better able to not only identify the broader issues, but also to more comprehensively assess specific issues, generate solutions and a desired response to the issue.

  6. The impact of data integrity on decision making in early lead discovery

    NASA Astrophysics Data System (ADS)

    Beck, Bernd; Seeliger, Daniel; Kriegl, Jan M.

    2015-09-01

    Data driven decision making is a key element of today's pharmaceutical research, including early drug discovery. It comprises questions like which target to pursue, which chemical series to pursue, which compound to make next, or which compound to select for advanced profiling and promotion to pre-clinical development. In the following paper we will exemplify how data integrity, i.e. the context data is generated in and auxiliary information that is provided for individual result records, can influence decision making in early lead discovery programs. In addition we will describe some approaches which we pursue at Boehringer Ingelheim to reduce the risk for getting misguided.

  7. Microseismic Monitoring Design Optimization Based on Multiple Criteria Decision Analysis

    NASA Astrophysics Data System (ADS)

    Kovaleva, Y.; Tamimi, N.; Ostadhassan, M.

    2017-12-01

    Borehole microseismic monitoring of hydraulic fracture treatments of unconventional reservoirs is a widely used method in the oil and gas industry. Sometimes, the quality of the acquired microseismic data is poor. One of the reasons for poor data quality is poor survey design. We attempt to provide a comprehensive and thorough workflow, using multiple criteria decision analysis (MCDA), to optimize planning micriseismic monitoring. So far, microseismic monitoring has been used extensively as a powerful tool for determining fracture parameters that affect the influx of formation fluids into the wellbore. The factors that affect the quality of microseismic data and their final results include average distance between microseismic events and receivers, complexity of the recorded wavefield, signal-to-noise ratio, data aperture, etc. These criteria often conflict with each other. In a typical microseismic monitoring, those factors should be considered to choose the best monitoring well(s), optimum number of required geophones, and their depth. We use MDCA to address these design challenges and develop a method that offers an optimized design out of all possible combinations to produce the best data acquisition results. We believe that this will be the first research to include the above-mentioned factors in a 3D model. Such a tool would assist companies and practicing engineers in choosing the best design parameters for future microseismic projects.

  8. Object-oriented design and programming in medical decision support.

    PubMed

    Heathfield, H; Armstrong, J; Kirkham, N

    1991-12-01

    The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

  9. Early infant feeding decisions in low-income Latinas.

    PubMed

    Bunik, Maya; Clark, Lauren; Zimmer, Lorena Marquez; Jimenez, Luz M; O'Connor, Mary E; Crane, Lori A; Kempe, Allison

    2006-01-01

    Breastfeeding rates remain low, especially among low-income minority women. The objective of this qualitative study was to assess barriers to breastfeeding and reasons for combination feeding among low-income Latina women and their families. Meetings were held with key informants to inform the sampling plan and develop questions for focus groups. Data were collected from eight qualitative focus groups with primiparous mothers postpartum, mothers breastfeeding at 4 to 6 months, mothers formula feeding at 4 to 6 months, grandmothers and fathers, and 29 individual interviews with formula- and combination-feeding mothers. Transcripts of focus groups and interviews were content coded and analyzed for thematic domains and then compared for concurrence and differences. Four main domains with 15 categories were identified: (a) Best of both: Mothers desire to ensure their babies get both the healthy aspects of breast milk and "vitamins" in formula. (b) Breastfeeding can be a struggle: Breastfeeding is natural but can be painful, embarrassing, and associated with breast changes and diet restrictions. (c) Not in Mother's Control: Mothers want to breastfeed, but things happen that cause them to discontinue breastfeeding. (d) Family and cultural beliefs: Relatives give messages about supplementation for babies who are crying or not chubby. Negative emotions are to be avoided so as to not affect mother's milk. Those counseling Latina mothers about infant feeding should discourage and/or limit early supplementation with formula, discuss the myth of "best of both," understand the fatalism involved in problem-solving breastfeeding issues, and enlist the altruism embedded in the family unit for support of the mother-infant pair.

  10. What contributes to a technical purchasing decision maker's reliance on brand name for design decisions involving I&T products

    NASA Astrophysics Data System (ADS)

    Coutoumanos, Vincent

    The following research is intended to develop more formal mechanisms for collection, analysis, retention and dissemination of information relating to brand influence on high-technology products. Specifically, these high-technology products are associated with the engineering applications that likely would involve the loss of human life in the advent of catastrophic failure. The results of the study lead to an extension of theory involving marketing and product selection of "highly engineered" parts within the aerospace industry. The findings were separated into three distinct areas: 1) Information load will play a large role in the final design decision. If the designer is under a high level of information load during the time of a design decision, he or she likely will gravitate to the traditional design choice, regardless of the level of brand strength. 2) Even when strong brand names, like 3M, were offered as the non-traditional design choice, engineers gravitated to the traditional design choice that was presented in a mock Society for Manufacturing Engineers article. 3) Designer self-efficacy by itself will not often contribute to a decision maker's design choice. However, these data collected indicates that a combination of high designer self-efficacy moderated by high brand strength is likely to contribute significantly to a decision maker's decision. The post-hoc finding shows that many designers having high levels of self-efficacy could be developing a sense of comfort with strong brand names (like 3M) when making a design choice.

  11. Research design of decision support system for team sport

    NASA Astrophysics Data System (ADS)

    Abidin, Mohammad Zukuwwan Zainol; Nawawi, Mohd Kamal Mohd; Kasim, Maznah Mat

    2016-10-01

    This paper proposes a suitable research procedure that can be referred to while conducting a Decision Support System (DSS) study, especially when the development activity of system artifacts becomes one of the research objectives. The design of the research procedure was based on the completion of a football DSS development that can help in determining the position of a player and the best team formation to be used during a game. After studying the relevant literature, we found that it is necessary to combine the conventional rainfall System Development Life Cycle (SDLC) approach with Case Study approach to help in structuring the research task and phases, which can contribute to the fulfillment of the research aim and objectives.

  12. Design Recommendations for Pharmacogenomics Clinical Decision Support Systems

    PubMed Central

    Khelifi, Maher; Tarczy-Hornoch, Peter; Devine, Emily B.; Pratt, Wanda

    2017-01-01

    The use of pharmacogenomics (PGx) in clinical practice still faces challenges to fully adopt genetic information in targeting drug therapy. To incorporate genetics into clinical practice, many support the use of Pharmacogenomics Clinical Decision Support Systems (PGx-CDS) for medication prescriptions. This support was fueled by new guidelines to incorporate genetics for optimizing drug dosage and reducing adverse events. In addition, the complexity of PGx led to exploring CDS outside the paradigm of the basic CDS tools embedded in commercial electronic health records. Therefore, designing the right CDS is key to unleashing the full potential of pharmacogenomics and making it a part of clinicians’ daily workflow. In this work, we 1) identify challenges and barriers of the implementation of PGx-CDS in clinical settings, 2) develop a new design approach to CDS with functional characteristics that can improve the adoption of pharmacogenomics guidelines and thus patient safety, and 3) create design guidelines and recommendations for such PGx-CDS tools. PMID:28815136

  13. Reducing Work Content in Early Stage Naval Ship Designs (Briefing Charts)

    DTIC Science & Technology

    2014-05-14

    criticizes US naval ships for: • early design decisions that lock in density • poor arrangements of piping and ventilation 8 An overly dense ship with...Thresholds Update Save As Exit T45 #1 T45 #2 T45 #3 HPC Enables Exhaustive Exploration by: and Visualization Exploring The Space Evaluating The Space From...design points such as traditional design spiral method 30 SHIP AVG Weighted Qty (Qty) by Cost 1980s Reagan Build-up 14 10% 1% 1990/2000s Low Rate

  14. Designing Real-time Decision Support for Trauma Resuscitations

    PubMed Central

    Yadav, Kabir; Chamberlain, James M.; Lewis, Vicki R.; Abts, Natalie; Chawla, Shawn; Hernandez, Angie; Johnson, Justin; Tuveson, Genevieve; Burd, Randall S.

    2016-01-01

    Background Use of electronic clinical decision support (eCDS) has been recommended to improve implementation of clinical decision rules. Many eCDS tools, however, are designed and implemented without taking into account the context in which clinical work is performed. Implementation of the pediatric traumatic brain injury (TBI) clinical decision rule at one Level I pediatric emergency department includes an electronic questionnaire triggered when ordering a head computed tomography using computerized physician order entry (CPOE). Providers use this CPOE tool in less than 20% of trauma resuscitation cases. A human factors engineering approach could identify the implementation barriers that are limiting the use of this tool. Objectives The objective was to design a pediatric TBI eCDS tool for trauma resuscitation using a human factors approach. The hypothesis was that clinical experts will rate a usability-enhanced eCDS tool better than the existing CPOE tool for user interface design and suitability for clinical use. Methods This mixed-methods study followed usability evaluation principles. Pediatric emergency physicians were surveyed to identify barriers to using the existing eCDS tool. Using standard trauma resuscitation protocols, a hierarchical task analysis of pediatric TBI evaluation was developed. Five clinical experts, all board-certified pediatric emergency medicine faculty members, then iteratively modified the hierarchical task analysis until reaching consensus. The software team developed a prototype eCDS display using the hierarchical task analysis. Three human factors engineers provided feedback on the prototype through a heuristic evaluation, and the software team refined the eCDS tool using a rapid prototyping process. The eCDS tool then underwent iterative usability evaluations by the five clinical experts using video review of 50 trauma resuscitation cases. A final eCDS tool was created based on their feedback, with content analysis of the

  15. Pedagogy and Space: Design Inspirations for Early Childhood Classrooms

    ERIC Educational Resources Information Center

    Zane, Linda M.

    2015-01-01

    The intersection of design and learning is a new and burgeoning area of interest in all levels of education. "Pedagogy and Space" combines architectural design information with early childhood theory to enhance children's learning and educators' experience within the space. Filled with colorful, inspiring photographs of intentionally…

  16. Expectations Do Not Alter Early Sensory Processing during Perceptual Decision-Making.

    PubMed

    Rungratsameetaweemana, Nuttida; Itthipuripat, Sirawaj; Salazar, Annalisa; Serences, John T

    2018-06-13

    Two factors play important roles in shaping perception: the allocation of selective attention to behaviorally relevant sensory features, and prior expectations about regularities in the environment. Signal detection theory proposes distinct roles of attention and expectation on decision-making such that attention modulates early sensory processing, whereas expectation influences the selection and execution of motor responses. Challenging this classic framework, recent studies suggest that expectations about sensory regularities enhance the encoding and accumulation of sensory evidence during decision-making. However, it is possible, that these findings reflect well documented attentional modulations in visual cortex. Here, we tested this framework in a group of male and female human participants by examining how expectations about stimulus features (orientation and color) and expectations about motor responses impacted electroencephalography (EEG) markers of early sensory processing and the accumulation of sensory evidence during decision-making (the early visual negative potential and the centro-parietal positive potential, respectively). We first demonstrate that these markers are sensitive to changes in the amount of sensory evidence in the display. Then we show, counter to recent findings, that neither marker is modulated by either feature or motor expectations, despite a robust effect of expectations on behavior. Instead, violating expectations about likely sensory features and motor responses impacts posterior alpha and frontal theta oscillations, signals thought to index overall processing time and cognitive conflict. These findings are inconsistent with recent theoretical accounts and suggest instead that expectations primarily influence decisions by modulating post-perceptual stages of information processing. SIGNIFICANCE STATEMENT Expectations about likely features or motor responses play an important role in shaping behavior. Classic theoretical

  17. Formal Verification Toolkit for Requirements and Early Design Stages

    NASA Technical Reports Server (NTRS)

    Badger, Julia M.; Miller, Sheena Judson

    2011-01-01

    Efficient flight software development from natural language requirements needs an effective way to test designs earlier in the software design cycle. A method to automatically derive logical safety constraints and the design state space from natural language requirements is described. The constraints can then be checked using a logical consistency checker and also be used in a symbolic model checker to verify the early design of the system. This method was used to verify a hybrid control design for the suit ports on NASA Johnson Space Center's Space Exploration Vehicle against safety requirements.

  18. Dimensions of design space: a decision-theoretic approach to optimal research design.

    PubMed

    Conti, Stefano; Claxton, Karl

    2009-01-01

    Bayesian decision theory can be used not only to establish the optimal sample size and its allocation in a single clinical study but also to identify an optimal portfolio of research combining different types of study design. Within a single study, the highest societal payoff to proposed research is achieved when its sample sizes and allocation between available treatment options are chosen to maximize the expected net benefit of sampling (ENBS). Where a number of different types of study informing different parameters in the decision problem could be conducted, the simultaneous estimation of ENBS across all dimensions of the design space is required to identify the optimal sample sizes and allocations within such a research portfolio. This is illustrated through a simple example of a decision model of zanamivir for the treatment of influenza. The possible study designs include: 1) a single trial of all the parameters, 2) a clinical trial providing evidence only on clinical endpoints, 3) an epidemiological study of natural history of disease, and 4) a survey of quality of life. The possible combinations, samples sizes, and allocation between trial arms are evaluated over a range of cost-effectiveness thresholds. The computational challenges are addressed by implementing optimization algorithms to search the ENBS surface more efficiently over such large dimensions.

  19. Instrumental relating and treatment decision making among older women with early-stage breast cancer.

    PubMed

    Pieters, Huibrie C; Heilemann, Marysue V; Maliski, Sally; Dornig, Katrina; Mentes, Jan

    2012-01-01

    To understand how women aged 70 years and older who had recently undergone treatment for early-stage breast cancer experienced treatment decision making. Qualitative, descriptive study guided by grounded theory. PARTICIPANTS' houses and apartments in southern California. 18 women, aged 70-94 years, who completed treatment for primary, early-stage breast cancer 3-15 months prior (X = 8.5 months). Twenty-eight semistructured personal interviews that lasted, on average, 104 minutes. Data were collected and analyzed using constructivist grounded theory. Gero-oncology perspective of treatment decision making. A major finding was that the power of relating spontaneously was used as a vehicle to connect with others. That process, which the authors called "instrumental relating," was grounded in a foundation of mutual caring for themselves and others. Within that mutual caring, the women participated in three ways of relating to share in treatment decision making: obtaining information, interpreting healthcare providers, and determining the trustworthiness of their providers. Those ways of relating were effortlessly and simultaneously employed. The women used their expert abilities of relating to get the factual and emotional information that they needed. That information supported what the women perceived to be decisions that were shared and effective. The findings are the first evidence of the importance of relating as a key factor in decision making from the personal perspective of older women with early-stage breast cancer. This work serves as a springboard for future clinical interventions and research opportunities to individualize communication and enhance effective decision making for older patients who wish to participate in their cancer care.

  20. A generalized concept for cost-effective structural design. [Statistical Decision Theory applied to aerospace systems

    NASA Technical Reports Server (NTRS)

    Thomas, J. M.; Hawk, J. D.

    1975-01-01

    A generalized concept for cost-effective structural design is introduced. It is assumed that decisions affecting the cost effectiveness of aerospace structures fall into three basic categories: design, verification, and operation. Within these basic categories, certain decisions concerning items such as design configuration, safety factors, testing methods, and operational constraints are to be made. All or some of the variables affecting these decisions may be treated probabilistically. Bayesian statistical decision theory is used as the tool for determining the cost optimum decisions. A special case of the general problem is derived herein, and some very useful parametric curves are developed and applied to several sample structures.

  1. Analytic Procedures For Designing and Evaluating Decision Aids.

    DTIC Science & Technology

    1980-04-01

    the taxonomy of decision charateristics . Chapter 5 applies the taxonomies to the information processing functions needed for AAW decisions, and...rationality emphasizes the extent to which organizations and other social institutions consist of individuals who pursue individual objectives by means of...adaptive rationality is always wrong or naive; most of us know persons that seem to be naturally good decision-makers. There is no logic that guarantees

  2. A Conceptual Design of a Departure Planner Decision Aid

    NASA Technical Reports Server (NTRS)

    Anagnostakis, Ioannis; Idris, Husni R.; Clark, John-Paul; Feron, Eric; Hansman, R. John; Odoni, Amedeo R.; Hall, William D.

    2000-01-01

    Terminal area Air Traffic Management handles both arriving and departing traffic. To date, research work on terminal area operations has focused primarily on the arrival flow and typically departures are taken into account only in an approximate manner. However, arrivals and departures are highly coupled processes especially in the terminal airspace, with complex interactions and sharing of the same airport resources between arrivals and departures taking place in practically every important terminal area. Therefore, the addition of automation aids for departures, possibly in co-operation with existing arrival flow automation systems, could have a profound contribution in enhancing the overall efficiency of airport operations. This paper presents the conceptual system architecture for such an automation aid, the Departure Planner (DP). This architecture can be used as a core in the development of decision-aiding systems to assist air traffic controllers in improving the performance of departure operations and optimize runway time allocation among different operations at major congested airports. The design of such systems is expected to increase the overall efficiency of terminal area operations and yield benefits for all stakeholders involved in Air Traffic Management (ATM) operations, users as well as service providers.

  3. Critical Design Decisions of The Planck LFI Level 1 Software

    NASA Astrophysics Data System (ADS)

    Morisset, N.; Rohlfs, R.; Türler, M.; Meharga, M.; Binko, P.; Beck, M.; Frailis, M.; Zacchei, A.

    2010-12-01

    The PLANCK satellite with two on-board instruments, a Low Frequency Instrument (LFI) and a High Frequency Instrument (HFI) has been launched on May 14th with Ariane 5. The ISDC Data Centre for Astrophysics in Versoix, Switzerland has developed and maintains the Planck LFI Level 1 software for the Data Processing Centre (DPC) in Trieste, Italy. The main tasks of the Level 1 processing are to retrieve the daily available scientific and housekeeping (HK) data of the LFI instrument, the Sorption Cooler and the 4k Cooler data from Mission Operation Centre (MOC) in Darmstadt; to sort them by time and by type (detector, observing mode, etc...); to extract the spacecraft attitude information from auxiliary files; to flag the data according to several criteria; and to archive the resulting Time Ordered Information (TOI), which will then be used to produce maps of the sky in different spectral bands. The output of the Level 1 software are the TOI files in FITS format, later ingested into the Data Management Component (DMC) database. This software has been used during different phases of the LFI instrument development. We started to reuse some ISDC components for the LFI Qualification Model (QM) and we completely rework the software for the Flight Model (FM). This was motivated by critical design decisions taken jointly with the DPC. The main questions were: a) the choice of the data format: FITS or DMC? b) the design of the pipelines: use of the Planck Process Coordinator (ProC) or a simple Perl script? c) do we adapt the existing QM software or do we restart from scratch? The timeline and available manpower are also important issues to be taken into account. We present here the orientation of our choices and discuss their pertinence based on the experience of the final pre-launch tests and the start of real Planck LFI operations.

  4. Kentucky's Early Childhood Continuous Assessment and Accountability System: Local Decisions and State Supports

    ERIC Educational Resources Information Center

    Rous, Beth; McCormick, Katherine; Gooden, Caroline; Townley, Kim F.

    2007-01-01

    Kentucky has developed an assessment and accountability system that provides outcome data for a set of state early childhood standards for children birth to 5 years of age that are aligned with early childhood outcomes designated by the Office of Special Education Programs (OSEP). Within this flexible and comprehensive state assessment system,…

  5. The Macro Dynamics of Weapon System Acquisition: Shaping Early Decisions to Get Better Outcomes

    DTIC Science & Technology

    2012-05-17

    defects and rework •Design tools and processes •Lack of feedback to key design and SE processes •Lack of quantified risk and uncertainty at key... Tools for Rapid Exploration of the Physical Design Space Coupling Operability, Interoperability, and Physical Feasibility Analyses – a Game Changer...Interoperability •Training Quantified Margins and Uncertainties at Each Critical Decision Point M&S RDT&E A Continuum of Tools Underpinned with

  6. Designing an over-the-counter consumer decision-making tool for older adults.

    PubMed

    Martin-Hammond, Aqueasha M; Abegaz, Tamirat; Gilbert, Juan E

    2015-10-01

    Older adults are at increased risk of adverse drug events due to medication. Older adults tend to take more medication and are at higher risk of chronic illness. Over-the-counter (OTC) medication does not require healthcare provider oversight and understanding OTC information is heavily dependent on a consumer's ability to understand and use the medication appropriately. Coupling health technology with effective communication is one approach to address the challenge of communicating health and improving health related tasks. However, the success of many health technologies also depends on how well the technology is designed and how well it addresses users needs. This is especially true for the older adult population. This paper describes (1) a formative study performed to understand how to design novel health technology to assist older adults with OTC medication information, and (2) how a user-centered design process helped to refine the initial assumptions of user needs and help to conceptualize the technology. An iterative design process was used. The process included two brainstorming and review sessions with human-computer interaction researchers and design sessions with older adults in the form of semi-structured interviews. Methods and principles of user-centered research and design were used to inform the research design. Two researchers with expertise in human-computer interaction performed expert reviews of early system prototypes. After initial prototypes were developed, seven older adults were engaged in semi-structured interviews to understand usability concerns and features and functionality older adults may find useful for selecting appropriate OTC medication. Eight usability concerns were discovered and addressed in the two rounds of expert review, and nine additional usability concerns were discovered in design sessions with older adults. Five themes emerged from the interview transcripts as recommendations for design. These recommendations

  7. Exploring the Role of Social Memory of Floods for Designing Flood Early Warning Operations

    NASA Astrophysics Data System (ADS)

    Girons Lopez, Marc; Di Baldassarre, Giuliano; Grabs, Thomas; Halldin, Sven; Seibert, Jan

    2016-04-01

    Early warning systems are an important tool for natural disaster mitigation practices, especially for flooding events. Warnings rely on near-future forecasts to provide time to take preventive actions before a flood occurs, thus reducing potential losses. However, on top of the technical capacities, successful warnings require an efficient coordination and communication among a range of different actors and stakeholders. The complexity of integrating the technical and social spheres of warning systems has, however, resulted in system designs neglecting a number of important aspects such as social awareness of floods thus leading to suboptimal results. A better understanding of the interactions and feedbacks among the different elements of early warning systems is therefore needed to improve their efficiency and therefore social resilience. When designing an early warning system two important decisions need to be made regarding (i) the hazard magnitude at and from which a warning should be issued and (ii) the degree of confidence required for issuing a warning. The first decision is usually taken based on the social vulnerability and climatic variability while the second one is related to the performance (i.e. accuracy) of the forecasting tools. Consequently, by estimating the vulnerability and the accuracy of the forecasts, these two variables can be optimized to minimize the costs and losses. Important parameters with a strong influence on the efficiency of warning systems such as social awareness are however not considered in their design. In this study we present a theoretical exploration of the impact of social awareness on the design of early warning systems. For this purpose we use a definition of social memory of flood events as a proxy for flood risk awareness and test its effect on the optimization of the warning system design variables. Understanding the impact of social awareness on warning system design is important to make more robust warnings that can

  8. Design space exploration for early identification of yield limiting patterns

    NASA Astrophysics Data System (ADS)

    Li, Helen; Zou, Elain; Lee, Robben; Hong, Sid; Liu, Square; Wang, JinYan; Du, Chunshan; Zhang, Recco; Madkour, Kareem; Ali, Hussein; Hsu, Danny; Kabeel, Aliaa; ElManhawy, Wael; Kwan, Joe

    2016-03-01

    In order to resolve the causality dilemma of which comes first, accurate design rules or real designs, this paper presents a flow for exploration of the layout design space to early identify problematic patterns that will negatively affect the yield. A new random layout generating method called Layout Schema Generator (LSG) is reported in this paper, this method generates realistic design-like layouts without any design rule violation. Lithography simulation is then used on the generated layout to discover the potentially problematic patterns (hotspots). These hotspot patterns are further explored by randomly inducing feature and context variations to these identified hotspots through a flow called Hotspot variation Flow (HSV). Simulation is then performed on these expanded set of layout clips to further identify more problematic patterns. These patterns are then classified into design forbidden patterns that should be included in the design rule checker and legal patterns that need better handling in the RET recipes and processes.

  9. Enabling Early Sustainment Decisions: Application to F-35 Depot-Level Maintenance

    DTIC Science & Technology

    2013-01-01

    Level Maintenance John G. Drew, Ronald G. McGarvey, Peter Buryk Research Report Enabling Early Sustainment Decisions Application to F-35 Depot-Level...Maintenance John G. Drew, Ronald G. McGarvey, Peter Buryk RAND Project AIR FORCE Prepared for the United States Air Force Approved for public...Related publications include the following: John Drew, Russell D. Shaver, Kristin F. Lynch, Mahyar A. Amouzegar, and Don Snyder, Unmanned Aerial

  10. The Design and Use of Decision Support Systems by Academic Departments. AIR 1987 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Johnson, F. Craig

    The design and use of a departmental decision support system at Florida State University are described from the perspective of a department head. The decisions selected for study are ones of adequacy, equitability, quality, efficiency, and consistency. The complexity of the decision is related to the complexity of the support system. The major…

  11. Kentucky's Individualized Kindergartens: A State Network Design for Early Intervention.

    ERIC Educational Resources Information Center

    Bright, B.; Cansler, D. P.

    The KIK (Kentucky Individualized Kindergartens) project, a collaborative project between Kentucky's Department of Education and the Chapel Hill (NC) Training-Outreach project, is designed to serve high risk children. KIK provides early identification of high risk kindergarteners, development of individualized education programs, and implementation…

  12. The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service.

    PubMed

    Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah

    2017-12-12

    Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.

  13. Improving decision speed, accuracy and group cohesion through early information gathering in house-hunting ants.

    PubMed

    Stroeymeyt, Nathalie; Giurfa, Martin; Franks, Nigel R

    2010-09-29

    Successful collective decision-making depends on groups of animals being able to make accurate choices while maintaining group cohesion. However, increasing accuracy and/or cohesion usually decreases decision speed and vice-versa. Such trade-offs are widespread in animal decision-making and result in various decision-making strategies that emphasize either speed or accuracy, depending on the context. Speed-accuracy trade-offs have been the object of many theoretical investigations, but these studies did not consider the possible effects of previous experience and/or knowledge of individuals on such trade-offs. In this study, we investigated how previous knowledge of their environment may affect emigration speed, nest choice and colony cohesion in emigrations of the house-hunting ant Temnothorax albipennis, a collective decision-making process subject to a classical speed-accuracy trade-off. Colonies allowed to explore a high quality nest site for one week before they were forced to emigrate found that nest and accepted it faster than emigrating naïve colonies. This resulted in increased speed in single choice emigrations and higher colony cohesion in binary choice emigrations. Additionally, colonies allowed to explore both high and low quality nest sites for one week prior to emigration remained more cohesive, made more accurate decisions and emigrated faster than emigrating naïve colonies. These results show that colonies gather and store information about available nest sites while their nest is still intact, and later retrieve and use this information when they need to emigrate. This improves colony performance. Early gathering of information for later use is therefore an effective strategy allowing T. albipennis colonies to improve simultaneously all aspects of the decision-making process--i.e. speed, accuracy and cohesion--and partly circumvent the speed-accuracy trade-off classically observed during emigrations. These findings should be taken into account

  14. Food Security, Decision Making and the Use of Remote Sensing in Famine Early Warning Systems

    NASA Technical Reports Server (NTRS)

    Brown, Molly E.

    2008-01-01

    Famine early warning systems use remote sensing in combination with socio-economic and household food economy analysis to provide timely and rigorous information on emerging food security crises. The Famine Early Warning Systems Network (FEWS NET) is the US Agency for International Development's decision support system in 20 African countries, as well as in Guatemala, Haiti and Afghanistan. FEWS NET provides early and actionable policy guidance for the US Government and its humanitarian aid partners. As we move into an era of climate change where weather hazards will become more frequent and severe, understanding how to provide quantitative and actionable scientific information for policy makers using biophysical data is critical for an appropriate and effective response.

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

    ERIC Educational Resources Information Center

    Hambleton, Ronald K.; Xing, Dehui

    2006-01-01

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

  16. Decision Support Systems Project. Design Review Conference, October 14-15, 1984. Summary Report of Findings.

    ERIC Educational Resources Information Center

    Tetlow, William L.

    Findings of a conference that reviewed and evaluated design decisions concerning the Decision Support System (DSS) Demonstrator are summarized. The DSS Demonstrator was designed by the National Center for Higher Education Management Systems as an example of the way in which microcomputer technology can support and make more effective planning and…

  17. Design Decisions in Developing Learning Trajectories-Based Assessments in Mathematics: A Case Study

    ERIC Educational Resources Information Center

    Penuel, William R.; Confrey, Jere; Maloney, Alan; Rupp, André A.

    2014-01-01

    This article analyzes the design decisions of a team developing diagnostic assessments for a learning trajectory focused on rational number reasoning. The analysis focuses on the design rationale for key decisions about how to develop the cognitive assessments and related validity arguments within a fluid state and national policy context. The…

  18. Pediatric obstetrical ethics: Medical decision-making by, with, and for pregnant early adolescents.

    PubMed

    Mercurio, Mark R

    2016-06-01

    Pregnancy in an early adolescent carries with it specific ethical considerations, in some ways different from pregnancy in an adult and from medical care of a non-pregnant adolescent. Obstetrical ethics emphasizes the right of the patient to autonomy and bodily integrity, including the right to refuse medical intervention. Pediatric ethics recognizes the right of parents, within limits, to make medical decisions for their children, and the right of a child to receive medical or surgical interventions likely to be of benefit to her, sometimes over her own objections. As the child gets older, and particularly during the years of adolescence, there is also a recognition of the right to an increasingly prominent role in decisions about her own healthcare. Pediatric obstetrical ethics, referring to ethical decisions made by, with, and for pregnant early adolescents, represents the intersection of these different cultures. Principles and approaches from both obstetrical and pediatric ethics, as well as a unified understanding of rights, obligations, and practical considerations, will be needed. Copyright © 2016. Published by Elsevier Inc.

  19. Earthquake Early Warning: User Education and Designing Effective Messages

    NASA Astrophysics Data System (ADS)

    Burkett, E. R.; Sellnow, D. D.; Jones, L.; Sellnow, T. L.

    2014-12-01

    The U.S. Geological Survey (USGS) and partners are transitioning from test-user trials of a demonstration earthquake early warning system (ShakeAlert) to deciding and preparing how to implement the release of earthquake early warning information, alert messages, and products to the public and other stakeholders. An earthquake early warning system uses seismic station networks to rapidly gather information about an occurring earthquake and send notifications to user devices ahead of the arrival of potentially damaging ground shaking at their locations. Earthquake early warning alerts can thereby allow time for actions to protect lives and property before arrival of damaging shaking, if users are properly educated on how to use and react to such notifications. A collaboration team of risk communications researchers and earth scientists is researching the effectiveness of a chosen subset of potential earthquake early warning interface designs and messages, which could be displayed on a device such as a smartphone. Preliminary results indicate, for instance, that users prefer alerts that include 1) a map to relate their location to the earthquake and 2) instructions for what to do in response to the expected level of shaking. A number of important factors must be considered to design a message that will promote appropriate self-protective behavior. While users prefer to see a map, how much information can be processed in limited time? Are graphical representations of wavefronts helpful or confusing? The most important factor to promote a helpful response is the predicted earthquake intensity, or how strong the expected shaking will be at the user's location. Unlike Japanese users of early warning, few Californians are familiar with the earthquake intensity scale, so we are exploring how differentiating instructions between intensity levels (e.g., "Be aware" for lower shaking levels and "Drop, cover, hold on" at high levels) can be paired with self-directed supplemental

  20. Decision Topology Assessment in Engineering Design Under Uncertainity

    DTIC Science & Technology

    2014-01-01

    those of the United States Government or the DoA, and shall not be used for advertising or product endorsement purposes. REFERENCES 1. Clemen ...Raiffa, H., 1994, Decisions with Multiple Objectives, Cambridge University Press, Cambridge, United Kingdom. 6. Lewis, K., W. Chen, and L.C. Schmidt

  1. Critical early mission design considerations for lunar data systems architecture

    NASA Technical Reports Server (NTRS)

    Hei, Donald J., Jr.; Stephens, Elaine

    1992-01-01

    This paper outlines recent early mission design activites for a lunar data systems architecture. Each major functional element is shown to be strikingly similar when viewed in a common reference system. While this similarity probably deviates with lower levels of decomposition, the sub-functions can always be arranged into similar and dissimilar categories. Similar functions can be implemented as objects - implemented once and reused several times like today's advanced integrated circuits. This approach to mission data systems, applied to other NASA programs, may result in substantial agency implementation and maintenance savings. In today's zero-sum-game budgetary environment, this approach could help to enable a lunar exploration program in the next decade. Several early mission studies leading to such an object-oriented data systems design are recommended.

  2. Enabling Parametric Optimal Ascent Trajectory Modeling During Early Phases of Design

    NASA Technical Reports Server (NTRS)

    Holt, James B.; Dees, Patrick D.; Diaz, Manuel J.

    2015-01-01

    During the early phases of engineering design, the costs committed are high, costs incurred are low, and the design freedom is high. It is well documented that decisions made in these early design phases drive the entire design's life cycle. In a traditional paradigm, key design decisions are made when little is known about the design. As the design matures, design changes become more difficult -- in both cost and schedule -- to enact. Indeed, the current capability-based paradigm that has emerged because of the constrained economic environment calls for the infusion of knowledge acquired during later design phases into earlier design phases, i.e. bring knowledge acquired during preliminary and detailed design into pre-conceptual and conceptual design. An area of critical importance to launch vehicle design is the optimization of its ascent trajectory, as the optimal trajectory will be able to take full advantage of the launch vehicle's capability to deliver a maximum amount of payload into orbit. Hence, the optimal ascent trajectory plays an important role in the vehicle's affordability posture as the need for more economically viable access to space solutions are needed in today's constrained economic environment. The problem of ascent trajectory optimization is not a new one. There are several programs that are widely used in industry that allows trajectory analysts to, based on detailed vehicle and insertion orbit parameters, determine the optimal ascent trajectory. Yet, little information is known about the launch vehicle early in the design phase - information that is required of many different disciplines in order to successfully optimize the ascent trajectory. Thus, the current paradigm of optimizing ascent trajectories involves generating point solutions for every change in a vehicle's design parameters. This is often a very tedious, manual, and time-consuming task for the analysts. Moreover, the trajectory design space is highly non-linear and multi

  3. Partnering Community Decision Makers with Early Career Scientists - The NASA DEVELOP Method for Dual Capacity Building

    NASA Astrophysics Data System (ADS)

    Ross, K. W.; Childs-Gleason, L. M.; Cripps, G. S.; Clayton, A.; Remillard, C.; Watkins, L. E.; Allsbrook, K. N.; Rogers, L.; Ruiz, M. L.

    2017-12-01

    The NASA DEVELOP National Program carries out many projects every year with the goal of bringing the benefits of NASA Earth science to bear on decision-making challenges that are local in scale. Every DEVELOP project partners end users with early/transitioning science professionals. Many of these projects invited communities to consider NASA science data in new ways to help them make informed decisions. All of these projects shared three characteristics: they were rapid, nimble and risk-taking. These projects work well for some communities, but might best be suited as a feasibility studies that build community/institutional capacity towards eventual solutions. This presentation will discuss DEVELOP's lessons learned and best practices in conducting short-term feasibility projects with communities, as well as highlight several past successes.

  4. Intersubjective decision-making for computer-aided forging technology design

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

  5. Design of a decision support system, trained on GPU, for assisting melanoma diagnosis in dermatoscopy images

    NASA Astrophysics Data System (ADS)

    Glotsos, Dimitris; Kostopoulos, Spiros; Lalissidou, Stella; Sidiropoulos, Konstantinos; Asvestas, Pantelis; Konstandinou, Christos; Xenogiannopoulos, George; Konstantina Nikolatou, Eirini; Perakis, Konstantinos; Bouras, Thanassis; Cavouras, Dionisis

    2015-09-01

    The purpose of this study was to design a decision support system for assisting the diagnosis of melanoma in dermatoscopy images. Clinical material comprised images of 44 dysplastic (clark's nevi) and 44 malignant melanoma lesions, obtained from the dermatology database Dermnet. Initially, images were processed for hair removal and background correction using the Dull Razor algorithm. Processed images were segmented to isolate moles from surrounding background, using a combination of level sets and an automated thresholding approach. Morphological (area, size, shape) and textural features (first and second order) were calculated from each one of the segmented moles. Extracted features were fed to a pattern recognition system assembled with the Probabilistic Neural Network Classifier, which was trained to distinguish between benign and malignant cases, using the exhaustive search and the leave one out method. The system was designed on the GPU card (GeForce 580GTX) using CUDA programming framework and C++ programming language. Results showed that the designed system discriminated benign from malignant moles with 88.6% accuracy employing morphological and textural features. The proposed system could be used for analysing moles depicted on smart phone images after appropriate training with smartphone images cases. This could assist towards early detection of melanoma cases, if suspicious moles were to be captured on smartphone by patients and be transferred to the physician together with an assessment of the mole's nature.

  6. A study to derive a clinical decision rule for triage of emergency department patients with chest pain: design and methodology

    PubMed Central

    Hess, Erik P; Wells, George A; Jaffe, Allan; Stiell, Ian G

    2008-01-01

    Background Chest pain is the second most common chief complaint in North American emergency departments. Data from the U.S. suggest that 2.1% of patients with acute myocardial infarction and 2.3% of patients with unstable angina are misdiagnosed, with slightly higher rates reported in a recent Canadian study (4.6% and 6.4%, respectively). Information obtained from the history, 12-lead ECG, and a single set of cardiac enzymes is unable to identify patients who are safe for early discharge with sufficient sensitivity. The 2007 ACC/AHA guidelines for UA/NSTEMI do not identify patients at low risk for adverse cardiac events who can be safely discharged without provocative testing. As a result large numbers of low risk patients are triaged to chest pain observation units and undergo provocative testing, at significant cost to the healthcare system. Clinical decision rules use clinical findings (history, physical exam, test results) to suggest a diagnostic or therapeutic course of action. Currently no methodologically robust clinical decision rule identifies patients safe for early discharge. Methods/design The goal of this study is to derive a clinical decision rule which will allow emergency physicians to accurately identify patients with chest pain who are safe for early discharge. The study will utilize a prospective cohort design. Standardized clinical variables will be collected on all patients at least 25 years of age complaining of chest pain prior to provocative testing. Variables strongly associated with the composite outcome acute myocardial infarction, revascularization, or death will be further analyzed with multivariable analysis to derive the clinical rule. Specific aims are to: i) apply standardized clinical assessments to patients with chest pain, incorporating results of early cardiac testing; ii) determine the inter-observer reliability of the clinical information; iii) determine the statistical association between the clinical findings and the

  7. Design and implementation of intelligent electronic warfare decision making algorithm

    NASA Astrophysics Data System (ADS)

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

    2017-05-01

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

  8. Simple uncertainty propagation for early design phase aircraft sizing

    NASA Astrophysics Data System (ADS)

    Lenz, Annelise

    Many designers and systems analysts are aware of the uncertainty inherent in their aircraft sizing studies; however, few incorporate methods to address and quantify this uncertainty. Many aircraft design studies use semi-empirical predictors based on a historical database and contain uncertainty -- a portion of which can be measured and quantified. In cases where historical information is not available, surrogate models built from higher-fidelity analyses often provide predictors for design studies where the computational cost of directly using the high-fidelity analyses is prohibitive. These surrogate models contain uncertainty, some of which is quantifiable. However, rather than quantifying this uncertainty, many designers merely include a safety factor or design margin in the constraints to account for the variability between the predicted and actual results. This can become problematic if a designer does not estimate the amount of variability correctly, which then can result in either an "over-designed" or "under-designed" aircraft. "Under-designed" and some "over-designed" aircraft will likely require design changes late in the process and will ultimately require more time and money to create; other "over-designed" aircraft concepts may not require design changes, but could end up being more costly than necessary. Including and propagating uncertainty early in the design phase so designers can quantify some of the errors in the predictors could help mitigate the extent of this additional cost. The method proposed here seeks to provide a systematic approach for characterizing a portion of the uncertainties that designers are aware of and propagating it throughout the design process in a procedure that is easy to understand and implement. Using Monte Carlo simulations that sample from quantified distributions will allow a systems analyst to use a carpet plot-like approach to make statements like: "The aircraft is 'P'% likely to weigh 'X' lbs or less, given the

  9. Decision-Making Training for Occupational Choice and Early Turnover: A Field Experiment

    ERIC Educational Resources Information Center

    Pazy, Asya; Ganzach, Yoav; Davidov, Yariv

    2006-01-01

    Purpose: The study seeks to examine how a short intervention, aimed at enhancing occupational choice skills, influences turnover during the early stages of organizational membership. It seeks to explore two theoretical rationales for this effect: social exchange and self-determination. Design/methodology/approach: The study is a "constructive…

  10. Onboarding Experiences: An Examination of Early Institutional Advancement Professionals' Decisions

    ERIC Educational Resources Information Center

    Radosh, Meghan E.

    2013-01-01

    Onboarding is a new employee orientation process that is designed to formalize and socialize new hires to an organization, or in this case higher education institutions. The onboarding experience that many new employees have can shape employee views and first impressions of their new employer, and shape their early career path to stay or leave…

  11. A two-stage clinical decision support system for early recognition and stratification of patients with sepsis: an observational cohort study.

    PubMed

    Amland, Robert C; Lyons, Jason J; Greene, Tracy L; Haley, James M

    2015-10-01

    To examine the diagnostic accuracy of a two-stage clinical decision support system for early recognition and stratification of patients with sepsis. Observational cohort study employing a two-stage sepsis clinical decision support to recognise and stratify patients with sepsis. The stage one component was comprised of a cloud-based clinical decision support with 24/7 surveillance to detect patients at risk of sepsis. The cloud-based clinical decision support delivered notifications to the patients' designated nurse, who then electronically contacted a provider. The second stage component comprised a sepsis screening and stratification form integrated into the patient electronic health record, essentially an evidence-based decision aid, used by providers to assess patients at bedside. Urban, 284 acute bed community hospital in the USA; 16,000 hospitalisations annually. Data on 2620 adult patients were collected retrospectively in 2014 after the clinical decision support was implemented. 'Suspected infection' was the established gold standard to assess clinical decision support clinimetric performance. A sepsis alert activated on 417 (16%) of 2620 adult patients hospitalised. Applying 'suspected infection' as standard, the patient population characteristics showed 72% sensitivity and 73% positive predictive value. A postalert screening conducted by providers at bedside of 417 patients achieved 81% sensitivity and 94% positive predictive value. Providers documented against 89% patients with an alert activated by clinical decision support and completed 75% of bedside screening and stratification of patients with sepsis within one hour from notification. A clinical decision support binary alarm system with cross-checking functionality improves early recognition and facilitates stratification of patients with sepsis.

  12. Regional early flood warning system: design and implementation

    NASA Astrophysics Data System (ADS)

    Chang, L. C.; Yang, S. N.; Kuo, C. L.; Wang, Y. F.

    2017-12-01

    This study proposes a prototype of the regional early flood inundation warning system in Tainan City, Taiwan. The AI technology is used to forecast multi-step-ahead regional flood inundation maps during storm events. The computing time is only few seconds that leads to real-time regional flood inundation forecasting. A database is built to organize data and information for building real-time forecasting models, maintaining the relations of forecasted points, and displaying forecasted results, while real-time data acquisition is another key task where the model requires immediately accessing rain gauge information to provide forecast services. All programs related database are constructed in Microsoft SQL Server by using Visual C# to extracting real-time hydrological data, managing data, storing the forecasted data and providing the information to the visual map-based display. The regional early flood inundation warning system use the up-to-date Web technologies driven by the database and real-time data acquisition to display the on-line forecasting flood inundation depths in the study area. The friendly interface includes on-line sequentially showing inundation area by Google Map, maximum inundation depth and its location, and providing KMZ file download of the results which can be watched on Google Earth. The developed system can provide all the relevant information and on-line forecast results that helps city authorities to make decisions during typhoon events and make actions to mitigate the losses.

  13. Maximizing Launch Vehicle and Payload Design Via Early Communications

    NASA Technical Reports Server (NTRS)

    Morris, Bruce

    2010-01-01

    The United States? current fleet of launch vehicles is largely derived from decades-old designs originally made for payloads that no longer exist. They were built primarily for national security or human exploration missions. Today that fleet can be divided roughly into small-, medium-, and large-payload classes based on mass and volume capability. But no vehicle in the U.S. fleet is designed to accommodate modern payloads. It is usually the payloads that must accommodate the capabilities of the launch vehicles. This is perhaps most true of science payloads. It was this paradigm that the organizers of two weekend workshops in 2008 at NASA's Ames Research Center sought to alter. The workshops brought together designers of NASA's Ares V cargo launch vehicle (CLV) with scientists and payload designers in the astronomy and planetary sciences communities. Ares V was still in a pre-concept development phase as part of NASA?s Constellation Program for exploration beyond low Earth orbit (LEO). The space science community was early in a Decadal Survey that would determine future priorities for research areas, observations, and notional missions to make those observations. The primary purpose of the meetings in April and August of 2008, including the novel format, was to bring vehicle designers together with space scientists to discuss the feasibility of using a heavy lift capability to launch large observatories and explore the Solar System. A key question put to the science community was whether this heavy lift capability enabled or enhanced breakthrough science. The meetings also raised the question of whether some trade-off between mass/volume and technical complexity existed that could reduce technical and programmatic risk. By engaging the scientific community early in the vehicle design process, vehicle engineers sought to better understand potential limitations and requirements that could be added to the Ares V from the mission planning community. From the vehicle

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

    NASA Astrophysics Data System (ADS)

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

    2017-05-01

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

  15. 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.

  16. 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

  17. Self-related factors and decision making styles among early adults.

    PubMed

    Batool, Naila; Riaz, Muhammad Naveed; Riaz, Muhammad Akram; Akhtar, Masud

    2017-05-01

    To examine the effect of self-related factors, including self-regulation, self-esteem and self-efficacy, on decision-making styles of early adults. The cross-sectional study was conducted from February to August, 2014 at four universities of Islamabad, Pakistan, and comprised adult students of both Social and Natural sciences. Data was collected through Self-Regulation Questionnaire, Self-Esteem Scale, Self-Efficacy Scale and the General Decision Making Styles Questionnaire. Data was subjected to multivariate regression analysis. Of the 300 participants, 160(53%) were men and 140(47%) were women. The overall mean age was 22.68±5.96 years. Besides, 170(56%) were studying Social sciences and 130(44%) Natural sciences. Self-regulation, self-esteem and self-efficacy positively predicted rational and intuitive style and negatively predicted avoidant and spontaneous style. Self-efficacy and self-regulation negatively predicted dependent style. Ensuring positive self-related factors affected adults' effective decision-making choices.

  18. Science and Systems in Support of Multi-hazard Early Warnings and Decisions

    NASA Astrophysics Data System (ADS)

    Pulwarty, R. S.

    2015-12-01

    The demand for improved climate knowledge and information is well documented. As noted in the IPCC (SREX, AR5), the UNISDR Global Assessment Reports and other assessments, this demand has increased pressure for information to support planning under changing rates and emergence of multiple hazards including climate extremes (drought, heat waves, floods). "Decision support" is now a popular term in the climate applications research community. While existing decision support activities can be identified in many disparate settings (e.g. federal, academic, private), the challenge of changing environments (coupled physical and social) is actually one of crafting implementation strategies for improving decision quality (not just meeting "user needs"). This includes overcoming weaknesses in co-production models, moving beyond DSSs as simply "software", coordinating innovation mapping and diffusion, and providing fora and gaming tools to identify common interests and differences in the way risks are perceived and managed among the affected groups. We outline the development and evolution of multi-hazard early warning systems in the United States and elsewhere, focusing on climate-related hazards. In particular, the presentation will focus on the climate science and information needed for (1) improved monitoring and modeling, (2) generating risk profiles, (3) developing information systems and scenarios for critical thresholds, (4) the net benefits of using new information (5) characterizing and bridging the "last mile" in the context of longer-term risk management.

  19. METHODS FOR INTEGRATING ENVIRONMENTAL CONSIDERATIONS INTO CHEMICAL PROCESS DESIGN DECISIONS

    EPA Science Inventory

    The objective of this cooperative agreement was to postulate a means by which an engineer could routinely include environmental considerations in day-to-day conceptual design problems; a means that could easily integrate with existing design processes, and thus avoid massive retr...

  20. Designing the Widget: A Group Decision and Negotiation Task

    ERIC Educational Resources Information Center

    Delise, Lisa A.; Mello, Abby L.

    2017-01-01

    The Widget design task is an in-class, experiential exercise that affords students the opportunity to develop interpersonal skills in group negotiation. Students engage in new product design in committees of two dyads where one dyad represents Consumer Research and the other represents Strategic Management. Task information creates different…

  1. The design of patient decision support interventions: addressing the theory-practice gap.

    PubMed

    Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

    2011-08-01

    Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards

  2. Making lineage decisions with biological noise: Lessons from the early mouse embryo.

    PubMed

    Simon, Claire S; Hadjantonakis, Anna-Katerina; Schröter, Christian

    2018-04-30

    Understanding how individual cells make fate decisions that lead to the faithful formation and homeostatic maintenance of tissues is a fundamental goal of contemporary developmental and stem cell biology. Seemingly uniform populations of stem cells and multipotent progenitors display a surprising degree of heterogeneity, primarily originating from the inherent stochastic nature of molecular processes underlying gene expression. Despite this heterogeneity, lineage decisions result in tissues of a defined size and with consistent proportions of differentiated cell types. Using the early mouse embryo as a model we review recent developments that have allowed the quantification of molecular intercellular heterogeneity during cell differentiation. We first discuss the relationship between these heterogeneities and developmental cellular potential. We then review recent theoretical approaches that formalize the mechanisms underlying fate decisions in the inner cell mass of the blastocyst stage embryo. These models build on our extensive knowledge of the genetic control of fate decisions in this system and will become essential tools for a rigorous understanding of the connection between noisy molecular processes and reproducible outcomes at the multicellular level. We conclude by suggesting that cell-to-cell communication provides a mechanism to exploit and buffer intercellular variability in a self-organized process that culminates in the reproducible formation of the mature mammalian blastocyst stage embryo that is ready for implantation into the maternal uterus. This article is categorized under: Gene Expression and Transcriptional Hierarchies > Cellular Differentiation Establishment of Spatial and Temporal Patterns > Regulation of Size, Proportion, and Timing Gene Expression and Transcriptional Hierarchies > Gene Networks and Genomics Gene Expression and Transcriptional Hierarchies > Quantitative Methods and Models. © 2018 Wiley Periodicals, Inc.

  3. Optimized smith waterman processor design for breast cancer early diagnosis

    NASA Astrophysics Data System (ADS)

    Nurdin, D. S.; Isa, M. N.; Ismail, R. C.; Ahmad, M. I.

    2017-09-01

    This paper presents an optimized design of Processing Element (PE) of Systolic Array (SA) which implements affine gap penalty Smith Waterman (SW) algorithm on the Xilinx Virtex-6 XC6VLX75T Field Programmable Gate Array (FPGA) for Deoxyribonucleic Acid (DNA) sequence alignment. The PE optimization aims to reduce PE logic resources to increase number of PEs in FPGA for higher degree of parallelism during alignment matrix computations. This is useful for aligning long DNA-based disease sequence such as Breast Cancer (BC) for early diagnosis. The optimized PE architecture has the smallest PE area with 15 slices in a PE and 776 PEs implemented in the Virtex - 6 FPGA.

  4. GREENER CHEMICAL PROCESS DESIGN ALTERNATIVES ARE REVEALED USING THE WASTE REDUCTION DECISION SUPPORT SYSTEM (WAR DSS)

    EPA Science Inventory

    The Waste Reduction Decision Support System (WAR DSS) is a Java-based software product providing comprehensive modeling of potential adverse environmental impacts (PEI) predicted to result from newly designed or redesigned chemical manufacturing processes. The purpose of this so...

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

    ERIC Educational Resources Information Center

    Vann, Linda S.

    2017-01-01

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

  6. Designing Studies to Test Causal Questions About Early Math: The Development of Making Pre-K Count.

    PubMed

    Mattera, Shira K; Morris, Pamela A; Jacob, Robin; Maier, Michelle; Rojas, Natalia

    2017-01-01

    A growing literature has demonstrated that early math skills are associated with later outcomes for children. This research has generated interest in improving children's early math competencies as a pathway to improved outcomes for children in elementary school. The Making Pre-K Count study was designed to test the effects of an early math intervention for preschoolers. Its design was unique in that, in addition to causally testing the effects of early math skills, it also allowed for the examination of a number of additional questions about scale-up, the influence of contextual factors and the counterfactual environment, the mechanism of long-term fade-out, and the role of measurement in early childhood intervention findings. This chapter outlines some of the design considerations and decisions put in place to create a rigorous test of the causal effects of early math skills that is also able to answer these questions in early childhood mathematics and intervention. The study serves as a potential model for how to advance science in the fields of preschool intervention and early mathematics. © 2017 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-09-01

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

  8. Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women

    PubMed Central

    Obeidat, Rana F.

    2015-01-01

    To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers’ support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system. PMID:27981122

  9. Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women.

    PubMed

    Obeidat, Rana F

    2015-01-01

    To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers' support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system.

  10. Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

    NASA Technical Reports Server (NTRS)

    Hanagud, S.; Uppaluri, B.

    1975-01-01

    This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

  11. Design and realization of tourism spatial decision support system based on GIS

    NASA Astrophysics Data System (ADS)

    Ma, Zhangbao; Qi, Qingwen; Xu, Li

    2008-10-01

    In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.

  12. Support for Assessment Practice: Developing the Assessment Design Decisions Framework

    ERIC Educational Resources Information Center

    Bearman, Margaret; Dawson, Phillip; Boud, David; Bennett, Sue; Hall, Matt; Molloy, Elizabeth

    2016-01-01

    There are many excellent publications outlining features of assessment and feedback design in higher education. However, university educators often find these ideas challenging to realise in practice, as much of the literature focuses on institutional change rather than supporting academics. This paper describes the conceptual development of a…

  13. Designing Case-Control Studies: Decisions About the Controls

    PubMed Central

    Hodge, Susan E.; Subaran, Ryan L.; Weissman, Myrna M.; Fyer, Abby J.

    2014-01-01

    The authors quantified, first, the effect of misclassified controls (i.e., individuals who are affected with the disease under study but who are classified as controls) on the ability of a case-control study to detect an association between a disease and a genetic marker, and second, the effect of leaving misclassified controls in the study, as opposed to removing them (thus decreasing sample size). The authors developed an informativeness measure of a study’s ability to identify real differences between cases and controls. They then examined this measure’s behavior when there are no misclassified controls, when there are misclassified controls, and when there were misclassified controls but they have been removed from the study. The results show that if, for example, 10% of controls are misclassified, the study’s informativeness is reduced to approximately 81% of what it would have been in a sample with no misclassified controls, whereas if these misclassified controls are removed from the study, the informativeness is only reduced to about 90%, despite the reduced sample size. If 25% are misclassified, those figures become approximately 56% and 75%, respectively. Thus, leaving the misclassified controls in the control sample is worse than removing them altogether. Finally, the authors illustrate how insufficient power is not necessarily circumvented by having an unlimited number of controls. The formulas provided by the authors enable investigators to make rational decisions about removing misclassified controls or leaving them in. PMID:22854929

  14. Future of Earthquake Early Warning: Quantifying Uncertainty and Making Fast Automated Decisions for Applications

    NASA Astrophysics Data System (ADS)

    Wu, Stephen

    Earthquake early warning (EEW) systems have been rapidly developing over the past decade. Japan Meteorological Agency (JMA) has an EEW system that was operating during the 2011 M9 Tohoku earthquake in Japan, and this increased the awareness of EEW systems around the world. While longer-time earthquake prediction still faces many challenges to be practical, the availability of shorter-time EEW opens up a new door for earthquake loss mitigation. After an earthquake fault begins rupturing, an EEW system utilizes the first few seconds of recorded seismic waveform data to quickly predict the hypocenter location, magnitude, origin time and the expected shaking intensity level around the region. This early warning information is broadcast to different sites before the strong shaking arrives. The warning lead time of such a system is short, typically a few seconds to a minute or so, and the information is uncertain. These factors limit human intervention to activate mitigation actions and this must be addressed for engineering applications of EEW. This study applies a Bayesian probabilistic approach along with machine learning techniques and decision theories from economics to improve different aspects of EEW operation, including extending it to engineering applications. Existing EEW systems are often based on a deterministic approach. Often, they assume that only a single event occurs within a short period of time, which led to many false alarms after the Tohoku earthquake in Japan. This study develops a probability-based EEW algorithm based on an existing deterministic model to extend the EEW system to the case of concurrent events, which are often observed during the aftershock sequence after a large earthquake. To overcome the challenge of uncertain information and short lead time of EEW, this study also develops an earthquake probability-based automated decision-making (ePAD) framework to make robust decision for EEW mitigation applications. A cost-benefit model that

  15. Real-time decision support systems: the famine early warning system network

    Funk, Christopher C.; Verdin, James P.

    2010-01-01

    A multi-institutional partnership, the US Agency for International Development’s Famine Early Warning System Network (FEWS NET) provides routine monitoring of climatic, agricultural, market, and socioeconomic conditions in over 20 countries. FEWS NET supports and informs disaster relief decisions that impact millions of people and involve billions of dollars. In this chapter, we focus on some of FEWS NET’s hydrologic monitoring tools, with a specific emphasis on combining “low frequency” and “high frequency” assessment tools. Low frequency assessment tools, tied to water and food balance estimates, enable us to evaluate and map long-term tendencies in food security. High frequency assessments are supported by agrohydrologic models driven by satellite rainfall estimates, such as the Water Requirement Satisfaction Index (WRSI). Focusing on eastern Africa, we suggest that both these high and low frequency approaches are necessary to capture the interaction of slow variations in vulnerability and the relatively rapid onset of climatic shocks.

  16. Modeling Tool for Decision Support during Early Days of an Anthrax Event.

    PubMed

    Rainisch, Gabriel; Meltzer, Martin I; Shadomy, Sean; Bower, William A; Hupert, Nathaniel

    2017-01-01

    Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat.

  17. Examining key design decisions involved in developing a serious game for child sexual abuse prevention.

    PubMed

    Stieler-Hunt, Colleen; Jones, Christian M; Rolfe, Ben; Pozzebon, Kay

    2014-01-01

    This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken.

  18. Examining key design decisions involved in developing a serious game for child sexual abuse prevention

    PubMed Central

    Stieler-Hunt, Colleen; Jones, Christian M.; Rolfe, Ben; Pozzebon, Kay

    2014-01-01

    This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken. PMID:24550880

  19. Attitudes and decision-making about early-infant versus early-adolescent male circumcision: Demand-side insights for sustainable HIV prevention strategies in Zambia and Zimbabwe.

    PubMed

    Sgaier, Sema K; Sharma, Sunny; Eletskaya, Maria; Prasad, Ram; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Getrude; Xaba, Sinokuthemba; Nanga, Alice; Gumede-Moyo, Sehlulekile; Kretschmer, Steve

    2017-01-01

    As countries approach their scale-up targets for the voluntary medical male circumcision program for HIV prevention, they are strategizing and planning for the sustainability phase to follow. Global guidance recommends circumcising adolescent (below 14 years) and/or early infant boys (aged 0-60 days), and countries need to consider several factors before prioritizing a cohort for their sustainability phase. We provide community and healthcare provider-side insights on attitudes and decision-making process as a key input for this strategic decision in Zambia and Zimbabwe. We studied expectant parents, parents of infant boys (aged 0-60 days), family members and neo-natal and ante-natal healthcare providers in Zambia and Zimbabwe. Our integrated methodology consisted of in-depth qualitative and quantitative one-on-one interviews, and a simulated-decision-making game, to uncover attitudes towards, and the decision-making process for, early adolescent or early infant medical circumcision (EAMC or EIMC). In both countries, parents viewed early infancy and early adolescence as equally ideal ages for circumcision (38% EIMC vs. 37% EAMC in Zambia; 24% vs. 27% in Zimbabwe). If offered for free, about half of Zambian parents and almost 2 in 5 Zimbabwean parents indicated they would likely circumcise their infant boy; however, half of parents in each country perceived that the community would not accept EIMC. Nurses believed their facilities currently could not absorb EIMC services and that they would have limited ability to influence fathers, who were seen as having the primary decision-making authority. Our analysis suggests that EAMC is more accepted by the community than EIMC and is the path of least resistance for the sustainability phase of VMMC. However, parents or community members do not reject EIMC. Should countries choose to prioritize this cohort for their sustainability phase, a number of barriers around information, decision-making by parents, and supply side

  20. Attitudes and decision-making about early-infant versus early-adolescent male circumcision: Demand-side insights for sustainable HIV prevention strategies in Zambia and Zimbabwe

    PubMed Central

    Sgaier, Sema K.; Sharma, Sunny; Eletskaya, Maria; Prasad, Ram; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Getrude; Xaba, Sinokuthemba; Nanga, Alice; Gumede-Moyo, Sehlulekile; Kretschmer, Steve

    2017-01-01

    As countries approach their scale-up targets for the voluntary medical male circumcision program for HIV prevention, they are strategizing and planning for the sustainability phase to follow. Global guidance recommends circumcising adolescent (below 14 years) and/or early infant boys (aged 0–60 days), and countries need to consider several factors before prioritizing a cohort for their sustainability phase. We provide community and healthcare provider-side insights on attitudes and decision-making process as a key input for this strategic decision in Zambia and Zimbabwe. We studied expectant parents, parents of infant boys (aged 0–60 days), family members and neo-natal and ante-natal healthcare providers in Zambia and Zimbabwe. Our integrated methodology consisted of in-depth qualitative and quantitative one-on-one interviews, and a simulated-decision-making game, to uncover attitudes towards, and the decision-making process for, early adolescent or early infant medical circumcision (EAMC or EIMC). In both countries, parents viewed early infancy and early adolescence as equally ideal ages for circumcision (38% EIMC vs. 37% EAMC in Zambia; 24% vs. 27% in Zimbabwe). If offered for free, about half of Zambian parents and almost 2 in 5 Zimbabwean parents indicated they would likely circumcise their infant boy; however, half of parents in each country perceived that the community would not accept EIMC. Nurses believed their facilities currently could not absorb EIMC services and that they would have limited ability to influence fathers, who were seen as having the primary decision-making authority. Our analysis suggests that EAMC is more accepted by the community than EIMC and is the path of least resistance for the sustainability phase of VMMC. However, parents or community members do not reject EIMC. Should countries choose to prioritize this cohort for their sustainability phase, a number of barriers around information, decision-making by parents, and supply side

  1. a Process-Based Drought Early Warning Indicator for Supporting State Drought Mitigation Decision

    NASA Astrophysics Data System (ADS)

    Fu, R.; Fernando, D. N.; Pu, B.

    2014-12-01

    Drought prone states such as Texas requires creditable and actionable drought early warning ranging from seasonal to multi-decadal scales. Such information cannot be simply extracted from the available climate prediction and projections because of their large uncertainties at regional scales and unclear connections to the needs of the decision makers. In particular, current dynamic seasonal predictions and climate projections, such as those produced by the NOAA national multi-models ensemble experiment (NMME) and the IPCC AR5 (CMIP5) models, are much more reliable for winter and spring than for the summer season for the US Southern Plains. They also show little connection between the droughts in winter/spring and those in summer, in contrast to the observed dry memory from spring to summer over that region. To mitigate the weakness of dynamic prediction/projections, we have identified three key processes behind the spring-to-summer dry memory through observational studies. Based on these key processes and related fields, we have developed a multivariate principle component statistical model to provide a probabilistic summer drought early warning indicator, using the observed or predicted climate conditions in winter and spring on seasonal scale and climate projection for the mid-21stcentury. The summer drought early warning indicator is constructed in a similar way to the NOAA probabilistic predictions that are familiar to water resource managers. The indicator skill is assessed using the standard NOAA climate prediction assessment tools, i.e., the two alternative forced choice (2AFC) and the Receiver Operating Characteristic (ROC). Comparison with long-term observations suggest that this summer drought early warning indicator is able to capture nearly all the strong summer droughts and outperform the dynamic prediction in this regard over the US Southern Plains. This early warning indicator has been used by the state water agency in May 2014 in briefing the state

  2. The Longitudinal Association Between Early Childhood Obesity and Fathers' Involvement in Caregiving and Decision-Making.

    PubMed

    Wong, Michelle S; Jones-Smith, Jessica C; Colantuoni, Elizabeth; Thorpe, Roland J; Bleich, Sara N; Chan, Kitty S

    2017-10-01

    Fathers have increased their involvement in child caregiving; however, their changing role in childhood obesity is understudied. This study assessed the longitudinal association between changes in obesity among children aged 2 to 4 years and changes in fathers' involvement with raising children. Longitudinal data from the Early Childhood Longitudinal Study-Birth Cohort were used to conduct child fixed-effects linear and logistic regression analyses to assess the association between changes in childhood obesity-related outcomes (sugar-sweetened beverage consumption, screen time, BMI z score, overweight/obesity, obesity) and fathers' involvement with raising children (caregiving and influencing child-related decisions). Fixed-effects models control for all time-invariant characteristics. Analyses were controlled for time-varying confounders, including child age, maternal and paternal employment, and family poverty status. Children whose fathers increased their frequency of taking children outside and involvement with physical childcare experienced a decrease in their odds of obesity from age 2 to age 4. Obesity-related outcomes were not associated with fathers' decision-making influence. Increases in fathers' involvement with some aspects of caregiving may be associated with lower odds of childhood obesity. Encouraging fathers to increase their involvement with raising children and including fathers in childhood obesity prevention efforts may help reduce obesity risk among young children. © 2017 The Obesity Society.

  3. Designing a Graphical Decision Support Tool to Improve System Acquisition Decisions

    DTIC Science & Technology

    2009-06-01

    relationships within the data [9]. Displaying acquisition data in a graphical manner was chosen because graphical formats, in general, have been...acquisition plan which includes information pertaining to the acquisition objectives, the required capability of the system, design trade-off, budgeting...which introduce artificial neural networks to approximate the real world experience of an acquisition manager [8]. However, these strategies lack a

  4. User-centered design to improve clinical decision support in primary care.

    PubMed

    Brunner, Julian; Chuang, Emmeline; Goldzweig, Caroline; Cain, Cindy L; Sugar, Catherine; Yano, Elizabeth M

    2017-08-01

    A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations." (1) Identify the prevalence of four user-centered design practices at United States Veterans Affairs (VA) primary care clinics and assess the perceived utility of clinical decision support at those clinics; (2) Evaluate the association between those user-centered design practices and the perceived utility of clinical decision support. We analyzed clinic-level survey data collected in 2006-2007 from 170 VA primary care clinics. We examined four user-centered design practices: 1) pilot testing, 2) provider satisfaction assessment, 3) formal usability assessment, and 4) analysis of impact on performance improvement. We used a regression model to evaluate the association between user-centered design practices and the perceived utility of clinical decision support, while accounting for other important factors at those clinics, including implementation climate, available resources, and structural characteristics. We also examined associations separately at community-based clinics and at hospital-based clinics. User-centered design practices for clinical decision support varied across clinics: 74% conducted pilot testing, 62% conducted provider satisfaction assessment, 36% conducted a formal usability assessment, and 79% conducted an analysis of impact on performance improvement. Overall perceived utility of clinical decision support was high, with a mean rating of 4.17 (±.67) out of 5 on a composite measure. "Analysis of impact on performance

  5. Visualization-based decision support for value-driven system design

    NASA Astrophysics Data System (ADS)

    Tibor, Elliott

    In the past 50 years, the military, communication, and transportation systems that permeate our world, have grown exponentially in size and complexity. The development and production of these systems has seen ballooning costs and increased risk. This is particularly critical for the aerospace industry. The inability to deal with growing system complexity is a crippling force in the advancement of engineered systems. Value-Driven Design represents a paradigm shift in the field of design engineering that has potential to help counteract this trend. The philosophy of Value-Driven Design places the desires of the stakeholder at the forefront of the design process to capture true preferences and reveal system alternatives that were never previously thought possible. Modern aerospace engineering design problems are large, complex, and involve multiple levels of decision-making. To find the best design, the decision-maker is often required to analyze hundreds or thousands of combinations of design variables and attributes. Visualization can be used to support these decisions, by communicating large amounts of data in a meaningful way. Understanding the design space, the subsystem relationships, and the design uncertainties is vital to the advancement of Value-Driven Design as an accepted process for the development of more effective, efficient, robust, and elegant aerospace systems. This research investigates the use of multi-dimensional data visualization tools to support decision-making under uncertainty during the Value-Driven Design process. A satellite design system comprising a satellite, ground station, and launch vehicle is used to demonstrate effectiveness of new visualization methods to aid in decision support during complex aerospace system design. These methods are used to facilitate the exploration of the feasible design space by representing the value impact of system attribute changes and comparing the results of multi-objective optimization formulations

  6. Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

    PubMed

    Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

    2018-02-21

    Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient

  7. An Engineering Educator's Decision Support Tool for Improving Innovation in Student Design Projects

    ERIC Educational Resources Information Center

    Ozaltin, Nur Ozge; Besterfield-Sacre, Mary; Clark, Renee M.

    2015-01-01

    Learning how to design innovatively is a critical process skill for undergraduate engineers in the 21st century. To this end, our paper discusses the development and validation of a Bayesian network decision support tool that can be used by engineering educators to make recommendations that positively impact the innovativeness of product designs.…

  8. Decision support systems in water and wastewater treatment process selection and design: a review.

    PubMed

    Hamouda, M A; Anderson, W B; Huck, P M

    2009-01-01

    The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

  9. The Advanced Technology Solar Telescope: design and early construction

    NASA Astrophysics Data System (ADS)

    McMullin, Joseph P.; Rimmele, Thomas R.; Keil, Stephen L.; Warner, Mark; Barden, Samuel; Bulau, Scott; Craig, Simon; Goodrich, Bret; Hansen, Eric; Hegwer, Steve; Hubbard, Robert; McBride, William; Shimko, Steve; Wöger, Friedrich; Ditsler, Jennifer

    2012-09-01

    The National Solar Observatory’s (NSO) Advanced Technology Solar Telescope (ATST) is the first large U.S. solar telescope accessible to the worldwide solar physics community to be constructed in more than 30 years. The 4-meter diameter facility will operate over a broad wavelength range (0.35 to 28 μm ), employing adaptive optics systems to achieve diffraction limited imaging and resolve features approximately 20 km on the Sun; the key observational parameters (collecting area, spatial resolution, spectral coverage, polarization accuracy, low scattered light) enable resolution of the theoretically-predicted, fine-scale magnetic features and their dynamics which modulate the radiative output of the sun and drive the release of magnetic energy from the Sun’s atmosphere in the form of flares and coronal mass ejections. In 2010, the ATST received a significant fraction of its funding for construction. In the subsequent two years, the project has hired staff and opened an office on Maui. A number of large industrial contracts have been placed throughout the world to complete the detailed designs and begin constructing the major telescope subsystems. These contracts have included the site development, AandE designs, mirrors, polishing, optic support assemblies, telescope mount and coudé rotator structures, enclosure, thermal and mechanical systems, and high-level software and controls. In addition, design development work on the instrument suite has undergone significant progress; this has included the completion of preliminary design reviews (PDR) for all five facility instruments. Permitting required for physically starting construction on the mountaintop of Haleakalā, Maui has also progressed. This paper will review the ATST goals and specifications, describe each of the major subsystems under construction, and review the contracts and lessons learned during the contracting and early construction phases. Schedules for site construction, key factory testing of

  10. Hierarchical Thinking: A Cognitive Tool for Guiding Coherent Decision Making in Design Problem Solving

    ERIC Educational Resources Information Center

    Haupt, Grietjie

    2018-01-01

    This paper builds on two concepts, the first of which is the extended information processing model of expert design cognition. This proposes twelve internal psychological characteristics interacting with the external world of expert designers during the early phases of the design process. Here, I explore one of the characteristics, hierarchical…

  11. An urban runoff model designed to inform stormwater management decisions.

    PubMed

    Beck, Nicole G; Conley, Gary; Kanner, Lisa; Mathias, Margaret

    2017-05-15

    We present an urban runoff model designed for stormwater managers to quantify runoff reduction benefits of mitigation actions that has lower input data and user expertise requirements than most commonly used models. The stormwater tool to estimate load reductions (TELR) employs a semi-distributed approach, where landscape characteristics and process representation are spatially-lumped within urban catchments on the order of 100 acres (40 ha). Hydrologic computations use a set of metrics that describe a 30-year rainfall distribution, combined with well-tested algorithms for rainfall-runoff transformation and routing to generate average annual runoff estimates for each catchment. User inputs include the locations and specifications for a range of structural best management practice (BMP) types. The model was tested in a set of urban catchments within the Lake Tahoe Basin of California, USA, where modeled annual flows matched that of the observed flows within 18% relative error for 5 of the 6 catchments and had good regional performance for a suite of performance metrics. Comparisons with continuous simulation models showed an average of 3% difference from TELR predicted runoff for a range of hypothetical urban catchments. The model usually identified the dominant BMP outflow components within 5% relative error of event-based measured flow data and simulated the correct proportionality between outflow components. TELR has been implemented as a web-based platform for use by municipal stormwater managers to inform prioritization, report program benefits and meet regulatory reporting requirements (www.swtelr.com). Copyright © 2017. Published by Elsevier Ltd.

  12. Design of an Aircrew Scheduling Decision Aid for the 6916th Electronic Security Squadron.

    DTIC Science & Technology

    1987-06-01

    Security Classification) Design of an Aircrew Scheduling Decision Aid for the 6916th Electronic Security Squadron 12. PERSONAL AUTHOR(S) Thomas J. Kopf...Because of the great number of possible scheduling alternatives, it is difficult to find an optimal solution to-the scheduling problem. Additionally...changes to the original schedule make it even more difficult to find an optimal solution. The emergence of capable microcompu- ters, decision support

  13. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making.

    PubMed

    Mokhles, S; Nuyttens, J J M E; de Mol, M; Aerts, J G J V; Maat, A P W M; Birim, Ö; Bogers, A J J C; Takkenberg, J J M

    2018-01-15

    The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician. This was assessed by multiple-choice, 1-5 Likert Scale, and open questions. The Decisional Conflict Scale was used to assess the decisional conflict. Health related quality of life (HRQoL) was measured with SF-36 questionnaire. In 19% of patients, there was self-reported perceived lack of knowledge about the advantages and disadvantages of the treatment options. Seventy-four percent of patients felt that they were sufficiently involved in decision-making by their physician, and 81% found it important to be involved in decision making. Forty percent experienced decisional conflict, and one-in-five patients to such an extent that it made them feel unsure about the decision. Subscores with regard to feeling uninformed and on uncertainty, contributed the most to decisional conflict, as 36% felt uninformed and 17% of patients were not satisfied with their decision. HRQoL was not influenced by patient experience with decision-making or patient preferences for shared decision making. Dutch early-stage NSCLC patients find it important to be involved in treatment decision making. Yet a substantial proportion experiences decisional conflict and feels uninformed. Better patient information and/or involvement in treatment-decision-making is needed in order to improve patient knowledge and hopefully reduce decisional conflict.

  14. Modeling Applications to Inform Hydromodification Management Design Decisions

    NASA Astrophysics Data System (ADS)

    Goodman, J.

    2013-12-01

    standard (Flow Duration Control vs. Erosion Potential), receiving stream susceptibility (critical low flow discharges for incipient motion of 5%Q2, 10%Q2, vs. 20%Q2), and outlet design (passive vs. active smart controls). nomograph

  15. The information value of early career productivity in mathematics: a ROC analysis of prediction errors in bibliometricly informed decision making.

    PubMed

    Lindahl, Jonas; Danell, Rickard

    The aim of this study was to provide a framework to evaluate bibliometric indicators as decision support tools from a decision making perspective and to examine the information value of early career publication rate as a predictor of future productivity. We used ROC analysis to evaluate a bibliometric indicator as a tool for binary decision making. The dataset consisted of 451 early career researchers in the mathematical sub-field of number theory. We investigated the effect of three different definitions of top performance groups-top 10, top 25, and top 50 %; the consequences of using different thresholds in the prediction models; and the added prediction value of information on early career research collaboration and publications in prestige journals. We conclude that early career performance productivity has an information value in all tested decision scenarios, but future performance is more predictable if the definition of a high performance group is more exclusive. Estimated optimal decision thresholds using the Youden index indicated that the top 10 % decision scenario should use 7 articles, the top 25 % scenario should use 7 articles, and the top 50 % should use 5 articles to minimize prediction errors. A comparative analysis between the decision thresholds provided by the Youden index which take consequences into consideration and a method commonly used in evaluative bibliometrics which do not take consequences into consideration when determining decision thresholds, indicated that differences are trivial for the top 25 and the 50 % groups. However, a statistically significant difference between the methods was found for the top 10 % group. Information on early career collaboration and publication strategies did not add any prediction value to the bibliometric indicator publication rate in any of the models. The key contributions of this research is the focus on consequences in terms of prediction errors and the notion of transforming uncertainty

  16. On decentralized design: Rationale, dynamics, and effects on decision-making

    NASA Astrophysics Data System (ADS)

    Chanron, Vincent

    The focus of this dissertation is the design of complex systems, including engineering systems such as cars, airplanes, and satellites. Companies who design these systems are under constant pressure to design better products that meet customer expectations, and competition forces them to develop them faster. One of the responses of the industry to these conflicting challenges has been the decentralization of the design responsibilities. The current lack of understanding of the dynamics of decentralized design processes is the main motivation for this research, and places value on the descriptive base. It identifies the main reasons and the true benefits for companies to decentralize the design of their products. It also demonstrates the limitations of this approach by listing the relevant issues and problems created by the decentralization of decisions. Based on these observations, a game-theoretic approach to decentralized design is proposed to model the decisions made during the design process. The dynamics are modeled using mathematical formulations inspired from control theory. Building upon this formalism, the issue of convergence in decentralized design is analyzed: the equilibrium points of the design space are identified and convergent and divergent patterns are recognized. This rigorous investigation of the design process provides motivation and support for proposing new approaches to decentralized design problems. Two methods are developed, which aim at improving the design process in two ways: decreasing the product development time, and increasing the optimality of the final design. The frame of these methods are inspired by eigenstructure decomposition and set-based design, respectively. The value of the research detailed within this dissertation is in the proposed methods which are built upon the sound mathematical formalism developed. The contribution of this work is two fold: rigorous investigation of the design process, and practical support to

  17. A Markovian state-space framework for integrating flexibility into space system design decisions

    NASA Astrophysics Data System (ADS)

    Lafleur, Jarret M.

    The past decades have seen the state of the art in aerospace system design progress from a scope of simple optimization to one including robustness, with the objective of permitting a single system to perform well even in off-nominal future environments. Integrating flexibility, or the capability to easily modify a system after it has been fielded in response to changing environments, into system design represents a further step forward. One challenge in accomplishing this rests in that the decision-maker must consider not only the present system design decision, but also sequential future design and operation decisions. Despite extensive interest in the topic, the state of the art in designing flexibility into aerospace systems, and particularly space systems, tends to be limited to analyses that are qualitative, deterministic, single-objective, and/or limited to consider a single future time period. To address these gaps, this thesis develops a stochastic, multi-objective, and multi-period framework for integrating flexibility into space system design decisions. Central to the framework are five steps. First, system configuration options are identified and costs of switching from one configuration to another are compiled into a cost transition matrix. Second, probabilities that demand on the system will transition from one mission to another are compiled into a mission demand Markov chain. Third, one performance matrix for each design objective is populated to describe how well the identified system configurations perform in each of the identified mission demand environments. The fourth step employs multi-period decision analysis techniques, including Markov decision processes from the field of operations research, to find efficient paths and policies a decision-maker may follow. The final step examines the implications of these paths and policies for the primary goal of informing initial system selection. Overall, this thesis unifies state-centric concepts of

  18. Dose Transition Pathways: The Missing Link Between Complex Dose-Finding Designs and Simple Decision-Making.

    PubMed

    Yap, Christina; Billingham, Lucinda J; Cheung, Ying Kuen; Craddock, Charlie; O'Quigley, John

    2017-12-15

    The ever-increasing pace of development of novel therapies mandates efficient methodologies for assessment of their tolerability and activity. Evidence increasingly support the merits of model-based dose-finding designs in identifying the recommended phase II dose compared with conventional rule-based designs such as the 3 + 3 but despite this, their use remains limited. Here, we propose a useful tool, dose transition pathways (DTP), which helps overcome several commonly faced practical and methodologic challenges in the implementation of model-based designs. DTP projects in advance the doses recommended by a model-based design for subsequent patients (stay, escalate, de-escalate, or stop early), using all the accumulated information. After specifying a model with favorable statistical properties, we utilize the DTP to fine-tune the model to tailor it to the trial's specific requirements that reflect important clinical judgments. In particular, it can help to determine how stringent the stopping rules should be if the investigated therapy is too toxic. Its use to design and implement a modified continual reassessment method is illustrated in an acute myeloid leukemia trial. DTP removes the fears of model-based designs as unknown, complex systems and can serve as a handbook, guiding decision-making for each dose update. In the illustrated trial, the seamless, clear transition for each dose recommendation aided the investigators' understanding of the design and facilitated decision-making to enable finer calibration of a tailored model. We advocate the use of the DTP as an integral procedure in the co-development and successful implementation of practical model-based designs by statisticians and investigators. Clin Cancer Res; 23(24); 7440-7. ©2017 AACR . ©2017 American Association for Cancer Research.

  19. A Distributed Architecture for Tsunami Early Warning and Collaborative Decision-support in Crises

    NASA Astrophysics Data System (ADS)

    Moßgraber, J.; Middleton, S.; Hammitzsch, M.; Poslad, S.

    2012-04-01

    The presentation will describe work on the system architecture that is being developed in the EU FP7 project TRIDEC on "Collaborative, Complex and Critical Decision-Support in Evolving Crises". The challenges for a Tsunami Early Warning System (TEWS) are manifold and the success of a system depends crucially on the system's architecture. A modern warning system following a system-of-systems approach has to integrate various components and sub-systems such as different information sources, services and simulation systems. Furthermore, it has to take into account the distributed and collaborative nature of warning systems. In order to create an architecture that supports the whole spectrum of a modern, distributed and collaborative warning system one must deal with multiple challenges. Obviously, one cannot expect to tackle these challenges adequately with a monolithic system or with a single technology. Therefore, a system architecture providing the blueprints to implement the system-of-systems approach has to combine multiple technologies and architectural styles. At the bottom layer it has to reliably integrate a large set of conventional sensors, such as seismic sensors and sensor networks, buoys and tide gauges, and also innovative and unconventional sensors, such as streams of messages from social media services. At the top layer it has to support collaboration on high-level decision processes and facilitates information sharing between organizations. In between, the system has to process all data and integrate information on a semantic level in a timely manner. This complex communication follows an event-driven mechanism allowing events to be published, detected and consumed by various applications within the architecture. Therefore, at the upper layer the event-driven architecture (EDA) aspects are combined with principles of service-oriented architectures (SOA) using standards for communication and data exchange. The most prominent challenges on this layer

  20. An approach to quantitative sustainability assessment in the early stages of process design.

    PubMed

    Tugnoli, Alessandro; Santarelli, Francesco; Cozzani, Valerio

    2008-06-15

    A procedure was developed for the quantitative assessment of key performance indicators suitable for the sustainability analysis of alternative processes, mainly addressing the early stages of process design. The methodology was based on the calculation of a set of normalized impact indices allowing a direct comparison of the additional burden of each process alternative on a selected reference area. Innovative reference criteria were developed to compare and aggregate the impact indicators on the basis of the site-specific impact burden and sustainability policy. An aggregation procedure also allows the calculation of overall sustainability performance indicators and of an "impact fingerprint" of each process alternative. The final aim of the method is to support the decision making process during process development, providing a straightforward assessment of the expected sustainability performances. The application of the methodology to case studies concerning alternative waste disposal processes allowed a preliminary screening of the expected critical sustainability impacts of each process. The methodology was shown to provide useful results to address sustainability issues in the early stages of process design.

  1. User-centered design and the development of patient decision aids: protocol for a systematic review.

    PubMed

    Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William

    2015-01-26

    Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely

  2. Schools' Responses to Voucher Policy: Participation Decisions and Early Implementation Experiences in the Indiana Choice Scholarship Program

    ERIC Educational Resources Information Center

    Austin, Megan J.

    2015-01-01

    Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…

  3. Incorporating Family Assessment and Individualized Family Service Plans into Early Intervention Programs: A Developmental, Decision Making Process.

    ERIC Educational Resources Information Center

    Kochanek, Thomas T.; Friedman, Donna Haig

    The monograph presents essential components of a decision making sequence used to incorporate formalized family assessment and service planning procedures into two existing early intervention programs in Massachusetts. The 1-year effort used a consultant to: (1) redefine screening and assessment processes to include both child and family centered…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  5. Prevention of and Early Intervention for Students with Emotional and Behavioral Disorders: Systems to Support Data-Based Decision Making

    ERIC Educational Resources Information Center

    Lewis, Timothy J.; Mitchell, Barbara S.

    2012-01-01

    Students with emotional and behavioral disorders are at great risk for long-term negative outcomes. Researchers and practitioners alike acknowledge the need for evidence-based, preventive, and early intervention strategies. Accordingly, in this chapter an expanded view of prevention is presented as a series of data driven decisions to guide…

  6. Dark Matter: The "Gravitational Pull" of Maternalist Discourses on Politicians' Decision Making for Early Childhood Policy in Australia

    ERIC Educational Resources Information Center

    Bown, Kathryn; Sumsion, Jennifer; Press, Frances

    2011-01-01

    The article reports on a study investigating influences on Australian politicians' decision making for early childhood education and care (ECEC) policy. The astronomical concept of dark matter is utilised as a metaphor for considering normalising, and therefore frequently difficult to detect and disrupt, influences implicated in politicians'…

  7. The Decision-Making Processes of Early Childhood Teachers When Working with Children Experiencing Parental Separation and Divorce

    ERIC Educational Resources Information Center

    Mahony, L.; Lunn, J.; Petriwskyj, A.; Walsh, K.

    2015-01-01

    In this study, the pedagogical decision-making processes of 21 Australian early childhood teachers working with children experiencing parental separation and divorce were examined. Transcripts from interviews and a focus group with teachers were analysed using grounded theory methodology. The findings showed that as teachers interacted with young…

  8. Early hospital discharge of infants born to group B streptococci-positive mothers: a decision analysis.

    PubMed

    Berger, M B; Xu, X; Williams, J A; Van de Ven, C J M; Mozurkewich, E L

    2012-03-01

    To compare the cost-effectiveness of an additional 24-hour inpatient observation for asymptomatic term neonates born to group B streptococcus (GBS)-colonised mothers with adequate intrapartum antibiotic prophylaxis (IAP) after an initial 24-hour in-hospital observation. Cost-effectiveness analysis from a societal perspective. United States. Asymptomatic term neonates born to GBS-colonised mothers with IAP after an initial 24-hour in-hospital observation. Monte Carlo simulation for a decision tree model incorporating the following chance events: development of GBS sepsis during the second 24 hours of life, development of GBS sepsis between 48 hours and 7 days of life, prompt versus delayed treatment for sepsis, neonatal mortality and long-term health sequelae. Expected cost and quality-adjusted life years (QALYs), Incremental cost-effectiveness ratio (ICER). Delayed, versus early, hospital discharge results in similar mean expected QALYs, but substantially higher expected cost. The mean difference in QALY is 0.00016 (95% CI 0.00005-0.00040), whereas the mean difference in cost is $1170.96 (95% CI $750.13-1584.32). The ICER is estimated to be $9,771,520.87 per QALY (95% CI $2,573,139.89-24,407,017.82). The proportion of early-onset GBS that develops during the second 24 hours of life, the cost of 24 hours of inpatient observation, and the probability of long-term sequelae following prompt versus delayed treatment play important roles in determining the cost-effectiveness of delayed hospital discharge. Cost-effectiveness analysis suggests that with adequate IAP, discharging asymptomatic term neonates to home after 24 hours is the preferred approach compared with 48 hours inpatient observation. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  9. Automatic design of decision-tree induction algorithms tailored to flexible-receptor docking data.

    PubMed

    Barros, Rodrigo C; Winck, Ana T; Machado, Karina S; Basgalupp, Márcio P; de Carvalho, André C P L F; Ruiz, Duncan D; de Souza, Osmar Norberto

    2012-11-21

    This paper addresses the prediction of the free energy of binding of a drug candidate with enzyme InhA associated with Mycobacterium tuberculosis. This problem is found within rational drug design, where interactions between drug candidates and target proteins are verified through molecular docking simulations. In this application, it is important not only to correctly predict the free energy of binding, but also to provide a comprehensible model that could be validated by a domain specialist. Decision-tree induction algorithms have been successfully used in drug-design related applications, specially considering that decision trees are simple to understand, interpret, and validate. There are several decision-tree induction algorithms available for general-use, but each one has a bias that makes it more suitable for a particular data distribution. In this article, we propose and investigate the automatic design of decision-tree induction algorithms tailored to particular drug-enzyme binding data sets. We investigate the performance of our new method for evaluating binding conformations of different drug candidates to InhA, and we analyze our findings with respect to decision tree accuracy, comprehensibility, and biological relevance. The empirical analysis indicates that our method is capable of automatically generating decision-tree induction algorithms that significantly outperform the traditional C4.5 algorithm with respect to both accuracy and comprehensibility. In addition, we provide the biological interpretation of the rules generated by our approach, reinforcing the importance of comprehensible predictive models in this particular bioinformatics application. We conclude that automatically designing a decision-tree algorithm tailored to molecular docking data is a promising alternative for the prediction of the free energy from the binding of a drug candidate with a flexible-receptor.

  10. Automatic design of decision-tree induction algorithms tailored to flexible-receptor docking data

    PubMed Central

    2012-01-01

    Background This paper addresses the prediction of the free energy of binding of a drug candidate with enzyme InhA associated with Mycobacterium tuberculosis. This problem is found within rational drug design, where interactions between drug candidates and target proteins are verified through molecular docking simulations. In this application, it is important not only to correctly predict the free energy of binding, but also to provide a comprehensible model that could be validated by a domain specialist. Decision-tree induction algorithms have been successfully used in drug-design related applications, specially considering that decision trees are simple to understand, interpret, and validate. There are several decision-tree induction algorithms available for general-use, but each one has a bias that makes it more suitable for a particular data distribution. In this article, we propose and investigate the automatic design of decision-tree induction algorithms tailored to particular drug-enzyme binding data sets. We investigate the performance of our new method for evaluating binding conformations of different drug candidates to InhA, and we analyze our findings with respect to decision tree accuracy, comprehensibility, and biological relevance. Results The empirical analysis indicates that our method is capable of automatically generating decision-tree induction algorithms that significantly outperform the traditional C4.5 algorithm with respect to both accuracy and comprehensibility. In addition, we provide the biological interpretation of the rules generated by our approach, reinforcing the importance of comprehensible predictive models in this particular bioinformatics application. Conclusions We conclude that automatically designing a decision-tree algorithm tailored to molecular docking data is a promising alternative for the prediction of the free energy from the binding of a drug candidate with a flexible-receptor. PMID:23171000

  11. From drought indicators to impacts: developing improved tools for monitoring and early warning with decision-makers in mind

    NASA Astrophysics Data System (ADS)

    Hannaford, Jamie; Barker, Lucy; Svensson, Cecilia; Tanguy, Maliko; Laize, Cedric; Bachmair, Sophie; Tijdeman, Erik; Stahl, Kerstin; Collins, Kevin

    2016-04-01

    Droughts pose a threat to water security in most climate zones and water use sectors. With projections suggesting that droughts will intensify in many parts of the globe, the magnitude of this threat is likely to increase in the future and thus vulnerability of society to drought must be reduced through better preparedness. While the occurrence of drought cannot be prevented in the short term, a number of actions can be taken to reduce vulnerability. Monitoring and early warning (M&EW) systems are often central to drought management strategies aimed at reducing vulnerability, but they are generally less developed than for other hazards. There are many drought indicators available for characterising the hazard but they have only rarely been tested for their ability to capture observed impacts on society or the environment. There is a pressing need to better integrate the physical and social vulnerability elements of drought to improve M&EW systems. The Belmont Forum project DrIVER (Drought Impacts: Vulnerability thresholds in monitoring and Early-warning Research, 2014 - 2016) aims to fill this gap by strengthening the link between natural (hydrometeorological) drought characterisation and ecological and socio-economic impacts on three continents (North America, Europe and Australia). The UK is a key DrIVER case study area. The UK has a well-developed hydrological monitoring programme, but there is currently no national drought focused M&EW system; different actors (water companies, regulators, farmers or industry) typically conduct M&EW for their own particular purposes. In this paper we present the early outcomes of an extensive programme of research designed to provide a scientific foundation for improved M&EW systems for the UK in future. The UK is used here as an example, and the findings could prove useful for other localities seeking to develop M&EW systems. Firstly, we present the results of stakeholder engagement exercises designed to ascertain current use

  12. Automatically updating predictive modeling workflows support decision-making in drug design.

    PubMed

    Muegge, Ingo; Bentzien, Jörg; Mukherjee, Prasenjit; Hughes, Robert O

    2016-09-01

    Using predictive models for early decision-making in drug discovery has become standard practice. We suggest that model building needs to be automated with minimum input and low technical maintenance requirements. Models perform best when tailored to answering specific compound optimization related questions. If qualitative answers are required, 2-bin classification models are preferred. Integrating predictive modeling results with structural information stimulates better decision making. For in silico models supporting rapid structure-activity relationship cycles the performance deteriorates within weeks. Frequent automated updates of predictive models ensure best predictions. Consensus between multiple modeling approaches increases the prediction confidence. Combining qualified and nonqualified data optimally uses all available information. Dose predictions provide a holistic alternative to multiple individual property predictions for reaching complex decisions.

  13. A framework for designing and analyzing binary decision-making strategies in cellular systems†

    PubMed Central

    Porter, Joshua R.; Andrews, Burton W.; Iglesias, Pablo A.

    2015-01-01

    Cells make many binary (all-or-nothing) decisions based on noisy signals gathered from their environment and processed through noisy decision-making pathways. Reducing the effect of noise to improve the fidelity of decision-making comes at the expense of increased complexity, creating a tradeoff between performance and metabolic cost. We present a framework based on rate distortion theory, a branch of information theory, to quantify this tradeoff and design binary decision-making strategies that balance low cost and accuracy in optimal ways. With this framework, we show that several observed behaviors of binary decision-making systems, including random strategies, hysteresis, and irreversibility, are optimal in an information-theoretic sense for various situations. This framework can also be used to quantify the goals around which a decision-making system is optimized and to evaluate the optimality of cellular decision-making systems by a fundamental information-theoretic criterion. As proof of concept, we use the framework to quantify the goals of the externally triggered apoptosis pathway. PMID:22370552

  14. Contribution of economic evaluation to decision making in early phases of product development: a methodological and empirical review.

    PubMed

    Hartz, Susanne; John, Jürgen

    2008-01-01

    Economic evaluation as an integral part of health technology assessment is today mostly applied to established technologies. Evaluating healthcare innovations in their early states of development has recently attracted attention. Although it offers several benefits, it also holds methodological challenges. The aim of our study was to investigate the possible contributions of economic evaluation to industry's decision making early in product development and to confront the results with the actual use of early data in economic assessments. We conducted a literature research to detect methodological contributions as well as economic evaluations that used data from early phases of product development. Economic analysis can be beneficially used in early phases of product development for various purposes including early market assessment, R&D portfolio management, and first estimations of pricing and reimbursement scenarios. Analytical tools available for these purposes have been identified. Numerous empirical works were detected, but most do not disclose any concrete decision context and could not be directly matched with the suggested applications. Industry can benefit from starting economic evaluation early in product development in several ways. Empirical evidence suggests that there is still potential left unused.

  15. Design and early performance of IGRINS (Immersion Grating Infrared Spectrometer)

    NASA Astrophysics Data System (ADS)

    Park, Chan; Jaffe, Daniel T.; Yuk, In-Soo; Chun, Moo-Young; Pak, Soojong; Kim, Kang-Min; Pavel, Michael; Lee, Hanshin; Oh, Heeyoung; Jeong, Ueejeong; Sim, Chae Kyung; Lee, Hye-In; Nguyen Le, Huynh Anh; Strubhar, Joseph; Gully-Santiago, Michael; Oh, Jae Sok; Cha, Sang-Mok; Moon, Bongkon; Park, Kwijong; Brooks, Cynthia; Ko, Kyeongyeon; Han, Jeong-Yeol; Nah, Jakyoung; Hill, Peter C.; Lee, Sungho; Barnes, Stuart; Yu, Young Sam; Kaplan, Kyle; Mace, Gregory; Kim, Hwihyun; Lee, Jae-Joon; Hwang, Narae; Park, Byeong-Gon

    2014-07-01

    The Immersion Grating Infrared Spectrometer (IGRINS) is a compact high-resolution near-infrared cross-dispersed spectrograph whose primary disperser is a silicon immersion grating. IGRINS covers the entire portion of the wavelength range between 1.45 and 2.45μm that is accessible from the ground and does so in a single exposure with a resolving power of 40,000. Individual volume phase holographic (VPH) gratings serve as cross-dispersing elements for separate spectrograph arms covering the H and K bands. On the 2.7m Harlan J. Smith telescope at the McDonald Observatory, the slit size is 1ʺ x 15ʺ and the plate scale is 0.27ʺ pixel. The spectrograph employs two 2048 x 2048 pixel Teledyne Scientific and Imaging HAWAII-2RG detectors with SIDECAR ASIC cryogenic controllers. The instrument includes four subsystems; a calibration unit, an input relay optics module, a slit-viewing camera, and nearly identical H and K spectrograph modules. The use of a silicon immersion grating and a compact white pupil design allows the spectrograph collimated beam size to be only 25mm, which permits a moderately sized (0.96m x 0.6m x 0.38m) rectangular cryostat to contain the entire spectrograph. The fabrication and assembly of the optical and mechanical components were completed in 2013. We describe the major design characteristics of the instrument including the system requirements and the technical strategy to meet them. We also present early performance test results obtained from the commissioning runs at the McDonald Observatory.

  16. Meiotic recombination protein Rec12: functional conservation, crossover homeostasis and early crossover/non-crossover decision

    PubMed Central

    Kan, Fengling; Davidson, Mari K.; Wahls, Wayne P.

    2011-01-01

    In fission yeast and other eukaryotes, Rec12 (Spo11) is thought to catalyze the formation of dsDNA breaks (DSBs) that initiate homologous recombination in meiosis. Rec12 is orthologous to the catalytic subunit of topoisomerase VI (Top6A). Guided by the crystal structure of Top6A, we engineered the rec12 locus to encode Rec12 proteins each with a single amino acid substitution in a conserved residue. Of 21 substitutions, 10 significantly reduced or abolished meiotic DSBs, gene conversion, crossover recombination and the faithful segregation of chromosomes. Critical residues map within the metal ion-binding pocket toprim (E179A, D229A, D231A), catalytic region 5Y-CAP (R94A, D95A, Y98F) and the DNA-binding interface (K201A, G202E, R209A, K242A). A subset of substitutions reduced DSBs but maintained crossovers, demonstrating crossover homeostasis. Furthermore, a strong separation of function mutation (R304A) suggests that the crossover/non-crossover decision is established early by a protein–protein interaction surface of Rec12. Fission yeast has multiple crossovers per bivalent, and chromosome segregation was robust above a threshold of about one crossover per bivalent, below which non-disjunction occurred. These results support structural and functional conservation among Rec12/Spo11/Top6A family members for the catalysis of DSBs, and they reveal how Rec12 regulates other features of meiotic chromosome dynamics. PMID:21030440

  17. Decision making with epistemic uncertainty under safety constraints: An application to seismic design

    Veneziano, D.; Agarwal, A.; Karaca, E.

    2009-01-01

    The problem of accounting for epistemic uncertainty in risk management decisions is conceptually straightforward, but is riddled with practical difficulties. Simple approximations are often used whereby future variations in epistemic uncertainty are ignored or worst-case scenarios are postulated. These strategies tend to produce sub-optimal decisions. We develop a general framework based on Bayesian decision theory and exemplify it for the case of seismic design of buildings. When temporal fluctuations of the epistemic uncertainties and regulatory safety constraints are included, the optimal level of seismic protection exceeds the normative level at the time of construction. Optimal Bayesian decisions do not depend on the aleatory or epistemic nature of the uncertainties, but only on the total (epistemic plus aleatory) uncertainty and how that total uncertainty varies randomly during the lifetime of the project. ?? 2009 Elsevier Ltd. All rights reserved.

  18. A decision model for cost effective design of biomass based green energy supply chains.

    PubMed

    Yılmaz Balaman, Şebnem; Selim, Hasan

    2015-09-01

    The core driver of this study is to deal with the design of anaerobic digestion based biomass to energy supply chains in a cost effective manner. In this concern, a decision model is developed. The model is based on fuzzy multi objective decision making in order to simultaneously optimize multiple economic objectives and tackle the inherent uncertainties in the parameters and decision makers' aspiration levels for the goals. The viability of the decision model is explored with computational experiments on a real-world biomass to energy supply chain and further analyses are performed to observe the effects of different conditions. To this aim, scenario analyses are conducted to investigate the effects of energy crop utilization and operational costs on supply chain structure and performance measures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Variation in choice of study design: findings from the Epidemiology Design Decision Inventory and Evaluation (EDDIE) survey.

    PubMed

    Stang, Paul E; Ryan, Patrick B; Overhage, J Marc; Schuemie, Martijn J; Hartzema, Abraham G; Welebob, Emily

    2013-10-01

    Researchers using observational data to understand drug effects must make a number of analytic design choices that suit the characteristics of the data and the subject of the study. Review of the published literature suggests that there is a lack of consistency even when addressing the same research question in the same database. To characterize the degree of similarity or difference in the method and analysis choices made by observational database research experts when presented with research study scenarios. On-line survey using research scenarios on drug-effect studies to capture method selection and analysis choices that follow a dependency branching based on response to key questions. Voluntary participants experienced in epidemiological study design solicited for participation through registration on the Observational Medical Outcomes Partnership website, membership in particular professional organizations, or links in relevant newsletters. Description (proportion) of respondents selecting particular methods and making specific analysis choices based on individual drug-outcome scenario pairs. The number of questions/decisions differed based on stem questions of study design, time-at-risk, outcome definition, and comparator. There is little consistency across scenarios, by drug or by outcome of interest, in the decisions made for design and analyses in scenarios using large healthcare databases. The most consistent choice was the cohort study design but variability in the other critical decisions was common. There is great variation among epidemiologists in the design and analytical choices that they make when implementing analyses in observational healthcare databases. These findings confirm that it will be important to generate empiric evidence to inform these decisions and to promote a better understanding of the impact of standardization on research implementation.

  20. Design and Data in Balance: Using Design-Driven Decision Making to Enable Student Success

    ERIC Educational Resources Information Center

    Fairchild, Susan; Farrell, Timothy; Gunton, Brad; Mackinnon, Anne; McNamara, Christina; Trachtman, Roberta

    2014-01-01

    Data-driven approaches to school decision making have come into widespread use in the past decade, nationally and in New York City. New Visions has been at the forefront of those developments: in New Visions schools, teacher teams and school teams regularly examine student performance data to understand patterns and drive classroom- and…

  1. Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.

    PubMed

    Islam, Roosan; Weir, Charlene R; Jones, Makoto; Del Fiol, Guilherme; Samore, Matthew H

    2015-11-30

    Clinical experts' cognitive mechanisms for managing complexity have implications for the design of future innovative healthcare systems. The purpose of the study is to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment. We used Cognitive Task Analysis (CTA) methods to interview 10 Infectious Disease (ID) experts at the University of Utah and Salt Lake City Veterans Administration Medical Center. Participants were asked to recall a complex, critical and vivid antibiotic-prescribing incident using the Critical Decision Method (CDM), a type of Cognitive Task Analysis (CTA). Using the four iterations of the Critical Decision Method, questions were posed to fully explore the incident, focusing in depth on the clinical components underlying the complexity. Probes were included to assess cognitive and decision strategies used by participants. The following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety. All these factors contribute to decision complexity. These factors almost always occurred together, creating unexpected events and uncertainty in clinical reasoning. Five themes emerged in the analyses of how experts deal with the complexity. Expert clinicians frequently used 1) watchful waiting instead of over- prescribing antibiotics, engaged in 2) theory of mind to project and simulate other practitioners' perspectives, reduced very complex cases into simple 3) heuristics, employed 4) anticipatory thinking to plan and re-plan events and consulted with peers to share knowledge, solicit opinions and 5) seek help on patient cases. The cognitive strategies to deal with decision complexity found in this study have important

  2. Other ways of knowing: considerations for information communication in decision aid design1

    PubMed Central

    Basile, Melissa J.; Kozikowski, Andrzej; Akerman, Meredith; Liberman, Tara; McGinn, Thomas; Diefenbach, Michael A.

    2016-01-01

    Background Patients with advanced stage chronic obstructive pulmonary disease (COPD) may suffer severe respiratory exacerbations and need to decide between accepting life sustaining treatments versus foregoing these treatments (choosing comfort care only). We designed the InformedTogether decision aid to inform this decision, and describe results of a pilot study to assess usability focusing on participants’ trust in the content of the decision aid, acceptability, recommendations for improvement; and emotional reactions to this emotionally-laden decision. Methods Study participants (N=26) comprised of clinicians, patients, and surrogates viewed the decision aid, completed usability tasks, and participated in interviews and focus groups assessing comprehension, trust, perception of bias, and perceived acceptability of InformedTogether implementation. Mixed methods were used to analyze results. Results Almost all participants understood the gist (general meaning) of InformedTogether. However, many lower literacy participants had difficulty answering the more detailed questions related to comprehension, especially when interpreting icon arrays, and many were not aware that they had misunderstood the information. Qualitative analysis showed a range of emotional reactions to the information. Participants with low verbatim comprehension frequently referenced lived experiences when answering knowledge questions, which we termed “alternative knowledge”. Conclusion We found a range of emotional reactions to the information, and frequent use of alternative knowledge frameworks for deriving meaning from the data. These observations led to insights into the impact of lived experiences on the uptake of biomedical information presented in decision aids. Communicating prognostic information could potentially be improved by eliciting alternative knowledge as a starting ground to build communication, in particular for low literacy patients. Decision aids designed to

  3. Designing Tools for Supporting User Decision-Making in e-Commerce

    NASA Astrophysics Data System (ADS)

    Sutcliffe, Alistair; Al-Qaed, Faisal

    The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.

  4. Design of a reliable and operational landslide early warning system at regional scale

    NASA Astrophysics Data System (ADS)

    Calvello, Michele; Piciullo, Luca; Gariano, Stefano Luigi; Melillo, Massimo; Brunetti, Maria Teresa; Peruccacci, Silvia; Guzzetti, Fausto

    2017-04-01

    Landslide early warning systems at regional scale are used to warn authorities, civil protection personnel and the population about the occurrence of rainfall-induced landslides over wide areas, typically through the prediction and measurement of meteorological variables. A warning model for these systems must include a regional correlation law and a decision algorithm. A regional correlation law can be defined as a functional relationship between rainfall and landslides; it is typically based on thresholds of rainfall indicators (e.g., cumulated rainfall, rainfall duration) related to different exceedance probabilities of landslide occurrence. A decision algorithm can be defined as a set of assumptions and procedures linking rainfall thresholds to warning levels. The design and the employment of an operational and reliable early warning system for rainfall-induced landslides at regional scale depend on the identification of a reliable correlation law as well as on the definition of a suitable decision algorithm. Herein, a five-step process chain addressing both issues and based on rainfall thresholds is proposed; the procedure is tested in a landslide-prone area of the Campania region in southern Italy. To this purpose, a database of 96 shallow landslides triggered by rainfall in the period 2003-2010 and rainfall data gathered from 58 rain gauges are used. First, a set of rainfall thresholds are defined applying a frequentist method to reconstructed rainfall conditions triggering landslides in the test area. In the second step, several thresholds at different exceedance probabilities are evaluated, and different percentile combinations are selected for the activation of three warning levels. Subsequently, within steps three and four, the issuing of warning levels is based on the comparison, over time and for each combination, between the measured rainfall and the pre-defined warning level thresholds. Finally, the optimal percentile combination to be employed in

  5. LIFE CYCLE ASSESSMENT IN MANAGEMENT, PRODUCT AND PROCESS DESIGN, AND POLICY DECISION MAKING: A CONFERENCE REPORT

    EPA Science Inventory

    On 24 September 2003, life cycle assessment (LCA) practitioners and decision makers gathered at the InLCA/LCM Conference in Seattle, Washington, USA (see http://www.lcacenter.org/InLCA-LCM03/index.html) to discuss the role of LCA in management, product design, process development...

  6. Designing a Decision-Support System for Enrollment Management. AIR 1985 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Glover, Robert H.

    University of Hartford's decision-support system for enrollment management, which uses fourth-generation software tools, is described, with attention to the conceptual framework, design and implementation plan, and progress to date. The university's planners, institutional researchers, and admissions and financial aid officers are cooperating in…

  7. A decision-making tool for incorporating sustainability measures into pavement design : research project capsule.

    DOT National Transportation Integrated Search

    2016-10-01

    The objective of the proposed study is to conceive and develop a decision-making tool : for evaluating sustainability of pavement designs based on a cradle-to-grave analysis. : This tool will utilize EPDs to enhance the reliability of the assessment ...

  8. Teachers' Thoughts on Student Decision Making during Engineering Design Lessons

    ERIC Educational Resources Information Center

    Meyer, Helen

    2018-01-01

    In this paper, I share the results of a study of teachers' ideas about student decision-making at entry into a professional development program to integrate engineering into their instruction. The framework for the Engineering Design Process (EDP) was based on a Challenge-Based Learning (CBL) model. The EDP embedded within the CBL model suggests…

  9. Designing an Alternative Teaching Approach (Feedback Lecture) through the Use of Guided Decision-Making.

    ERIC Educational Resources Information Center

    Osterman, Dean

    This chapter explains how the Guided Design method of teaching can be used to solve problems, and how this method was used in the development of a new method of teaching. Called the Feedback Lecture, this method is illustrated through an example, and research data on its effectiveness is presented. The Guided Decision-Making Process is also…

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

    NASA Technical Reports Server (NTRS)

    Lewis, Kemper; Mistree, Farrokh

    1995-01-01

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

  11. Making Informed Decisions: The Role of Information Literacy in Ethical and Effective Engineering Design

    ERIC Educational Resources Information Center

    Fosmire, Michael

    2017-01-01

    Engineering designers must make evidence-based decisions when applying the practical tools and techniques of their discipline to human problems. Information literacy provides a structure for determining information gaps, locating appropriate and relevant information, applying that information effectively, and documenting and managing the knowledge…

  12. WAR DSS: A DECISION SUPPORT SYSTEM FOR ENVIRONMENTALLY CONSCIOUS CHEMICAL PROCESS DESIGN

    EPA Science Inventory

    The second generation of the Waste Reduction (WAR) Algorithm is constructed as a decision support system (DSS) in the design of chemical manufacturing facilities. The WAR DSS is a software tool that can help reduce the potential environmental impacts (PEIs) of industrial chemical...

  13. Developing a Decision Model of Sustainable Product Design and Development from Product Servicizing in Taiwan

    ERIC Educational Resources Information Center

    Huang, Yu-Chen; Tu, Jui-Che; Hung, So-Jeng

    2016-01-01

    In response to the global trend of low carbon and the concept of sustainable development, enterprises need to develop R&D for the manufacturing of energy-saving and sustainable products and low carbon products. Therefore, the purpose of this study was to construct a decision model for sustainable product design and development from product…

  14. 14 CFR 33.201 - Design and test requirements for Early ETOPS eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Design and test requirements for Early... Aircraft Engines § 33.201 Design and test requirements for Early ETOPS eligibility. An applicant seeking type design approval for an engine to be installed on a two-engine airplane approved for ETOPS without...

  15. Designs for Living and Learning: Transforming Early Childhood Environments.

    ERIC Educational Resources Information Center

    Curtis, Deb; Carter, Margie

    While the early childhood field has formed standards to help in recognizing quality programs for children, practitioners seldom use values to guide in selection of materials or to help plan early childhood environments. This book draws on a variety of educational approaches, including Waldorf, Montessori, and Reggio Emilia, to outline hundreds of…

  16. Designing Dynamic Adaptive Policy Pathways using Many-Objective Robust Decision Making

    NASA Astrophysics Data System (ADS)

    Kwakkel, Jan; Haasnoot, Marjolijn

    2017-04-01

    Dealing with climate risks in water management requires confronting a wide variety of deeply uncertain factors, while navigating a many dimensional space of trade-offs amongst objectives. There is an emerging body of literature on supporting this type of decision problem, under the label of decision making under deep uncertainty. Two approaches within this literature are Many-Objective Robust Decision Making, and Dynamic Adaptive Policy Pathways. In recent work, these approaches have been compared. One of the main conclusions of this comparison was that they are highly complementary. Many-Objective Robust Decision Making is a model based decision support approach, while Dynamic Adaptive Policy Pathways is primarily a conceptual framework for the design of flexible strategies that can be adapted over time in response to how the future is actually unfolding. In this research we explore this complementarity in more detail. Specifically, we demonstrate how Many-Objective Robust Decision Making can be used to design adaptation pathways. We demonstrate this combined approach using a water management problem, in the Netherlands. The water level of Lake IJselmeer, the main fresh water resource of the Netherlands, is currently managed through discharge by gravity. Due to climate change, this won't be possible in the future, unless water levels are changed. Changing the water level has undesirable flood risk and spatial planning consequences. The challenge is to find promising adaptation pathways that balance objectives related to fresh water supply, flood risk, and spatial issues, while accounting for uncertain climatic and land use change. We conclude that the combination of Many-Objective Robust Decision Making and Dynamic Adaptive Policy Pathways is particularly suited for dealing with deeply uncertain climate risks.

  17. Using participatory design to develop (public) health decision support systems through GIS.

    PubMed

    Dredger, S Michelle; Kothari, Anita; Morrison, Jason; Sawada, Michael; Crighton, Eric J; Graham, Ian D

    2007-11-27

    Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for non-specialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool. A case study design is being used whereby the case is defined as the data analyst and manager dyad (a two person team) in selected Ontario Early Year Centres (OEYCs). Multiple cases are used to support the reliability of findings. With nine producer/user pair participants, the goal in Phase 1 was to identify barriers to map production, and through the participatory design process, develop a web-based GIS tool suited for data analysts and their managers. This study has been guided by the Ottawa Model of Research Use (OMRU) conceptual framework. Due to wide variations in OEYC structures, only some data analysts used mapping software and there was no consistency or standardization in the software being used. Consequently, very little sharing of maps and data occurred among data analysts. Using PD, this project developed a web-based mapping tool (EYEMAP) that was easy to use, protected proprietary data, and permit limited and controlled sharing between participants. By providing data analysts with training on its use, the project also ensured that data analysts would not break cartographic conventions (e.g. using a chloropleth map for count data). Interoperability was built into the web-based solution; that is, EYEMAP can read many different standard mapping file formats (e.g. ESRI, MapInfo, CSV

  18. Using participatory design to develop (public) health decision support systems through GIS

    PubMed Central

    Dredger, S Michelle; Kothari, Anita; Morrison, Jason; Sawada, Michael; Crighton, Eric J; Graham, Ian D

    2007-01-01

    Background Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for non-specialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool. Methods A case study design is being used whereby the case is defined as the data analyst and manager dyad (a two person team) in selected Ontario Early Year Centres (OEYCs). Multiple cases are used to support the reliability of findings. With nine producer/user pair participants, the goal in Phase 1 was to identify barriers to map production, and through the participatory design process, develop a web-based GIS tool suited for data analysts and their managers. This study has been guided by the Ottawa Model of Research Use (OMRU) conceptual framework. Results Due to wide variations in OEYC structures, only some data analysts used mapping software and there was no consistency or standardization in the software being used. Consequently, very little sharing of maps and data occurred among data analysts. Using PD, this project developed a web-based mapping tool (EYEMAP) that was easy to use, protected proprietary data, and permit limited and controlled sharing between participants. By providing data analysts with training on its use, the project also ensured that data analysts would not break cartographic conventions (e.g. using a chloropleth map for count data). Interoperability was built into the web-based solution; that is, EYEMAP can read many different standard mapping file formats

  19. The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy.

    PubMed

    MacDonald, Karen V; Bombard, Yvonne; Deal, Ken; Trudeau, Maureen; Leighl, Natasha; Marshall, Deborah A

    2016-07-01

    Women with early-stage breast cancer, of whom only 15% will experience a recurrence, are often conflicted or uncertain about taking chemotherapy. Gene expression profiling (GEP) of tumours informs risk prediction, potentially affecting treatment decisions. We examined whether receiving a GEP test score reduces decisional conflict in chemotherapy treatment decision making. A general population sample of 200 women completed the decisional conflict scale (DCS) at baseline (no GEP test score scenario) and after (scenario with GEP test score added) completing a discrete choice experiment survey for early-stage breast cancer chemotherapy. We scaled the 16-item DCS total scores and subscores from 0 to 100 and calculated means, standard deviations and change in scores, with significance (p < 0.05) based on matched pairs t-tests. We identified five respondent subgroups based on preferred treatment option; almost 40% did not change their chemotherapy decision after receiving GEP testing information. Total score and all subscores (uncertainty, informed, values clarity, support, and effective decision) decreased significantly in the respondent subgroup who were unsure about taking chemotherapy initially but changed to no chemotherapy (n =33). In the subgroup of respondents (n = 25) who chose chemotherapy initially but changed to unsure, effective decision subscore increased significantly. In the overall sample, changes in total and all subscores were non-significant. GEP testing adds value for women initially unsure about chemotherapy treatment with a decrease in decisional conflict. However, for women who are confident about their treatment decisions, GEP testing may not add value. Decisions to request GEP testing should be personalised based on patient preferences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. A framework to support decision making in the selection of sustainable drainage system design alternatives.

    PubMed

    Wang, Mingming; Sweetapple, Chris; Fu, Guangtao; Farmani, Raziyeh; Butler, David

    2017-10-01

    This paper presents a new framework for decision making in sustainable drainage system (SuDS) scheme design. It integrates resilience, hydraulic performance, pollution control, rainwater usage, energy analysis, greenhouse gas (GHG) emissions and costs, and has 12 indicators. The multi-criteria analysis methods of entropy weight and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were selected to support SuDS scheme selection. The effectiveness of the framework is demonstrated with a SuDS case in China. Indicators used include flood volume, flood duration, a hydraulic performance indicator, cost and resilience. Resilience is an important design consideration, and it supports scheme selection in the case study. The proposed framework will help a decision maker to choose an appropriate design scheme for implementation without subjectivity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The mediating and moderating role of planning on mothers' decisions for early childhood dietary behaviours.

    PubMed

    Hamilton, Kyra; Kothe, Emily J; Mullan, Barbara; Spinks, Teagan

    2017-12-01

    Examine the roles of action and coping planning on the intention-behaviour relationship for mothers' decisions for their young children's dietary behaviours. Prospective design with two waves of data collection, one week apart. Mothers (N = 197, M age  = 34.39, SD = 5.65) of children aged 2-3 years completed a main questionnaire assessing planning constructs and intentions, and a one-week follow-up of the target behaviours - 'healthy eating' and 'discretionary choices'. Intention was the strongest predictor of behaviour for both dietary behaviours. For healthy eating, intention moderated the indirect relationship between intention-behaviour via planning; coping planning was less important when intention was strong. Further, intention was not a direct predictor of behaviour when intention was relatively low. Action planning was not a direct predictor of either behaviour after accounting for intention and coping planning; action planning on behaviour was mediated by coping planning (only for healthy eating). Intention was not a direct predictor of coping planning; intention on coping planning was mediated by action planning. Neither type of planning predicted discretionary choices. Current findings contribute novel information on the mechanisms underpinning the effect of action and coping planning on the intention-behaviour relationship.

  2. Innovative design for early detection of invasive species

    EPA Science Inventory

    Non-native aquatic species impose significant ecological impacts and rising financial costs in marine and freshwater ecosystems worldwide. Early detection of invasive species, as they enter a vulnerable ecosystem, is critical to successful containment and eradication. ORD, at t...

  3. Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior.

    PubMed

    Tai-Seale, Ming; Elwyn, Glyn; Wilson, Caroline J; Stults, Cheryl; Dillon, Ellis C; Li, Martina; Chuang, Judith; Meehan, Amy; Frosch, Dominick L

    2016-04-01

    Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary care providers to communicate more openly. The intervention was tested against an existing intervention, which focused mainly on changing patients' behaviors, in four primary care clinics involving 26 primary care providers and 300 patients. Study results suggest that compared to usual care, both the novel and existing interventions were associated with better patient reports of how well primary care providers engaged them in shared decision making. Future research should build on the work in this pilot to rigorously examine the comparative effectiveness and scalability of these interventions to improve shared decision making at the point of care. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Decision making and action implementation: evidence for an early visually triggered motor activation specific to potential actions.

    PubMed

    Tandonnet, Christophe; Garry, Michael I; Summers, Jeffery J

    2013-07-01

    To make a decision may rely on accumulating evidence in favor of one alternative until a threshold is reached. Sequential-sampling models differ by the way of accumulating evidence and the link with action implementation. Here, we tested a model's prediction of an early action implementation specific to potential actions. We assessed the dynamics of action implementation in go/no-go and between-hand choice tasks by transcranial magnetic stimulation of the motor cortex (single- or paired-pulse TMS; 3-ms interstimulus interval). Prior to implementation of the selected action, the amplitude of the motor evoked potential first increased whatever the visual stimulus but only for the hand potentially involved in the to-be-produced action. These findings suggest that visual stimuli can trigger an early motor activation specific to potential actions, consistent with race-like models with continuous transmission between decision making and action implementation. Copyright © 2013 Society for Psychophysiological Research.

  5. Improvement of sand filter and constructed wetland design using an environmental decision support system.

    PubMed

    Turon, Clàudia; Comas, Joaquim; Torrens, Antonina; Molle, Pascal; Poch, Manel

    2008-01-01

    With the aim of improving effluent quality of waste stabilization ponds, different designs of vertical flow constructed wetlands and intermittent sand filters were tested on an experimental full-scale plant within the framework of a European project. The information extracted from this study was completed and updated with heuristic and bibliographic knowledge. The data and knowledge acquired were difficult to integrate into mathematical models because they involve qualitative information and expert reasoning. Therefore, it was decided to develop an environmental decision support system (EDSS-Filter-Design) as a tool to integrate mathematical models and knowledge-based techniques. This paper describes the development of this support tool, emphasizing the collection of data and knowledge and representation of this information by means of mathematical equations and a rule-based system. The developed support tool provides the main design characteristics of filters: (i) required surface, (ii) media type, and (iii) media depth. These design recommendations are based on wastewater characteristics, applied load, and required treatment level data provided by the user. The results of the EDSS-Filter-Design provide appropriate and useful information and guidelines on how to design filters, according to the expert criteria. The encapsulation of the information into a decision support system reduces the design period and provides a feasible, reasoned, and positively evaluated proposal.

  6. Shared decision making in designing new healthcare environments-time to begin improving quality.

    PubMed

    Elf, Marie; Fröst, Peter; Lindahl, Göran; Wijk, Helle

    2015-03-21

    Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

  7. Addressing adoption and research design decisions simultaneously: the role of value of sample information analysis.

    PubMed

    McKenna, Claire; Claxton, Karl

    2011-01-01

    to estimate the cost-effectiveness of technologies are well developed with increasing experience of their application to inform adoption decisions in a timely way. However, the experience of using similarly explicit methods to inform the associated research decisions is less well developed despite appropriate methods being available with an increasing number of applications in health. The authors demonstrate that evaluation of both adoption and research decisions is feasible within typical time and resource constraints relevant to policy decisions, even in situations in which data are sparse and formal elicitation is required. In addition to demonstrating the application of expected value of sample information (EVSI) in these circumstances, the authors examine and carefully distinguish the impact that the research decision is expected to have on patients while enrolled in the trial, those not enrolled, and once the trial reports. In doing so, the authors are able to account for the range of opportunity cost associated with research and evaluate a number of s including length of follow-up and sample size. The authors also explore the implications for research design of conducting research while the technology is approved for widespread use and whether approval should be withheld until research reports. In doing so, the authors highlight the impact of irrecoverable opportunity costs when the initial costs of a technology are compensated only by later gains in health outcome.

  8. Decision-Making in the Classroom and Early Adolescents' Valuing of Mathematics.

    ERIC Educational Resources Information Center

    Mac Iver, Douglas; Reuman, David A.

    In many upper-elementary school classrooms, students are given few decision-making prerogatives. In junior high school, it becomes increasingly rare for them to receive the decision-making opportunities they believe they should have. Both person-environment fit theory and pawn theory would predict that a failure to provide students with such…

  9. Decision Making in Children and Adolescents: Impaired Iowa Gambling Task Performance in Early Adolescence

    ERIC Educational Resources Information Center

    Smith, Dana G.; Xiao, Lin; Bechara, Antoine

    2012-01-01

    Disadvantageous decision making is cited as one of the premier problems in childhood development, underlying risky behavior and causing adolescents to make poor choices that could prove detrimental later in life. However, there are relatively few studies looking at the development of decision making in children and adolescents, and fewer still…

  10. Future perspectives toward the early definition of a multivariate decision-support scheme employed in clinical decision making for senior citizens.

    PubMed

    Frantzidis, Christos A; Gilou, Sotiria; Billis, Antonis; Karagianni, Maria; Bratsas, Charalampos D; Bamidis, Panagiotis

    2016-03-01

    Recent neuroscientific studies focused on the identification of pathological neurophysiological patterns (emotions, geriatric depression, memory impairment and sleep disturbances) through computerised clinical decision-support systems. Almost all these research attempts employed either resting-state condition (e.g. eyes-closed) or event-related potentials extracted during a cognitive task known to be affected by the disease under consideration. This Letter reviews existing data mining techniques and aims to enhance their robustness by proposing a holistic decision framework dealing with comorbidities and early symptoms' identification, while it could be applied in realistic occasions. Multivariate features are elicited and fused in order to be compared with average activities characteristic of each neuropathology group. A proposed model of the specific cognitive function which may be based on previous findings (a priori information) and/or validated by current experimental data should be then formed. So, the proposed scheme facilitates the early identification and prevention of neurodegenerative phenomena. Neurophysiological semantic annotation is hypothesised to enhance the importance of the proposed framework in facilitating the personalised healthcare of the information society and medical informatics research community.

  11. POLLUTION PREVENTION IN THE EARLY STAGES OF HIERARCHICAL PROCESS DESIGN

    EPA Science Inventory

    Hierarchical methods are often used in the conceptual stages of process design to synthesize and evaluate process alternatives. In this work, the methods of hierarchical process design will be focused on environmental aspects. In particular, the design methods will be coupled to ...

  12. Decision Support Systems and Early Warning Solutions: a review in European context.

    NASA Astrophysics Data System (ADS)

    Cortes, V. J.; Frigerio, S.; Schenato, L.; Sterlacchini, S.; Pasuto, A.

    2012-04-01

    According to the aim of the CHANGES network, an EU funded project, research is carried out towards the improvement of the emergency management strategies for hydro-meteorological hazards under the effects of climate and the pressure of socio-economic changes. Aim supported on the need to enhance local resilience to these hazards under different scenarios, if possible by means of a multi-disciplinary and multi-hazard approach. Both requirements recognized on the scientific and practical community. In this context, the current management of hydro-meteorological hazards have posed some difficulties due to the complexity of the phenomena and the processes associated. These impacts, usually developed as a domino effect are still not properly understood and require a management strategy that combines active and passive mitigation measures. On the other hand, the every time most destructive effect of these hazards and the available information and communication techniques has also stressed the responsible authorities to prepare, develop and implement more effective safeguard plans. Finally, a combined approach to this situation depicts a research way by integrating the development and implementation of early warning systems (EWS) and contingency plans (CP), which is generally constricted by the state-of-art and particular conditions for the assessment of hazards in place. Consequently, here is presented a review of Decision Support Systems (DSS) and EWS on hydrometeorological hazards such as flash floods, debris flows and landslides as a starting point for such a research initiative. Identification of common and basic features, advantages and disadvantages are expected to derive some elements for possible developments. The review is carried from the key conclusions and recommendations identified with past experiences of testing and developing a common platform; which generally comprises workflow management modules encrypted in a DSS with GIS interface and communication

  13. Rebuilding the NAVSEA Early Stage Ship Design Environment

    DTIC Science & Technology

    2010-04-01

    rules -of- thumb to base these crucial decisions upon. With High Performance Computing (HPC) as an enabler, the vision is to explore all downstream...the results of the analysis back into LEAPS. Another software development worthy of discussion here is Intelligent Ship Arrangements ( ISA ), which...constraints and rules set by the users ahead of time. When used in a systematic and stochastic way, and when integrated using LEAPS, having this

  14. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    NASA Astrophysics Data System (ADS)

    Raposo, João; Rodrigues, Ana; Silva, Carlos; Dentinho, Tomaz

    2015-05-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city's urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE's characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  15. Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS): Rationale, Design, and Methods

    ERIC Educational Resources Information Center

    McClellan, Jon; Sikich, Linmarie; Findling, Robert L.; Frazier, Jean A.; Vitiello, Benedetto; Hlastala, Stefanie A.; Williams, Emily; Ambler, Denisse; Hunt-Harrison, Tyehimba; Maloney, Ann E.; Ritz, Louise; Anderson, Robert; Hamer, Robert M.; Lieberman, Jeffrey A.

    2007-01-01

    Objective: The Treatment of Early Onset Schizophrenia Spectrum Disorders Study is a publicly funded clinical trial designed to compare the therapeutic benefits, safety, and tolerability of risperidone, olanzapine, and molindone in youths with early-onset schizophrenia spectrum disorders. The rationale, design, and methods of the Treatment of Early…

  16. A Policymaker's Guide to Early College Designs: Expanding a Strategy for Achieving College Readiness for All

    ERIC Educational Resources Information Center

    Hoffman, Nancy; Vargas, Joel

    2010-01-01

    Today, states and the federal government recognize the potential of early college designs to improve the economic prospects of future generations. But individuals are just beginning to put in place public policies that promote and support early college designs on a significant scale. Jobs for the Future (JFF) prepared this guide to help…

  17. Early Design Choices: Capture, Model, Integrate, Analyze, Simulate

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.

    2004-01-01

    I. Designs are constructed incrementally to meet requirements and solve problems: a) Requirements types: objectives, scenarios, constraints, ilities. etc. b) Problem/issue types: risk/safety, cost/difficulty, interaction, conflict, etc. II. Capture requirements, problems and solutions: a) Collect design and analysis products and make them accessible for integration and analysis; b) Link changes in design requirements, problems and solutions; and c) Harvest design data for design models and choice structures. III. System designs are constructed by multiple groups designing interacting subsystems a) Diverse problems, choice criteria, analysis methods and point solutions. IV. Support integration and global analysis of repercussions: a) System implications of point solutions; b) Broad analysis of interactions beyond totals of mass, cost, etc.

  18. Low-income women with early-stage breast cancer: physician and patient decision-making styles.

    PubMed

    McVea, K L; Minier, W C; Johnson Palensky, J E

    2001-01-01

    Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study. Copyright 2001 John Wiley & Sons, Ltd.

  19. Effects of Newly Designed Hospital Buildings on Staff Perceptions: A Pre-Post Study to Validate Design Decisions.

    PubMed

    Schreuder, Eliane; van Heel, Liesbeth; Goedhart, Rien; Dusseldorp, Elise; Schraagen, Jan Maarten; Burdorf, Alex

    2015-01-01

    This study investigates effects of the newly built nonpatient-related buildings of a large university medical center on staff perceptions and whether the design objectives were achieved. The medical center is gradually renewing its hospital building area of 200,000 m.(2) This redevelopment is carefully planned and because lessons learned can guide design decisions of the next phase, the medical center is keen to evaluate the performance of the new buildings. A pre- and post-study with a control group was conducted. Prior to the move to the new buildings an occupancy evaluation was carried out in the old setting (n = 729) (pre-study). Post occupation of the new buildings another occupancy evaluation (post-study) was carried out in the new setting (intervention group) and again in some old settings (control group) (n = 664). The occupancy evaluation consisted of an online survey that measured the perceived performance of different aspects of the building. Longitudinal multilevel analysis was used to compare the performance of the old buildings with the new buildings. Significant improvements were found in indoor climate, perceived safety, working environment, well-being, facilities, sustainability, and overall satisfaction. Commitment to the employer, working atmosphere, orientation, work performance, and knowledge sharing did not improve. The results were interpreted by relating them to specific design choices. We showed that it is possible to measure the performance improvements of a complex intervention being a new building design and validate design decisions. A focused design process aiming for a safe, pleasant and sustainable building resulted in actual improvements in some of the related performance measures. © The Author(s) 2015.

  20. Mixed-Reality Prototypes to Support Early Creative Design

    NASA Astrophysics Data System (ADS)

    Safin, Stéphane; Delfosse, Vincent; Leclercq, Pierre

    The domain we address is creative design, mainly architecture. Rooted in a multidisciplinary approach as well as a deep understanding of architecture and design, our method aims at proposing adapted mixed-reality solutions to support two crucial activities: sketch-based preliminary design and distant synchronous collaboration in design. This chapter provides a summary of our work on a mixed-reality device, based on a drawing table (the Virtual Desktop), designed specifically to address real-life/business-focused issues. We explain our methodology, describe the two supported activities and the related users’ needs, detail the technological solution we have developed, and present the main results of multiple evaluation sessions. We conclude with a discussion of the usefulness of a profession-centered methodology and the relevance of mixed reality to support creative design activities.

  1. Development and Evaluation of Computer-Based Versions of the Decision Board for Early Breast Cancer

    DTIC Science & Technology

    1999-10-01

    develop a decision aid for women with breast cancer. Patient Education and Counselling 1999, 37:283-29 1. 8. Levine MN, Bramwell VH, Pritchard KI...likelihood of their occurrence: often, All patient education cards and a smaller repro- sometimes, or rarely. Information about the results duction of the...choice between two adjuvant chemotherapy regimens: A pilot study to develop a decision aid for women with breast cancer. Patient Education and

  2. Engaging Gatekeepers, Optimizing Decision Making, and Mitigating Bias: Design Specifications for Systemic Diversity Interventions.

    PubMed

    Vinkenburg, Claartje J

    2017-06-01

    In this contribution to the Journal of Applied Behavioral Science Special Issue on Understanding Diversity Dynamics in Systems: Social Equality as an Organization Change Issue, I develop and describe design specifications for systemic diversity interventions in upward mobility career systems, aimed at optimizing decision making through mitigating bias by engaging gatekeepers. These interventions address the paradox of meritocracy that underlies the surprising lack of diversity at the top of the career pyramid in these systems. I ground the design specifications in the limited empirical evidence on "what works" in systemic interventions. Specifically, I describe examples from interventions in academic settings, including a bias literacy program, participatory modeling, and participant observation. The design specifications, paired with inspirational examples of successful interventions, should assist diversity officers and consultants in designing and implementing interventions to promote the advancement to and representation of nondominant group members at the top of the organizational hierarchy.

  3. Engaging Gatekeepers, Optimizing Decision Making, and Mitigating Bias: Design Specifications for Systemic Diversity Interventions

    PubMed Central

    Vinkenburg, Claartje J.

    2017-01-01

    In this contribution to the Journal of Applied Behavioral Science Special Issue on Understanding Diversity Dynamics in Systems: Social Equality as an Organization Change Issue, I develop and describe design specifications for systemic diversity interventions in upward mobility career systems, aimed at optimizing decision making through mitigating bias by engaging gatekeepers. These interventions address the paradox of meritocracy that underlies the surprising lack of diversity at the top of the career pyramid in these systems. I ground the design specifications in the limited empirical evidence on “what works” in systemic interventions. Specifically, I describe examples from interventions in academic settings, including a bias literacy program, participatory modeling, and participant observation. The design specifications, paired with inspirational examples of successful interventions, should assist diversity officers and consultants in designing and implementing interventions to promote the advancement to and representation of nondominant group members at the top of the organizational hierarchy. PMID:28546644

  4. Data Sufficiency Assessment and Pumping Test Design for Groundwater Prediction Using Decision Theory and Genetic Algorithms

    NASA Astrophysics Data System (ADS)

    McPhee, J.; William, Y. W.

    2005-12-01

    This work presents a methodology for pumping test design based on the reliability requirements of a groundwater model. Reliability requirements take into consideration the application of the model results in groundwater management, expressed in this case as a multiobjective management model. The pumping test design is formulated as a mixed-integer nonlinear programming (MINLP) problem and solved using a combination of genetic algorithm (GA) and gradient-based optimization. Bayesian decision theory provides a formal framework for assessing the influence of parameter uncertainty over the reliability of the proposed pumping test. The proposed methodology is useful for selecting a robust design that will outperform all other candidate designs under most potential 'true' states of the system

  5. [Decision-making and apathy in early stage of Alzheimer's disease and in mild cognitive impairment].

    PubMed

    Jacus, Jean-Pierre; Bayard, Sophie; Raffard, Stéphane; Gély-Nargeot, Marie-Christine

    2013-06-01

    Decision-making and apathy have common neuropsychological processes and neuroanatomical substrates. However, their links in mild cognitive impairment (MCI) and Alzheimer's disease (AD) remain unclear. in order to evaluate these links, we compared 3 groups of 20 control subjects to 20 patients with MCI and 20 patients with mild AD. All participants completed the mini mental state examination (MMSE), the Lille apathy rating scale (LARS, a multidimensional scale of apathy), the game of dice task (GDT, assessing decision under risk) and the Iowa gambling task (IGT, assessing decision under ambiguity). 60% of patients in both clinical groups were apathetic versus 5% of control subjects. In both clinical groups the IGT and GDT net scores were comparable (respectively: p = 0.76 and p = 0.84), while the control group had higher scores than MCI and AD's groups (respectively, GDT p < 0.02 and p < 0.05; IGT: p < 0.05 and p < 0.05). Cognitive impairment increased the risk of disadvantageous choices in decision under risk (× 6), and under ambiguity (× 3.5). No global contribution of apathy was found for decision-making performances (all PS > 0.05), but on the LARS, the "intellectual curiosity" (cognitive dimension) was a predictor for the performances on GDT's (OR = 1.73, p = 0.05), while the "action initiation" (behavioral dimension) was a predictor of those on IGT (OR = 1.57, p = 0.05). these results highlight the behavioral and the cognitive sensitivity of the IGT and the GDT, and are analyzed according to Levy and Dubois's model of apathy, and to the three steps of the decision-making process of Gleichgerrcht et al. (2010). However, more researches are necessary to explain the causality links between action initiation and decision under ambiguity.

  6. Flexibility in Early Stage Design of U. S. Navy Ships: An Analysis of Options

    DTIC Science & Technology

    2011-01-01

    Flexibility in Early Stage Design of US Navy Ships: An Analysis of Options by Jonathan Page B.S., Systems Engineering, US Naval Academy, 2002...8217C/ v = (;!;!: ;: Pat Hale Director, Systems Design and Ma~ement Fellows Program E~i_yfering.S~~pivi~i~ Acceptedby...2. REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Flexibility in Early Stage Design of U. S. Navy Ships: An

  7. Assessment and Decision-Making in Early Childhood Education and Intervention

    ERIC Educational Resources Information Center

    Strand, Paul S.; Cerna, Sandra; Skucy, Jim

    2007-01-01

    Assessment within the fields of early childhood education and early childhood intervention is guided by the "deductive-psychometric model", which is a framework for legitimizing constructs that arise from theories. An alternative approach, termed the "inductive-experimental model", places significantly more restrictions on what constitutes a…

  8. Guessing right for the next war: streamlining, pooling, and right-timing force design decisions for an environment of uncertainty

    DTIC Science & Technology

    2017-05-25

    Guessing Right for the Next War: Streamlining, Pooling, and Right-Timing Force Design Decisions for an Environment of Uncertainty A...JUN 2016 – MAY 2017 4. TITLE AND SUBTITLE Guessing Right for the Next War: Streamlining, Pooling, and Right- Timing Force Design Decisions for an...committing to one force design solution to modern combat. The Army after World War II shied away from temporary organizational systems like these in

  9. Information theory-based decision support system for integrated design of multivariable hydrometric networks

    NASA Astrophysics Data System (ADS)

    Keum, Jongho; Coulibaly, Paulin

    2017-07-01

    Adequate and accurate hydrologic information from optimal hydrometric networks is an essential part of effective water resources management. Although the key hydrologic processes in the water cycle are interconnected, hydrometric networks (e.g., streamflow, precipitation, groundwater level) have been routinely designed individually. A decision support framework is proposed for integrated design of multivariable hydrometric networks. The proposed method is applied to design optimal precipitation and streamflow networks simultaneously. The epsilon-dominance hierarchical Bayesian optimization algorithm was combined with Shannon entropy of information theory to design and evaluate hydrometric networks. Specifically, the joint entropy from the combined networks was maximized to provide the most information, and the total correlation was minimized to reduce redundant information. To further optimize the efficiency between the networks, they were designed by maximizing the conditional entropy of the streamflow network given the information of the precipitation network. Compared to the traditional individual variable design approach, the integrated multivariable design method was able to determine more efficient optimal networks by avoiding the redundant stations. Additionally, four quantization cases were compared to evaluate their effects on the entropy calculations and the determination of the optimal networks. The evaluation results indicate that the quantization methods should be selected after careful consideration for each design problem since the station rankings and the optimal networks can change accordingly.

  10. Early Withdrawal Decision-Making in Patients with Coma After Cardiac Arrest: A Qualitative Study of Intensive Care Clinicians.

    PubMed

    Ong, Charlene J; Dhand, Amar; Diringer, Michael N

    2016-10-01

    Neurologists are often asked to define prognosis in comatose patients. However, comatose patients following cardiac arrest are usually cared for by cardiologists or intensivists, and it is their approach that will influence decisions regarding withdrawal of life-sustaining interventions (WLSI). We observed that factors leading to these decisions vary across specialties and considered whether they could result in self-fulfilling prophecies and early WLSI. We conducted a hypothesis-generating qualitative study to identify factors used by non-neurologists to define prognosis in these patients and construct an explanatory model for how early WLSI might occur. This was a single-center qualitative study of intensivists caring for cardiac arrest patients with hypoxic-ischemic coma. Thirty attending physicians (n = 16) and fellows (n = 14) from cardiac (n = 8), medical (n = 6), surgical (n = 10), and neuro (n = 6) intensive care units underwent semi-structured interviews. Interview transcripts were analyzed using grounded theory techniques. We found three components of early WLSI among non-neurointensivists: (1) development of fixed negative opinions; (2) early framing of poor clinical pictures to families; and (3) shortened windows for judging recovery potential. In contrast to neurointensivists, non-neurointensivists' negative opinions were frequently driven by patients' lack of consciousness and cardiopulmonary resuscitation circumstances. Both groups were influenced by age and comorbidities. The results demonstrate that factors influencing prognostication differ across specialties. Some differ from those recommended by published guidelines and may lead to self-fulfilling prophecies and early WLSI. Better understanding of this framework would facilitate educational interventions to mitigate this phenomenon and its implications on patient care.

  11. Matched Comparison Group Design Standards in Systematic Reviews of Early Childhood Interventions.

    PubMed

    Thomas, Jaime; Avellar, Sarah A; Deke, John; Gleason, Philip

    2017-06-01

    Systematic reviews assess the quality of research on program effectiveness to help decision makers faced with many intervention options. Study quality standards specify criteria that studies must meet, including accounting for baseline differences between intervention and comparison groups. We explore two issues related to systematic review standards: covariate choice and choice of estimation method. To help systematic reviews develop/refine quality standards and support researchers in using nonexperimental designs to estimate program effects, we address two questions: (1) How well do variables that systematic reviews typically require studies to account for explain variation in key child and family outcomes? (2) What methods should studies use to account for preexisting differences between intervention and comparison groups? We examined correlations between baseline characteristics and key outcomes using Early Childhood Longitudinal Study-Birth Cohort data to address Question 1. For Question 2, we used simulations to compare two methods-matching and regression adjustment-to account for preexisting differences between intervention and comparison groups. A broad range of potential baseline variables explained relatively little of the variation in child and family outcomes. This suggests the potential for bias even after accounting for these variables, highlighting the need for systematic reviews to provide appropriate cautions about interpreting the results of moderately rated, nonexperimental studies. Our simulations showed that regression adjustment can yield unbiased estimates if all relevant covariates are used, even when the model is misspecified, and preexisting differences between the intervention and the comparison groups exist.

  12. Incomplete and inconsistent information provided to men making decisions for treatment of early-stage prostate cancer.

    PubMed

    Snow, Stephanie L; Panton, Rachel L; Butler, Lorna J; Wilke, Derek R; Rutledge, Robert D H; Bell, David G; Rendon, Ricardo A

    2007-05-01

    To determine whether there is a gap between what patients know about early-stage prostate cancer and what they need to know to make treatment decisions, and whether the information patients receive varies depending on their treating physician. Needs assessment was performed using a questionnaire consisting of 41 statements about early-stage prostate cancer. Statements were divided into six thematic subsets. Participants used a 5-point Likert scale to rate statements in terms of knowledge of the information and importance to a treatment decision. Information gaps were defined as significant difference between the importance and knowledge of an item. Descriptive statistics were used to describe demographic subscale scores. The information gap was analyzed by a paired t test for each thematic subset. One-way analyses of variance were used to detect any differences on the basis of treating physician. Questionnaires were distributed to 270 men (135 treated by radical prostatectomy, 135 by external beam radiotherapy). The return rate was 51% (138 questionnaires). A statistically significant information gap was found among all six thematic subsets, with five of the six P values less than 0.0001. Statistically significant variation was observed in the amount of information patients received from their treating physicians among four of the thematic subsets. There is an information gap between what early-stage prostate cancer patients need to know and the information they receive. Additionally there is a difference in the amount of information provided by different physicians.

  13. Critical decision-making in radiotherapy for early stage breast cancer in a neo-adjuvant treatment era.

    PubMed

    De Felice, Francesca; Osti, Mattia Falchetto; De Sanctis, Vitaliana; Musio, Daniela; Tombolini, Vincenzo

    2017-05-01

    In breast cancer management, the role of adjuvant radiation therapy (RT) has been the subject of intense controversy over the past several years, due to the improvement in neoadjuvant chemotherapy (NACT) prescription. One of the most controversial questions regarding indication for adjuvant RT is whether or not RT is essential in patients with early stage disease at diagnosis. The value of adjuvant RT remains highly debatable in those patients with clinically negative nodes at the completion of NACT. Areas covered: This review is focused on this gray area and is intended to assist with clinical decision-making. We provide a comprehensive review using PubMed and meeting proceedings of San Antonio Breast Cancer Symposium, European Society for Radiotherapy & Oncology, European Society of Medical Oncology and American Society of Clinical Oncology. Expert commentary: The identification of potential prognostic factors may lead to novel adjuvant RT indications. Phase III clinical trials are underway and their results will help guide treatment decisions.

  14. A probabilistic multi-criteria decision making technique for conceptual and preliminary aerospace systems design

    NASA Astrophysics Data System (ADS)

    Bandte, Oliver

    It has always been the intention of systems engineering to invent or produce the best product possible. Many design techniques have been introduced over the course of decades that try to fulfill this intention. Unfortunately, no technique has succeeded in combining multi-criteria decision making with probabilistic design. The design technique developed in this thesis, the Joint Probabilistic Decision Making (JPDM) technique, successfully overcomes this deficiency by generating a multivariate probability distribution that serves in conjunction with a criterion value range of interest as a universally applicable objective function for multi-criteria optimization and product selection. This new objective function constitutes a meaningful Xnetric, called Probability of Success (POS), that allows the customer or designer to make a decision based on the chance of satisfying the customer's goals. In order to incorporate a joint probabilistic formulation into the systems design process, two algorithms are created that allow for an easy implementation into a numerical design framework: the (multivariate) Empirical Distribution Function and the Joint Probability Model. The Empirical Distribution Function estimates the probability that an event occurred by counting how many times it occurred in a given sample. The Joint Probability Model on the other hand is an analytical parametric model for the multivariate joint probability. It is comprised of the product of the univariate criterion distributions, generated by the traditional probabilistic design process, multiplied with a correlation function that is based on available correlation information between pairs of random variables. JPDM is an excellent tool for multi-objective optimization and product selection, because of its ability to transform disparate objectives into a single figure of merit, the likelihood of successfully meeting all goals or POS. The advantage of JPDM over other multi-criteria decision making

  15. Four principles for user interface design of computerised clinical decision support systems.

    PubMed

    Kanstrup, Anne Marie; Christiansen, Marion Berg; Nøhr, Christian

    2011-01-01

    The paper presents results from a design research project of a user interface (UI) for a Computerised Clinical Decision Support System (CDSS). The ambition has been to design Human-Computer Interaction (HCI) that can minimise medication errors. Through an iterative design process a digital prototype for prescription of medicine has been developed. This paper presents results from the formative evaluation of the prototype conducted in a simulation laboratory with ten participating physicians. Data from the simulation is analysed by use of theory on how users perceive information. The conclusion is a model, which sum up four principles of interaction for design of CDSS. The four principles for design of user interfaces for CDSS are summarised as four A's: All in one, At a glance, At hand and Attention. The model emphasises integration of all four interaction principles in the design of user interfaces for CDSS, i.e. the model is an integrated model which we suggest as a guide for interaction design when working with preventing medication errors.

  16. A Longitudinal Study of Teaching Practice and Early Career Decisions: A Cautionary Tale

    ERIC Educational Resources Information Center

    Cochran-Smith, Marilyn; McQuillan, Patrick; Mitchell, Kara; Terrell, Dianna Gahlsdorf; Barnatt, Joan; D'Souza, Lisa; Jong, Cindy; Shakman, Karen; Lam, Karen; Gleeson, Ann Marie

    2012-01-01

    Although the turnover rate among beginning teachers has been a major concern for some time, most studies do not link teacher retention with teaching practice. In contrast, this study looks specifically at career decisions coupled with practice. Guided by a view of teaching as social and cultural practice, the study used multiple qualitative data…

  17. Investigating Analytic Tools for e-Book Design in Early Literacy Learning

    ERIC Educational Resources Information Center

    Roskos, Kathleen; Brueck, Jeremy; Widman, Sarah

    2009-01-01

    Toward the goal of better e-book design to support early literacy learning, this study investigates analytic tools for examining design qualities of e-books for young children. Three research-based analytic tools related to e-book design were applied to a mixed genre collection of 50 e-books from popular online sites. Tool performance varied…

  18. VARED: Verification and Analysis of Requirements and Early Designs

    NASA Technical Reports Server (NTRS)

    Badger, Julia; Throop, David; Claunch, Charles

    2014-01-01

    Requirements are a part of every project life cycle; everything going forward in a project depends on them. Good requirements are hard to write, there are few useful tools to test, verify, or check them, and it is difficult to properly marry them to the subsequent design, especially if the requirements are written in natural language. In fact, the inconsistencies and errors in the requirements along with the difficulty in finding these errors contribute greatly to the cost of the testing and verification stage of flight software projects [1]. Large projects tend to have several thousand requirements written at various levels by different groups of people. The design process is distributed and a lack of widely accepted standards for requirements often results in a product that varies widely in style and quality. A simple way to improve this would be to standardize the design process using a set of tools and widely accepted requirements design constraints. The difficulty with this approach is finding the appropriate constraints and tools. Common complaints against the tools available include ease of use, functionality, and available features. Also, although preferable, it is rare that these tools are capable of testing the quality of the requirements.

  19. Early detection network design and search strategy issues

    EPA Science Inventory

    We conducted a series of field and related modeling studies (2005-2012) to evaluate search strategies for Great Lakes coastal ecosystems that are at risk of invasion by non-native aquatic species. In developing a network, we should design to achieve an acceptable limit of detect...

  20. Are Gains in Decision-Making Autonomy during Early Adolescence Beneficial for Emotional Functioning? The Case of the United States and China

    ERIC Educational Resources Information Center

    Qin, Lili; Pomerantz, Eva M.; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children…

  1. Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

    PubMed

    Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly R; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy Oʼhara; Lemon, Stephenie C

    2013-01-01

    Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. Five barriers to consideration of physical activity in community design and layout were assessed. The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing

  2. Making the case for evidence-based design in healthcare: a descriptive case study of organizational decision making.

    PubMed

    Shoemaker, Lorie K; Kazley, Abby Swanson; White, Andrea

    2010-01-01

    The aim of this study was to describe the organizational decision-making process used in the selection of evidence-based design (EBD) concepts, the criteria used to make these decisions, and the extent to which leadership style may have influenced the decision-making process. Five research questions were formulated to frame the direction of this study, including: (1) How did healthcare leaders learn of innovations in design? (2) How did healthcare leaders make decisions in the selection of healthcare design concepts? (3) What criteria did healthcare leaders use in the decision-making process? (4) How did healthcare leaders consider input from the staff in design decisions? and (5) To what extent did the leadership style of administrators affect the outcomes of the decision-making process? Current issues affecting healthcare in the community led the principal investigator's organization to undertake an ambitious facilities expansion project. As part of its planning process, the organization learned of EBD principles that seemingly had a positive impact on patient care and safety and staff working conditions. Although promising, a paucity of empirical research addressed the cost/benefit of incorporating many EBD concepts into one hospital setting, and there was no research that articulated the organizational decision-making process used by healthcare administrators when considering the use of EBD in expansion projects. A mixed-method, descriptive, qualitative, single-case study and quantitative design were used to address the five research questions. The Systems Research Organizing Model provided the theoretical framework. A variety of data collection methods was used, including interviews of key respondents, the review of documentary evidence, and the Multifactor Leadership Questionnaire. A participatory process was used throughout the design decision phases, involving staff at all levels of the organization. The Internet and architects facilitated learning about

  3. 78 FR 4435 - Notice of Availability of the Restoration Design Energy Project Record of Decision/Approved...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... Project (RDEP) Record of Decision (ROD)/approved Resource Management Plan (RMP) amendments for BLM... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLAZ910000.L13400000.DT0000.LXSS058A0000] Notice of Availability of the Restoration Design Energy Project Record of Decision/Approved Resource...

  4. Life cycle assessment based environmental impact estimation model for pre-stressed concrete beam bridge in the early design phase

    SciT

    Kim, Kyong Ju, E-mail: kjkim@cau.ac.kr; Yun, Won Gun, E-mail: ogun78@naver.com; Cho, Namho, E-mail: nhc51@cau.ac.kr

    The late rise in global concern for environmental issues such as global warming and air pollution is accentuating the need for environmental assessments in the construction industry. Promptly evaluating the environmental loads of the various design alternatives during the early stages of a construction project and adopting the most environmentally sustainable candidate is therefore of large importance. Yet, research on the early evaluation of a construction project's environmental load in order to aid the decision making process is hitherto lacking. In light of this dilemma, this study proposes a model for estimating the environmental load by employing only the mostmore » basic information accessible during the early design phases of a project for the pre-stressed concrete (PSC) beam bridge, the most common bridge structure. Firstly, a life cycle assessment (LCA) was conducted on the data from 99 bridges by integrating the bills of quantities (BOQ) with a life cycle inventory (LCI) database. The processed data was then utilized to construct a case based reasoning (CBR) model for estimating the environmental load. The accuracy of the estimation model was then validated using five test cases; the model's mean absolute error rates (MAER) for the total environmental load was calculated as 7.09%. Such test results were shown to be superior compared to those obtained from a multiple-regression based model and a slab area base-unit analysis model. Henceforth application of this model during the early stages of a project is expected to highly complement environmentally friendly designs and construction by facilitating the swift evaluation of the environmental load from multiple standpoints. - Highlights: • This study is to develop the model of assessing the environmental impacts on LCA. • Bills of quantity from completed designs of PSC Beam were linked with the LCI DB. • Previous cases were used to estimate the environmental load of new case by CBR model. • CBR

  5. Application of multiple criteria decision methods in space exploration initiative design and planning

    NASA Technical Reports Server (NTRS)

    Masud, Abu S. M.

    1991-01-01

    Fellowship activities were directed towards the identification of opportunities for application of the Multiple Criteria Decision Making (MCDM) techniques in the Space Exploration Initiative (SEI) domain. I identified several application possibilities and proposed demonstration application in these three areas: evaluation and ranking of SEI architectures, space mission planning and selection, and space system design. Here, only the first problem is discussed. The most meaningful result of the analysis is the wide separation between the two top ranked architectures, indicating a significant preference difference between them. It must also be noted that the final ranking reflects, to some extent, the biases of the evaluators and their understanding of the architecture.

  6. New designs of LMJ targets for early ignition experiments

    NASA Astrophysics Data System (ADS)

    C-Clérouin, C.; Bonnefille, M.; Dattolo, E.; Fremerye, P.; Galmiche, D.; Gauthier, P.; Giorla, J.; Laffite, S.; Liberatore, S.; Loiseau, P.; Malinie, G.; Masse, L.; Poggi, F.; Seytor, P.

    2008-05-01

    The LMJ experimental plans include the attempt of ignition and burn of an ICF capsule with 40 laser quads, delivering up to 1.4MJ and 380TW. New targets needing reduced laser energy with only a small decrease in robustness are then designed for this purpose. A first strategy is to use scaled-down cylindrical hohlraums and capsules, taking advantage of our better understanding of the problem, set on theoretical modelling, simulations and experiments. Another strategy is to work specifically on the coupling efficiency parameter, i.e. the ratio of the energy absorbed by the capsule to the laser energy, which is with parametric instabilities a crucial drawback of indirect drive. An alternative design is proposed, made up of the nominal 60 quads capsule, named A1040, in a rugby-shaped hohlraum. Robustness evaluations of these different targets are in progress.

  7. Kepler Mission Design, Realized Photometric Performance, and Early Science

    DTIC Science & Technology

    2010-04-20

    USA 19 Institute for Astronomy, University of Hawaii, Honolulu, HI 96822, USA 20 Ball Aerospace and Technologies Corp., Boulder, CO 80306, USA 21...was to perform multi-band photometric observations using a filter set similar to the Sloan Survey (g, r, i, z ) with the addition of a filter for the...Dynamic range 7 Kp 17 Meets photometric precision Operating temperature −85 ◦C 10 mK stability Controller Ball Aerospace Design and manufacturer

  8. Design and validation of a model to predict early mortality in haemodialysis patients.

    PubMed

    Mauri, Joan M; Clèries, Montse; Vela, Emili

    2008-05-01

    Mortality and morbidity rates are higher in patients receiving haemodialysis therapy than in the general population. Detection of risk factors related to early death in these patients could be of aid for clinical and administrative decision making. Objectives. The aims of this study were (1) to identify risk factors (comorbidity and variables specific to haemodialysis) associated with death in the first year following the start of haemodialysis and (2) to design and validate a prognostic model to quantify the probability of death for each patient. An analysis was carried out on all patients starting haemodialysis treatment in Catalonia during the period 1997-2003 (n = 5738). The data source was the Renal Registry of Catalonia, a mandatory population registry. Patients were randomly divided into two samples: 60% (n = 3455) of the total were used to develop the prognostic model and the remaining 40% (n = 2283) to validate the model. Logistic regression analysis was used to construct the model. One-year mortality in the total study population was 16.5%. The predictive model included the following variables: age, sex, primary renal disease, grade of functional autonomy, chronic obstructive pulmonary disease, malignant processes, chronic liver disease, cardiovascular disease, initial vascular access and malnutrition. The analyses showed adequate calibration for both the sample to develop the model and the validation sample (Hosmer-Lemeshow statistic 0.97 and P = 0.49, respectively) as well as adequate discrimination (ROC curve 0.78 in both cases). Risk factors implicated in mortality at one year following the start of haemodialysis have been determined and a prognostic model designed. The validated, easy-to-apply model quantifies individual patient risk attributable to various factors, some of them amenable to correction by directed interventions.

  9. Enhancing Research and Practice in Early Childhood through Formative and Design Experiments

    ERIC Educational Resources Information Center

    Bradley, Barbara A.; Reinking, David

    2011-01-01

    This article describes formative and design experiments and how they can advance research and instructional practices in early childhood education. We argue that this relatively new approach to education research closes the gap between research and practice, and it addresses limitations that have been identified in early childhood research. We…

  10. Exploring a Comprehensive Model for Early Childhood Vocabulary Instruction: A Design Experiment

    ERIC Educational Resources Information Center

    Wang, X. Christine; Christ, Tanya; Chiu, Ming Ming

    2014-01-01

    Addressing a critical need for effective vocabulary practices in early childhood classrooms, we conducted a design experiment to achieve three goals: (1) developing a comprehensive model for early childhood vocabulary instruction, (2) examining the effectiveness of this model, and (3) discerning the contextual conditions that hinder or facilitate…

  11. A Taxonomy of Instructional Strategies in Early Childhood Education; Toward a Developmental Theory of Instructional Design.

    ERIC Educational Resources Information Center

    Vance, Barbara

    This paper suggests two steps in instructional deisgn for early childhood that can be derived from a recent major paper on instructional strategy taxonomy. These steps, together with the instructional design variables involved in each step, are reviewed relative to current research in child development and early education. The variables reviewed…

  12. Participatory design of probability-based decision support tools for in-hospital nurses.

    PubMed

    Jeffery, Alvin D; Novak, Laurie L; Kennedy, Betsy; Dietrich, Mary S; Mion, Lorraine C

    2017-11-01

    To describe nurses' preferences for the design of a probability-based clinical decision support (PB-CDS) tool for in-hospital clinical deterioration. A convenience sample of bedside nurses, charge nurses, and rapid response nurses (n = 20) from adult and pediatric hospitals completed participatory design sessions with researchers in a simulation laboratory to elicit preferred design considerations for a PB-CDS tool. Following theme-based content analysis, we shared findings with user interface designers and created a low-fidelity prototype. Three major themes and several considerations for design elements of a PB-CDS tool surfaced from end users. Themes focused on "painting a picture" of the patient condition over time, promoting empowerment, and aligning probability information with what a nurse already believes about the patient. The most notable design element consideration included visualizing a temporal trend of the predicted probability of the outcome along with user-selected overlapping depictions of vital signs, laboratory values, and outcome-related treatments and interventions. Participants expressed that the prototype adequately operationalized requests from the design sessions. Participatory design served as a valuable method in taking the first step toward developing PB-CDS tools for nurses. This information about preferred design elements of tools that support, rather than interrupt, nurses' cognitive workflows can benefit future studies in this field as well as nurses' practice. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.

  13. The early growth and development study: a prospective adoption design.

    PubMed

    Leve, Leslie D; Neiderhiser, Jenae M; Ge, Xiaojia; Scaramella, Laura V; Conger, Rand D; Reid, John B; Shaw, Daniel S; Reiss, David

    2007-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N=359 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study are recruited through adoption agencies located throughout the United States, following the birth of a child. Assessments occur at 6-month intervals until the child reaches 3 years of age. Data collection includes the following primary constructs: infant and toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described.

  14. The Early Growth and Development Study: A Prospective Adoption Design

    PubMed Central

    Leve, Leslie D.; Neiderhiser, Jenae M.; Ge, Xiaojia; Scaramella, Laura V.; Conger, Rand D.; Reid, John B.; Shaw, Daniel S.; Reiss, David

    2014-01-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N = 350 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study were recruited following the birth of the child through adoption agencies located throughout the United States. Assessments occur at 6-month intervals until child age 3 years. Data collection includes the following primary constructs: infant/toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described. PMID:17539368

  15. Designing and Developing Game-Like Learning Experience in Virtual Worlds: Challenges and Design Decisions of Novice Instructional Designers

    ERIC Educational Resources Information Center

    Yilmaz, Turkan Karakus; Cagiltay, Kursat

    2016-01-01

    Many virtual worlds have been adopted for implementation within educational settings because they are potentially useful for building effective learning environments. Since the flexibility of virtual worlds challenges to obtain effective and efficient educational outcomes, the design of such platforms need more attention. In the present study, the…

  16. Design of a Multi-mode Flight Deck Decision Support System for Airborne Conflict Management

    NASA Technical Reports Server (NTRS)

    Barhydt, Richard; Krishnamurthy, Karthik

    2004-01-01

    NASA Langley has developed a multi-mode decision support system for pilots operating in a Distributed Air-Ground Traffic Management (DAG-TM) environment. An Autonomous Operations Planner (AOP) assists pilots in performing separation assurance functions, including conflict detection, prevention, and resolution. Ongoing AOP design has been based on a comprehensive human factors analysis and evaluation results from previous human-in-the-loop experiments with airline pilot test subjects. AOP considers complex flight mode interactions and provides flight guidance to pilots consistent with the current aircraft control state. Pilots communicate goals to AOP by setting system preferences and actively probing potential trajectories for conflicts. To minimize training requirements and improve operational use, AOP design leverages existing alerting philosophies, displays, and crew interfaces common on commercial aircraft. Future work will consider trajectory prediction uncertainties, integration with the TCAS collision avoidance system, and will incorporate enhancements based on an upcoming air-ground coordination experiment.

  17. Project Assessment Framework through Design (PAFTD) - A Project Assessment Framework in Support of Strategic Decision Making

    NASA Technical Reports Server (NTRS)

    Depenbrock, Brett T.; Balint, Tibor S.; Sheehy, Jeffrey A.

    2014-01-01

    Research and development organizations that push the innovation edge of technology frequently encounter challenges when attempting to identify an investment strategy and to accurately forecast the cost and schedule performance of selected projects. Fast moving and complex environments require managers to quickly analyze and diagnose the value of returns on investment versus allocated resources. Our Project Assessment Framework through Design (PAFTD) tool facilitates decision making for NASA senior leadership to enable more strategic and consistent technology development investment analysis, beginning at implementation and continuing through the project life cycle. The framework takes an integrated approach by leveraging design principles of useability, feasibility, and viability and aligns them with methods employed by NASA's Independent Program Assessment Office for project performance assessment. The need exists to periodically revisit the justification and prioritization of technology development investments as changes occur over project life cycles. The framework informs management rapidly and comprehensively about diagnosed internal and external root causes of project performance.

  18. Cognitive Tutoring based on Intelligent Decision Support in the PENTHA Instructional Design Model

    NASA Astrophysics Data System (ADS)

    dall'Acqua, Luisa

    2010-06-01

    The research finality of this paper is how to support Authors to develop rule driven—subject oriented, adaptable course content, meta-rules—representing the disciplinary epistemology, model of teaching, Learning Path structure, and assessment parameters—for intelligent Tutoring actions in a personalized, adaptive e-Learning environment. The focus is to instruct the student to be a decision manager for himself, able to recognize the elements of a problem, select the necessary information with the perspective of factual choices. In particular, our research intends to provide some fundamental guidelines for the definition of didactical rules and logical relations, that Authors should provide to a cognitive Tutoring system through the use of an Instructional Design method (PENTHA Model) which proposes an educational environment, able to: increase productivity and operability, create conditions for a cooperative dialogue, developing participatory research activities of knowledge, observations and discoveries, customizing the learning design in a complex and holistic vision of the learning / teaching processes.

  19. "It's All About Ben10[TM]": Children's Play, Health and Sustainability Decisions in the Early Years

    ERIC Educational Resources Information Center

    Edwards, S.; Skouteris, H.; Rutherford, L.; Cutter-Mackenzie, A.

    2013-01-01

    In today's fast food, fast-paced consumer society, too few questions are asked about the influence of digital media on young children's health and sustainability choices, and indeed how such choices are expressed in children's play (and early childhood classrooms). By interviewing children and parents, and using such data to prompt teacher…

  20. Early decision framework for integrating sustainable risk management for complex remediation sites: Drivers, barriers, and performance metrics.

    PubMed

    Harclerode, Melissa A; Macbeth, Tamzen W; Miller, Michael E; Gurr, Christopher J; Myers, Teri S

    2016-12-15

    As the environmental remediation industry matures, remaining sites often have significant underlying technical challenges and financial constraints. More often than not, significant remediation efforts at these "complex" sites have not achieved stringent, promulgated cleanup goals. Decisions then have to be made about whether and how to commit additional resources towards achieving those goals, which are often not achievable nor required to protect receptors. Guidance on cleanup approaches focused on evaluating and managing site-specific conditions and risks, rather than uniformly meeting contaminant cleanup criteria in all media, is available to aid in this decision. Although these risk-based cleanup approaches, such as alternative endpoints and adaptive management strategies, have been developed, they are under-utilized due to environmental, socio-economic, and risk perception barriers. Also, these approaches are usually implemented late in the project life cycle after unsuccessful remedial attempts to achieve stringent cleanup criteria. In this article, we address these barriers by developing an early decision framework to identify if site characteristics support sustainable risk management, and develop performance metrics and tools to evaluate and implement successful risk-based cleanup approaches. In addition, we address uncertainty and risk perception challenges by aligning risk-based cleanup approaches with the concepts of risk management and sustainable remediation. This approach was developed in the context of lessons learned from implementing remediation at complex sites, but as a framework can, and should, be applied to all sites undergoing remediation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus: decision-curve analysis.

    PubMed

    Kondo, M; Nagao, Y; Mahbub, M H; Tanabe, T; Tanizawa, Y

    2018-04-29

    To identify factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus, using decision-curve analysis. A retrospective cohort study was performed. The participants were 123 Japanese women with gestational diabetes who underwent 75-g oral glucose tolerance tests at 8-12 weeks after delivery. They were divided into a glucose intolerance and a normal glucose tolerance group based on postpartum oral glucose tolerance test results. Analysis of the pregnancy oral glucose tolerance test results showed predictive factors for postpartum glucose intolerance. We also evaluated the clinical usefulness of the prediction model based on decision-curve analysis. Of 123 women, 78 (63.4%) had normoglycaemia and 45 (36.6%) had glucose intolerance. Multivariable logistic regression analysis showed insulinogenic index/fasting immunoreactive insulin and summation of glucose levels, assessed during pregnancy oral glucose tolerance tests (total glucose), to be independent risk factors for postpartum glucose intolerance. Evaluating the regression models, the best discrimination (area under the curve 0.725) was obtained using the basic model (i.e. age, family history of diabetes, BMI ≥25 kg/m 2 and use of insulin during pregnancy) plus insulinogenic index/fasting immunoreactive insulin <1.1. Decision-curve analysis showed that combining insulinogenic index/fasting immunoreactive insulin <1.1 with basic clinical information resulted in superior net benefits for prediction of postpartum glucose intolerance. Insulinogenic index/fasting immunoreactive insulin calculated using oral glucose tolerance test results during pregnancy is potentially useful for predicting early postpartum glucose intolerance in Japanese women with gestational diabetes. © 2018 Diabetes UK.

  2. Quantitative light-induced fluorescence (QLF): a tool for early occlusal dental caries detection and supporting decision making in vivo.

    PubMed

    Alammari, M R; Smith, P W; de Josselin de Jong, E; Higham, S M

    2013-02-01

    This study reports the development and assessment of a novel method using quantitative light-induced fluorescence (QLF), to determine whether QLF parameters ΔF and ΔQ were appropriate for aiding diagnosis and clinical decision making of early occlusal mineral loss by comparing QLF analysis with actual restorative management. Following ethical approval, 46 subjects attending a dental teaching hospital were enrolled. White light digital (WL) and QLF images/analyses of 46 unrestored posterior teeth with suspected occlusal caries were made after a clinical decision had already been taken to explore fissures operatively. WL and QLF imaging/analysis were repeated after initial cavity preparation. The type of restorative treatment was determined by the supervising clinician independent of any imaging performed. Actual restorative management carried out was recorded as fissure sealant/preventive resin restoration (F/P) or class I occlusal restoration (Rest.) thus reflecting the extent of intervention (=gold standard). All QLF images were analysed independently. The results showed statistically significant differences between the two treatment groups ΔF (p=0.002) (mean 22.60 - F/P and 28.80 - Rest.) and ΔQ (p=0.012) (mean 230.49 - F/P and 348.30 - Rest.). ΔF and ΔQ values may be useful in aiding clinical diagnosis and decision making in relation to the management of early mineral loss and restorative intervention of occlusal caries. QLF has the potential to be a valuable tool for caries diagnosis in clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Institutionalising Design Education and Design Promotion in Australia: From Early British Influences to Wider International Engagement

    ERIC Educational Resources Information Center

    Jackson, Simon

    2016-01-01

    Industrial design has grown in Australia from a series of unnamed activities clustered about an emerging 19th century manufacturing industry into a recognised profession. This transformation largely occurred because of the emergence of specific design education and the support offered by professional design associations. Designers working for the…

  4. Interface, information, interaction: a narrative review of design and functional requirements for clinical decision support.

    PubMed

    Miller, Kristen; Mosby, Danielle; Capan, Muge; Kowalski, Rebecca; Ratwani, Raj; Noaiseh, Yaman; Kraft, Rachel; Schwartz, Sanford; Weintraub, William S; Arnold, Ryan

    2018-05-01

    Provider acceptance and associated patient outcomes are widely discussed in the evaluation of clinical decision support systems (CDSSs), but critical design criteria for tools have generally been overlooked. The objective of this work is to inform electronic health record alert optimization and clinical practice workflow by identifying, compiling, and reporting design recommendations for CDSS to support the efficient, effective, and timely delivery of high-quality care. A narrative review was conducted from 2000 to 2016 in PubMed and The Journal of Human Factors and Ergonomics Society to identify papers that discussed/recommended design features of CDSSs that are associated with the success of these systems. Fourteen papers were included as meeting the criteria and were found to have a total of 42 unique recommendations; 11 were classified as interface features, 10 as information features, and 21 as interaction features. Features are defined and described, providing actionable guidance that can be applied to CDSS development and policy. To our knowledge, no reviews have been completed that discuss/recommend design features of CDSS at this scale, and thus we found that this was important for the body of literature. The recommendations identified in this narrative review will help to optimize design, organization, management, presentation, and utilization of information through presentation, content, and function. The designation of 3 categories (interface, information, and interaction) should be further evaluated to determine the critical importance of the categories. Future work will determine how to prioritize them with limited resources for designers and developers in order to maximize the clinical utility of CDSS. This review will expand the field of knowledge and provide a novel organization structure to identify key recommendations for CDSS.

  5. Decision tree analysis of treatment strategies for mild and moderate cases of clinical mastitis occurring in early lactation.

    PubMed

    Pinzón-Sánchez, C; Cabrera, V E; Ruegg, P L

    2011-04-01

    The objective of this study was to develop a decision tree to evaluate the economic impact of different durations of intramammary treatment for the first case of mild or moderate clinical mastitis (CM) occurring in early lactation with various scenarios of pathogen distributions and use of on-farm culture. The tree included 2 decision and 3 probability events. The first decision evaluated use of on-farm culture (OFC; 2 programs using OFC and 1 not using OFC) and the second decision evaluated treatment strategies (no intramammary antimicrobials or antimicrobials administered for 2, 5, or 8 d). The tree included probabilities for the distribution of etiologies (gram-positive, gram-negative, or no growth), bacteriological cure, and recurrence. The economic consequences of mastitis included costs of diagnosis and initial treatment, additional treatments, labor, discarded milk, milk production losses due to clinical and subclinical mastitis, culling, and transmission of infection to other cows (only for CM caused by Staphylococcus aureus). Pathogen-specific estimates for bacteriological cure and milk losses were used. The economically optimal path for several scenarios was determined by comparison of expected monetary values. For most scenarios, the optimal economic strategy was to treat CM caused by gram-positive pathogens for 2 d and to avoid antimicrobials for CM cases caused by gram-negative pathogens or when no pathogen was recovered. Use of extended intramammary antimicrobial therapy (5 or 8 d) resulted in the least expected monetary values. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  6. A framework for a decision support system for municipal solid waste landfill design.

    PubMed

    Verge, Ashley; Rowe, R Kerry

    2013-12-01

    A decision support system (Landfill Advisor or LFAdvisor) was developed to integrate current knowledge of barrier systems into a computer application to assist in landfill design. The program was developed in Visual Basic and includes an integrated database to store information. LFAdvisor presents the choices available for each liner component (e.g. leachate collection system, geomembrane liner, clay liners) and provides advice on their suitability for different situations related to municipal solid waste landfills (e.g. final cover, base liner, lagoon liner). Unique to LFAdvisor, the service life of each engineered component is estimated based on results from the latest research. LFAdvisor considers the interactions between liner components, operating conditions, and the existing site environment. LFAdvisor can be used in the initial stage of design to give designers a good idea of what liner components will likely be required, while alerting them to issues that are likely to arise. A systems approach is taken to landfill design with the ultimate goal of maximising long-term performance and service life.

  7. Universal Design for Learning: Cognitive Theory into Practice for Facilitating Comprehension in Early Literacy

    ERIC Educational Resources Information Center

    Brand, Susan Trostle; Dalton, Elizabeth M.

    2012-01-01

    Addressing the unique needs of children of all ages and abilities, Universal Design for Learning (UDL) is gaining momentum in schools and preschools around the nation and the globe. This article explores Universal Design for Learning and its promising applications to a variety of reading and language arts experiences in the Early Childhood…

  8. Early detection of lung cancer recurrence after stereotactic ablative radiation therapy: radiomics system design

    NASA Astrophysics Data System (ADS)

    Dammak, Salma; Palma, David; Mattonen, Sarah; Senan, Suresh; Ward, Aaron D.

    2018-02-01

    Stereotactic ablative radiotherapy (SABR) is the standard treatment recommendation for Stage I non-small cell lung cancer (NSCLC) patients who are inoperable or who refuse surgery. This option is well tolerated by even unfit patients and has a low recurrence risk post-treatment. However, SABR induces changes in the lung parenchyma that can appear similar to those of recurrence, and the difference between the two at an early follow-up time point is not easily distinguishable for an expert physician. We hypothesized that a radiomics signature derived from standard-of-care computed tomography (CT) imaging can detect cancer recurrence within six months of SABR treatment. This study reports on the design phase of our work, with external validation planned in future work. In this study, we performed cross-validation experiments with four feature selection approaches and seven classifiers on an 81-patient data set. We extracted 104 radiomics features from the consolidative and the peri-consolidative regions on the follow-up CT scans. The best results were achieved using the sum of estimated Mahalanobis distances (Maha) for supervised forward feature selection and a trainable automatic radial basis support vector classifier (RBSVC). This system produced an area under the receiver operating characteristic curve (AUC) of 0.84, an error rate of 16.4%, a false negative rate of 12.7%, and a false positive rate of 20.0% for leaveone patient out cross-validation. This suggests that once validated on an external data set, radiomics could reliably detect post-SABR recurrence and form the basis of a tool assisting physicians in making salvage treatment decisions.

  9. Sounding the Alert: Designing an Effective Voice for Earthquake Early Warning

    NASA Astrophysics Data System (ADS)

    Burkett, E. R.; Given, D. D.

    2015-12-01

    The USGS is working with partners to develop the ShakeAlert Earthquake Early Warning (EEW) system (http://pubs.usgs.gov/fs/2014/3083/) to protect life and property along the U.S. West Coast, where the highest national seismic hazard is concentrated. EEW sends an alert that shaking from an earthquake is on its way (in seconds to tens of seconds) to allow recipients or automated systems to take appropriate actions at their location to protect themselves and/or sensitive equipment. ShakeAlert is transitioning toward a production prototype phase in which test users might begin testing applications of the technology. While a subset of uses will be automated (e.g., opening fire house doors), other applications will alert individuals by radio or cellphone notifications and require behavioral decisions to protect themselves (e.g., "Drop, Cover, Hold On"). The project needs to select and move forward with a consistent alert sound to be widely and quickly recognized as an earthquake alert. In this study we combine EEW science and capabilities with an understanding of human behavior from the social and psychological sciences to provide insight toward the design of effective sounds to help best motivate proper action by alert recipients. We present a review of existing research and literature, compiled as considerations and recommendations for alert sound characteristics optimized for EEW. We do not yet address wording of an audible message about the earthquake (e.g., intensity and timing until arrival of shaking or possible actions), although it will be a future component to accompany the sound. We consider pitch(es), loudness, rhythm, tempo, duration, and harmony. Important behavioral responses to sound to take into account include that people respond to discordant sounds with anxiety, can be calmed by harmony and softness, and are innately alerted by loud and abrupt sounds, although levels high enough to be auditory stressors can negatively impact human judgment.

  10. LSNR Airborne LIDAR Mapping System Design and Early Results (Invited)

    NASA Astrophysics Data System (ADS)

    Shrestha, K.; Carter, W. E.; Slatton, K. C.

    2009-12-01

    Low signal-to-noise ratio (LSNR) detection techniques allow for implementation of airborne light detection and range (LIDAR) instrumentation aboard platforms with prohibitive power, size, and weight restrictions. The University of Florida has developed the Coastal Area Tactical-mapping System (CATS), a prototype LSNR LIDAR system capable of single photon laser ranging. CATS is designed to operate in a fixed-wing aircraft flying 600 m above ground level, producing 532 nm, 480 ps, 3 μJ output pulses at 8 kHz. To achieve continuous coverage of the terrain with 20 cm spatial resolution in a single pass, a 10x10 array of laser beamlets is scanned. A Risley prism scanner (two rotating V-coated optical wedges) allows the array of laser beamlets to be deflected in a variety of patterns, including conical, spiral, and lines at selected angles to the direction of flight. Backscattered laser photons are imaged onto a 100 channel (10x10 segmented-anode) photomultiplier tube (PMT) with a micro-channel plate (MCP) amplifier. Each channel of the PMT is connected to a multi-stop 2 GHz event timer. Here we report on tests in which ranges for known targets were accumulated for repeated laser shots and statistical analyses were applied to evaluate range accuracy, minimum separation distance, bathymetric mapping depth, and atmospheric scattering. Ground-based field test results have yielded 10 cm range accuracy and sub-meter feature identification at variable scan settings. These experiments also show that a secondary surface can be detected at a distance of 15 cm from the first. Range errors in secondary surface identification for six separate trials were within 7.5 cm, or within the timing resolution limit of the system. Operating at multi-photon sensitivity may have value for situations in which high ambient noise precludes single-photon sensitivity. Low reflectivity targets submerged in highly turbid waters can cause detection issues. CATS offers the capability to adjust the

  11. A game-based decision support methodology for competitive systems design

    NASA Astrophysics Data System (ADS)

    Briceno, Simon Ignacio

    This dissertation describes the development of a game-based methodology that facilitates the exploration and selection of research and development (R&D) projects under uncertain competitive scenarios. The proposed method provides an approach that analyzes competitor positioning and formulates response strategies to forecast the impact of technical design choices on a project's market performance. A critical decision in the conceptual design phase of propulsion systems is the selection of the best architecture, centerline, core size, and technology portfolio. This selection can be challenging when considering evolving requirements from both the airframe manufacturing company and the airlines in the market. Furthermore, the exceedingly high cost of core architecture development and its associated risk makes this strategic architecture decision the most important one for an engine company. Traditional conceptual design processes emphasize performance and affordability as their main objectives. These areas alone however, do not provide decision-makers with enough information as to how successful their engine will be in a competitive market. A key objective of this research is to examine how firm characteristics such as their relative differences in completing R&D projects, differences in the degree of substitutability between different project types, and first/second-mover advantages affect their product development strategies. Several quantitative methods are investigated that analyze business and engineering strategies concurrently. In particular, formulations based on the well-established mathematical field of game theory are introduced to obtain insights into the project selection problem. The use of game theory is explored in this research as a method to assist the selection process of R&D projects in the presence of imperfect market information. The proposed methodology focuses on two influential factors: the schedule uncertainty of project completion times and

  12. Designing Observation and Modeling Systems to Inform Decisions and Policies on Freshwater Objectives in New Zealand

    NASA Astrophysics Data System (ADS)

    Baisden, W. T.; Ellis, T.; Rissman, C.; Moore, C.; Matthews, A.

    2016-12-01

    Declines in New Zealand's freshwater quality have led to legislation - the 2014 National Policy Statement on Freshwater Management (NPS-FM) - which requires regional governments to set "objectives" and design policies accordingly. In most regions, increases in freshwater contaminants are derived largely from intensifying agriculture and come as nitrogen, phosphorous or sediment, or a combination thereof. Here, the development and application of N and O isotopes as natural tracers for nitrate is examined as a case study, in the context of a wider hierarchy of observations such as N concentrations, flow and broader hydrochemistry used for NPS-FM implementation. The analysis of N and O isotopes in nitrate provides specific information on sources and removal processes that cannot be obtained by other measurements. Yet, despite considerable development of the technical methodology and environment-specific interpretation, application of measurements has faced barriers. Many may be typical of science in a small advanced nation with a population of 4.5 million, but others are unique due to New Zealand's limited rural population base and large diversity in physical geography, as well as a unique economic reliance on highly productive pastoral agricultural systems. Seventeen different regional governments are empowered to regulate in ways consistent with local consultation and democracy within their catchment boundaries, but with limited resources to align highly technical observational data to policies and decisions, as well as supporting models. The resulting gaps in communication and technical capability combine with a diversity of approaches to pose both challenges and opportunities for development and application of hierarchical observation systems. Success appears to lie in ensuring decision frameworks can be `mapped', so that different frameworks can be compared, and the benefits of sophisticated observations understood directly in relation to influence on regional

  13. Design and implementation of a risk assessment module in a spatial decision support system

    NASA Astrophysics Data System (ADS)

    Zhang, Kaixi; van Westen, Cees; Bakker, Wim

    2014-05-01

    The spatial decision support system named 'Changes SDSS' is currently under development. The goal of this system is to analyze changing hydro-meteorological hazards and the effect of risk reduction alternatives to support decision makers in choosing the best alternatives. The risk assessment module within the system is to assess the current risk, analyze the risk after implementations of risk reduction alternatives, and analyze the risk in different future years when considering scenarios such as climate change, land use change and population growth. The objective of this work is to present the detailed design and implementation plan of the risk assessment module. The main challenges faced consist of how to shift the risk assessment from traditional desktop software to an open source web-based platform, the availability of input data and the inclusion of uncertainties in the risk analysis. The risk assessment module is developed using Ext JS library for the implementation of user interface on the client side, using Python for scripting, as well as PostGIS spatial functions for complex computations on the server side. The comprehensive consideration of the underlying uncertainties in input data can lead to a better quantification of risk assessment and a more reliable Changes SDSS, since the outputs of risk assessment module are the basis for decision making module within the system. The implementation of this module will contribute to the development of open source web-based modules for multi-hazard risk assessment in the future. This work is part of the "CHANGES SDSS" project, funded by the European Community's 7th Framework Program.

  14. A decision aid for men with early stage prostate cancer: theoretical basis and a test by surrogate patients

    PubMed Central

    Feldman‐Stewart, Deb; Brundage, Michael D.; Van Manen, Lori

    2008-01-01

    Background We developed a decision aid for patients with curable prostate cancer based on Svenson’s DiffCon Theory of Decision Making. This study was designed to determine if surrogate patients using the aid could understand the information presented, complete all tasks, show evidence of differentiation, and arrive at a preferred treatment choice. Methods Men, at least 50 years old and never diagnosed with prostate cancer, were recruited through local advertisements. Participants were asked to imagine that they were a case‐scenario patient. Then they completed the decision aid interview, which included three components: (i) information presentation, with comprehension questions, (ii) exercises to help identify attributes important to the decision, and (iii) value‐clarification exercises. Results Sixty‐nine men volunteered. They had a mean age of 61.2 (range 50–83) years, 37% had no formal education beyond high school, and 87% were living with a partner. All participants completed all aspects of the interview. They answered an average of 10 comprehension questions each, with a mean of 94.7% correct without a prompt. Each attribute in the information presented was identified by at least one participant as important to his decision. Participants identified a median of five attributes as important (ranges 1–14) at each of three points during the interview; 75% changed at least one important attribute during the interview. Forty‐nine per cent of participants also identified attributes as important that were not included in the presented information. Participants showed a wide range of values in each of seven trade‐off exercises. Eighty‐eight per cent of participants showed evidence of differentiation; 75% had a clear treatment preference by the end of the interview. Conclusions Our decision aid appears to meet its goals for surrogate patients and illustrates the strengths of the DiffCon theory. The ability of the aid to accommodate wide

  15. Cost-effectiveness of the 21-gene assay for guiding adjuvant chemotherapy decisions in early breast cancer.

    PubMed

    Paulden, Mike; Franek, Jacob; Pham, Ba'; Bedard, Philippe L; Trudeau, Maureen; Krahn, Murray

    2013-01-01

    Adjuvant chemotherapy decisions in early breast cancer are complex. The 21-gene assay can potentially aid such decisions, but costs US $4175 per patient. Adjuvant! Online is a freely available decision aid. We evaluate the cost-effectiveness of using the 21-gene assay in conjunction with Adjuvant! Online, and of providing adjuvant chemotherapy conditional upon risk classification. A probabilistic Markov decision model simulated risk classification, treatment, and the natural history of breast cancer in a hypothetical cohort of 50-year-old women with lymph node-negative, estrogen receptor- and/or progesterone receptor-positive, human epidermal growth factor receptor 2/neu-negative early breast cancer. Cost-effectiveness was considered from an Ontario public-payer perspective by deriving the lifetime incremental cost (2012 Canadian dollars) per quality-adjusted life-year (QALY) for each strategy, and the probability each strategy is cost-effective, assuming a willingness-to-pay of $50,000 per QALY. The 21-gene assay has an incremental cost per QALY in patients at low, intermediate, or high Adjuvant Online! risk of $22,440 (probability cost-effective 78.46%), $2,526 (99.40%), or $1,111 (99.82%), respectively. In patients at low (high) 21-gene assay risk, adjuvant chemotherapy increases (reduces) costs and worsens (improves) health outcomes. For patients at intermediate 21-gene assay risk and low, intermediate, or high Adjuvant! Online risk, chemotherapy has an incremental cost per QALY of $44,088 (50.59%), $1,776 (77.65%), or $1,778 (82.31%), respectively. The 21-gene assay appears cost-effective, regardless of Adjuvant! Online risk. Adjuvant chemotherapy appears cost-effective for patients at intermediate or high 21-gene assay risk, although this finding is uncertain in patients at intermediate 21-gene assay and low Adjuvant! Online risk. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights

  16. Design and implementation of wireless dose logger network for radiological emergency decision support system.

    PubMed

    Gopalakrishnan, V; Baskaran, R; Venkatraman, B

    2016-08-01

    A decision support system (DSS) is implemented in Radiological Safety Division, Indira Gandhi Centre for Atomic Research for providing guidance for emergency decision making in case of an inadvertent nuclear accident. Real time gamma dose rate measurement around the stack is used for estimating the radioactive release rate (source term) by using inverse calculation. Wireless gamma dose logging network is designed, implemented, and installed around the Madras Atomic Power Station reactor stack to continuously acquire the environmental gamma dose rate and the details are presented in the paper. The network uses XBee-Pro wireless modules and PSoC controller for wireless interfacing, and the data are logged at the base station. A LabView based program is developed to receive the data, display it on the Google Map, plot the data over the time scale, and register the data in a file to share with DSS software. The DSS at the base station evaluates the real time source term to assess radiation impact.

  17. Design and implementation of wireless dose logger network for radiological emergency decision support system

    SciT

    Gopalakrishnan, V.; Baskaran, R.; Venkatraman, B.

    A decision support system (DSS) is implemented in Radiological Safety Division, Indira Gandhi Centre for Atomic Research for providing guidance for emergency decision making in case of an inadvertent nuclear accident. Real time gamma dose rate measurement around the stack is used for estimating the radioactive release rate (source term) by using inverse calculation. Wireless gamma dose logging network is designed, implemented, and installed around the Madras Atomic Power Station reactor stack to continuously acquire the environmental gamma dose rate and the details are presented in the paper. The network uses XBee–Pro wireless modules and PSoC controller for wireless interfacing,more » and the data are logged at the base station. A LabView based program is developed to receive the data, display it on the Google Map, plot the data over the time scale, and register the data in a file to share with DSS software. The DSS at the base station evaluates the real time source term to assess radiation impact.« less

  18. Conceptual and statistical issues in couples observational research: Rationale and methods for design decisions.

    PubMed

    Baucom, Brian R W; Leo, Karena; Adamo, Colin; Georgiou, Panayiotis; Baucom, Katherine J W

    2017-12-01

    Observational behavioral coding methods are widely used for the study of relational phenomena. There are numerous guidelines for the development and implementation of these methods that include principles for creating new and adapting existing coding systems as well as principles for creating coding teams. While these principles have been successfully implemented in research on relational phenomena, the ever expanding array of phenomena being investigated with observational methods calls for a similar expansion of these principles. Specifically, guidelines are needed for decisions that arise in current areas of emphasis in couple research including observational investigation of related outcomes (e.g., relationship distress and psychological symptoms), the study of change in behavior over time, and the study of group similarities and differences in the enactment and perception of behavior. This article describes conceptual and statistical considerations involved in these 3 areas of research and presents principle- and empirically based rationale for design decisions related to these issues. A unifying principle underlying these guidelines is the need for careful consideration of fit between theory, research questions, selection of coding systems, and creation of coding teams. Implications of (mis)fit for the advancement of theory are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. Results from conceptual design study of potential early commercial MHD/steam power plants

    NASA Technical Reports Server (NTRS)

    Hals, F.; Kessler, R.; Swallom, D.; Westra, L.; Zar, J.; Morgan, W.; Bozzuto, C.

    1981-01-01

    This paper presents conceptual design information for a potential early MHD power plant developed in the second phase of a joint study of such plants. Conceptual designs of plant components and equipment with performance, operational characteristics and costs are reported on. Plant economics and overall performance including full and part load operation are reviewed. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen oxides are reviewed. Results from reliability/availability analysis conducted are also included.

  20. Nonmedical influences on medical decision making: an experimental technique using videotapes, factorial design, and survey sampling.

    PubMed Central

    Feldman, H A; McKinlay, J B; Potter, D A; Freund, K M; Burns, R B; Moskowitz, M A; Kasten, L E

    1997-01-01

    OBJECTIVE: To study nonmedical influences on the doctor-patient interaction. A technique using simulated patients and "real" doctors is described. DATA SOURCES: A random sample of physicians, stratified on such characteristics as demographics, specialty, or experience, and selected from commercial and professional listings. STUDY DESIGN: A medical appointment is depicted on videotape by professional actors. The patient's presenting complaint (e.g., chest pain) allows a range of valid interpretation. Several alternative versions are taped, featuring the same script with patient-actors of different age, sex, race, or other characteristics. Fractional factorial design is used to select a balanced subset of patient characteristics, reducing costs without biasing the outcome. DATA COLLECTION: Each physician is shown one version of the videotape appointment and is asked to describe how he or she would diagnose or treat such a patient. PRINCIPAL FINDINGS: Two studies using this technique have been completed to date, one involving chest pain and dyspnea and the other involving breast cancer. The factorial design provided sufficient power, despite limited sample size, to demonstrate with statistical significance various influences of the experimental and stratification variables, including the patient's gender and age and the physician's experience. Persistent recruitment produced a high response rate, minimizing selection bias and enhancing validity. CONCLUSION: These techniques permit us to determine, with a degree of control unattainable in observational studies, whether medical decisions as described by actual physicians and drawn from a demographic or professional group of interest, are influenced by a prescribed set of nonmedical factors. PMID:9240285

  1. Toward a Theoretical Model of Decision-Making and Resistance to Change among Higher Education Online Course Designers

    ERIC Educational Resources Information Center

    Dodd, Bucky J.

    2013-01-01

    Online course design is an emerging practice in higher education, yet few theoretical models currently exist to explain or predict how the diffusion of innovations occurs in this space. This study used a descriptive, quantitative survey research design to examine theoretical relationships between decision-making style and resistance to change…

  2. Temporal variations in early developmental decisions: an engine of forebrain evolution.

    PubMed

    Bielen, H; Pal, S; Tole, S; Houart, C

    2017-02-01

    Tight control of developmental timing is pivotal to many major processes in developmental biology, such as patterning, fate specification, cell cycle dynamics, cell migration and connectivity. Temporal change in these ontogenetic sequences is known as heterochrony, a major force in the evolution of body plans and organogenesis. In the last 5 years, studies in fish and rodents indicate that heterochrony in signaling during early development generates diversity in forebrain size and complexity. Here, we summarize these findings and propose that, additionally to spatio-temporal tuning of neurogenesis, temporal and quantitative modulation of signaling events drive pivotal changes in shape, size and complexity of the forebrain across evolution, participating to the generation of diversity in animal behavior and emergence of cognition. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Modeling screening, prevention, and delaying of Alzheimer's disease: an early-stage decision analytic model

    PubMed Central

    2010-01-01

    Background Alzheimer's Disease (AD) affects a growing proportion of the population each year. Novel therapies on the horizon may slow the progress of AD symptoms and avoid cases altogether. Initiating treatment for the underlying pathology of AD would ideally be based on biomarker screening tools identifying pre-symptomatic individuals. Early-stage modeling provides estimates of potential outcomes and informs policy development. Methods A time-to-event (TTE) simulation provided estimates of screening asymptomatic patients in the general population age ≥55 and treatment impact on the number of patients reaching AD. Patients were followed from AD screen until all-cause death. Baseline sensitivity and specificity were 0.87 and 0.78, with treatment on positive screen. Treatment slowed progression by 50%. Events were scheduled using literature-based age-dependent incidences of AD and death. Results The base case results indicated increased AD free years (AD-FYs) through delays in onset and a reduction of 20 AD cases per 1000 screened individuals. Patients completely avoiding AD accounted for 61% of the incremental AD-FYs gained. Total years of treatment per 1000 screened patients was 2,611. The number-needed-to-screen was 51 and the number-needed-to-treat was 12 to avoid one case of AD. One-way sensitivity analysis indicated that duration of screening sensitivity and rescreen interval impact AD-FYs the most. A two-way sensitivity analysis found that for a test with an extended duration of sensitivity (15 years) the number of AD cases avoided was 6,000-7,000 cases for a test with higher sensitivity and specificity (0.90,0.90). Conclusions This study yielded valuable parameter range estimates at an early stage in the study of screening for AD. Analysis identified duration of screening sensitivity as a key variable that may be unavailable from clinical trials. PMID:20433705

  4. Modeling screening, prevention, and delaying of Alzheimer's disease: an early-stage decision analytic model.

    PubMed

    Furiak, Nicolas M; Klein, Robert W; Kahle-Wrobleski, Kristin; Siemers, Eric R; Sarpong, Eric; Klein, Timothy M

    2010-04-30

    Alzheimer's Disease (AD) affects a growing proportion of the population each year. Novel therapies on the horizon may slow the progress of AD symptoms and avoid cases altogether. Initiating treatment for the underlying pathology of AD would ideally be based on biomarker screening tools identifying pre-symptomatic individuals. Early-stage modeling provides estimates of potential outcomes and informs policy development. A time-to-event (TTE) simulation provided estimates of screening asymptomatic patients in the general population age > or =55 and treatment impact on the number of patients reaching AD. Patients were followed from AD screen until all-cause death. Baseline sensitivity and specificity were 0.87 and 0.78, with treatment on positive screen. Treatment slowed progression by 50%. Events were scheduled using literature-based age-dependent incidences of AD and death. The base case results indicated increased AD free years (AD-FYs) through delays in onset and a reduction of 20 AD cases per 1000 screened individuals. Patients completely avoiding AD accounted for 61% of the incremental AD-FYs gained. Total years of treatment per 1000 screened patients was 2,611. The number-needed-to-screen was 51 and the number-needed-to-treat was 12 to avoid one case of AD. One-way sensitivity analysis indicated that duration of screening sensitivity and rescreen interval impact AD-FYs the most. A two-way sensitivity analysis found that for a test with an extended duration of sensitivity (15 years) the number of AD cases avoided was 6,000-7,000 cases for a test with higher sensitivity and specificity (0.90,0.90). This study yielded valuable parameter range estimates at an early stage in the study of screening for AD. Analysis identified duration of screening sensitivity as a key variable that may be unavailable from clinical trials.

  5. Social status strategy in early adolescent girls: Testosterone and value-based decision making.

    PubMed

    Cardoos, Stephanie L; Ballonoff Suleiman, Ahna; Johnson, Megan; van den Bos, Wouter; Hinshaw, Stephen P; Dahl, Ronald E

    2017-07-01

    There has been strong interest, spanning several disciplines, in understanding adolescence as a developmental period of increased risk-taking behavior. Our goals focus on one line of investigation within this larger developmental risk framework. Specifically, we examined levels of pubertal hormones in girls in relation to their willingness to take greater financial risks to gain social status. To this end, we tested the hypothesis that higher levels of testosterone during the ages of pubertal maturation are associated with a greater willingness to sacrifice money for social admiration. Sixty-three girls ages 10-14 (M age =12.74) participated in laboratory measures and completed at-home saliva sample collection. The Pubertal Development Scale (PDS) and basal hormone levels (testosterone, estradiol, DHEA) measured pubertal maturation. We made use of a developmentally appropriate version of an Auction Task in which adolescents could take financial risks in order to gain socially motivated outcomes (social status). PDS and testosterone were each associated with overall levels of financial risk taking over the course of the Auction Task. In hierarchical models, PDS and testosterone were predictors of the slope of overbidding over the course of the task. Results provide evidence for the role of testosterone and pubertal maturation in girls' motivations to engage in costly decision making in order to gain social status. Findings contribute to our understanding of the developmental underpinnings of some interesting aspects of adolescent risk behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Decision Support Tool for Early Differential Diagnosis of Acute Lung Injury and Cardiogenic Pulmonary Edema in Medical Critically Ill Patients

    PubMed Central

    Shahjehan, Khurram; Li, Guangxi; Dhokarh, Rajanigandha; Kashyap, Rahul; Janish, Christopher; Alsara, Anas; Jaffe, Allan S.; Hubmayr, Rolf D.; Gajic, Ognjen

    2012-01-01

    Background: At the onset of acute hypoxic respiratory failure, critically ill patients with acute lung injury (ALI) may be difficult to distinguish from those with cardiogenic pulmonary edema (CPE). No single clinical parameter provides satisfying prediction. We hypothesized that a combination of those will facilitate early differential diagnosis. Methods: In a population-based retrospective development cohort, validated electronic surveillance identified critically ill adult patients with acute pulmonary edema. Recursive partitioning and logistic regression were used to develop a decision support tool based on routine clinical information to differentiate ALI from CPE. Performance of the score was validated in an independent cohort of referral patients. Blinded post hoc expert review served as gold standard. Results: Of 332 patients in a development cohort, expert reviewers (κ, 0.86) classified 156 as having ALI and 176 as having CPE. The validation cohort had 161 patients (ALI = 113, CPE = 48). The score was based on risk factors for ALI and CPE, age, alcohol abuse, chemotherapy, and peripheral oxygen saturation/Fio2 ratio. It demonstrated good discrimination (area under curve [AUC] = 0.81; 95% CI, 0.77-0.86) and calibration (Hosmer-Lemeshow [HL] P = .16). Similar performance was obtained in the validation cohort (AUC = 0.80; 95% CI, 0.72-0.88; HL P = .13). Conclusions: A simple decision support tool accurately classifies acute pulmonary edema, reserving advanced testing for a subset of patients in whom satisfying prediction cannot be made. This novel tool may facilitate early inclusion of patients with ALI and CPE into research studies as well as improve and rationalize clinical management and resource use. PMID:22030803

  7. Actionable knowledge and strategic decision making for bio- and agroterrorism threats: building a collaborative early warning culture.

    PubMed

    Mårtensson, Per-Åke; Hedström, Lars; Sundelius, Bengt; Skiby, Jeffrey E; Elbers, Armin; Knutsson, Rickard

    2013-09-01

    Current trends in biosecurity and cybersecurity include (1) the wide availability of technology and specialized knowledge that previously were available only to governments; (2) the global economic recession, which may increase the spread of radical non-state actors; and (3) recent US and EU commission reports that reflect concerns about non-state actors in asymmetric threats. The intersectoral and international nature of bioterrorism and agroterrorism threats requires collaboration across several sectors including intelligence, police, forensics, customs, and other law enforcement organizations who must work together with public and animal health organizations as well as environmental and social science organizations. This requires coordinated decision making among these organizations, based on actionable knowledge and information sharing. The risk of not sharing information among organizations compared to the benefit of sharing information can be considered in an "information sharing risk-benefit analysis" to prevent a terrorism incident from occurring and to build a rapid response capability. In the EU project AniBioThreat, early warning is the main topic in work package 3 (WP 3). A strategy has been generated based on an iterative approach to bring law enforcement agencies and human and animal health institutes together. Workshops and exercises have taken place during the first half of the project, and spin-off activities include new preparedness plans for institutes and the formation of a legal adviser network for decision making. In addition, a seminar on actionable knowledge was held in Stockholm, Sweden, in 2012, which identified the need to bring various agency cultures together to work on developing a resilient capability to identify early signs of bio- and agroterrorism threats. The seminar concluded that there are a number of challenges in building a collaborative culture, including developing an education program that supports collaboration and shared

  8. Use of CHAID Decision Trees to Formulate Pathways for the Early Detection of Metabolic Syndrome in Young Adults

    PubMed Central

    Liu, Pei-Yang

    2014-01-01

    Metabolic syndrome (MetS) in young adults (age 20–39) is often undiagnosed. A simple screening tool using a surrogate measure might be invaluable in the early detection of MetS. Methods. A chi-squared automatic interaction detection (CHAID) decision tree analysis with waist circumference user-specified as the first level was used to detect MetS in young adults using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 Cohort as a representative sample of the United States population (n = 745). Results. Twenty percent of the sample met the National Cholesterol Education Program Adult Treatment Panel III (NCEP) classification criteria for MetS. The user-specified CHAID model was compared to both CHAID model with no user-specified first level and logistic regression based model. This analysis identified waist circumference as a strong predictor in the MetS diagnosis. The accuracy of the final model with waist circumference user-specified as the first level was 92.3% with its ability to detect MetS at 71.8% which outperformed comparison models. Conclusions. Preliminary findings suggest that young adults at risk for MetS could be identified for further followup based on their waist circumference. Decision tree methods show promise for the development of a preliminary detection algorithm for MetS. PMID:24817904

  9. Women's views of two interventions designed to assist in the prophylactic oophorectomy decision: a qualitative pilot evaluation

    PubMed Central

    Bhavnani, Vanita; Clarke, Aileen; Dowie, Jack; Kennedy, Andrew; Pell, Ian

    2002-01-01

    included the possibility for women to see how their individual risks of different outcomes are affected in the Decision Chart and enhanced explanation of the CGP tasks. Future design and evaluation of decision aids, will need to accommodate differences between patients in the desire for amount and type of information and level of involvement in the decision‐making process. PMID:12031056

  10. Practice Patterns of Radiation Field Design for Sentinel Lymph Node-Positive Early-Stage Breast Cancer.

    PubMed

    Azghadi, Soheila; Daly, Megan; Mayadev, Jyoti

    2016-10-01

    Recent randomized trials have led to decreased use of completion axillary lymph node dissection (ALND) in early-stage breast cancer patients with a positive sentinel lymph node (SLN), causing controversy surrounding radiotherapy coverage of the axilla. We investigated the practice variation among radiation oncologists for regional nodal coverage for clinicopathologic scenarios and evaluated axillary field design decision-making processes. A customized, web-based questionnaire was e-mailed to 983 community (n = 617) and academic (n = 366) radiation oncologists with a breast cancer subspecialty practicing in the United States. The survey consisted of 18 multiple-choice questions evaluating general clinical preferences surrounding radiation therapy (RT) field design for patients with early-stage breast cancer and a positive SLN. Seven case scenarios were developed to investigate the field design in the setting of specific clinical and pathologic risk factors. Nodal coverage was classified as standard tangents (STs), high tangents (HTs), STs and a supraclavicular field (SCF), or STs and full axillary coverage (AX). A total of 145 evaluable responses were collected, with a response rate of 15.0%. Of the respondents, 12 (8.3%) reported using completion ALND for patients with 1 to 3 positive SLNs without extracapsular extension (ECE) and 66 (45.5%) performed ALND with 1 to 3 positive SLNs with ECE. For micrometastatic SLNs, with no lymphovascular system invasion, 115 (87.1%) used STs or HTs. The use of neoadjuvant chemotherapy (NAC) influenced RT field design for patients with a positive SLN without ECE, with 64 (48.5%) using STs and SCF or STs and AX treatment without NAC and 94 (70.7%) using SCF and AX after NAC. With macrometastatic SLN involvement, most respondents preferred SCF (45.27%) and AX (45.66%). In contrast, for micrometastatic involvement, HTs (43.61%) were frequently chosen. Forty (27.8%) reported using online predictive nomograms to predict further

  11. Design, delivery, and evaluation of early interventions for children exposed to acute trauma

    PubMed Central

    Kassam-Adams, Nancy

    2014-01-01

    Background Exposure to acute, potentially traumatic events is an unfortunately common experience for children and adolescents. Posttraumatic stress (PTS) responses following acute trauma can have an ongoing impact on child development and well-being. Early intervention to prevent or reduce PTS responses holds promise but requires careful development and empirical evaluation. Objectives The aims of this review paper are to present a framework for thinking about the design, delivery, and evaluation of early interventions for children who have been exposed to acute trauma; highlight targets for early intervention; and describe next steps for research and practice. Results and conclusions Proposed early intervention methods must (1) have a firm theoretical grounding that guides the design of intervention components; (2) be practical for delivery in peri-trauma or early post-trauma contexts, which may require creative models that go outside of traditional means of providing services to children; and (3) be ready for evaluation of both outcomes and mechanisms of action. This paper describes three potential targets for early intervention—maladaptive trauma-related appraisals, excessive early avoidance, and social/interpersonal processes—for which there is theory and evidence suggesting an etiological role in the development or persistence of PTS symptoms in children. PMID:25018860

  12. Development of Environmental Load Estimation Model for Road Drainage Systems in the Early Design Phase

    NASA Astrophysics Data System (ADS)

    Park, Jin-Young; Lee, Dong-Eun; Kim, Byung-Soo

    2017-10-01

    Due to the increasing concern about climate change, efforts to reduce environmental load are continuously being made in construction industry, and LCA (life cycle assessment) is being presented as an effective method to assess environmental load. Since LCA requires information on construction quantity used for environmental load estimation, however, it is not being utilized in the environmental review in the early design phase where it is difficult to obtain such information. In this study, computation system for construction quantity based on standard cross section of road drainage facilities was developed to compute construction quantity required for LCA using only information available in the early design phase to develop and verify the effectiveness of a model that can perform environmental load estimation. The result showed that it is an effective model that can be used in the early design phase as it revealed a 13.39% mean absolute error rate.

  13. The no-project alternative analysis: An early product of the Tahoe Decision Support System

    Halsing, David L.; Hessenflow, Mark L.; Wein, Anne

    2005-01-01

    We report on the development of a No-project alternative analysis (NPAA) or “business as usual” scenario with respect to a 20-year projection of 21 indicators of environmental and socioeconomic conditions in the Lake Tahoe Basin for the Tahoe Regional Planning Agency (TRPA). Our effort was inspired by earlier work that investigated the tradeoffs between an environmental and an economic objective. The NPAA study has implications for a longer term goal of building a Tahoe Decision Support System (TDSS) to assist the TRPA and other Basin agencies in assessing the outcomes of management strategies. The NPAA assumes no major deviations from current management practices or from recent environmental or societal trends and planned Environmental Improvement Program (EIP) projects. Quantitative “scenario generation” tools were constructed to simulate site-specific land uses, various population categories, and associated vehicle miles traveled. Projections of each indicator’s attainment status were made by building visual conceptual models of the relevant natural and social processes, extrapolating trends, and using available models, research, and expert opinion. We present results of the NPAA, projected indicator status, key factors affecting the indicators, indicator functionality, and knowledge gaps. One important result is that current management practices may slow the loss or degradation of environmental qualities but not halt or reverse it. Our analysis also predicts an increase in recreation and commuting into and within the basin, primarily in private vehicles. Private vehicles, which are a critical mechanism by which the Basin population affects the surrounding environment, are a key determinant of air-quality indicators, a source of particulate matter affecting Secchi depth, a source of noise, and a factor in recreational and scenic quality, largely owing to congestion. Key uncertainties in the NPAA include climate change, EIP project effectiveness, and

  14. An ontology-driven, case-based clinical decision support model for removable partial denture design

    NASA Astrophysics Data System (ADS)

    Chen, Qingxiao; Wu, Ji; Li, Shusen; Lyu, Peijun; Wang, Yong; Li, Miao

    2016-06-01

    We present the initial work toward developing a clinical decision support model for specific design of removable partial dentures (RPDs) in dentistry. We developed an ontological paradigm to represent knowledge of a patient’s oral conditions and denture component parts. During the case-based reasoning process, a cosine similarity algorithm was applied to calculate similarity values between input patients and standard ontology cases. A group of designs from the most similar cases were output as the final results. To evaluate this model, the output designs of RPDs for 104 randomly selected patients were compared with those selected by professionals. An area under the curve of the receiver operating characteristic (AUC-ROC) was created by plotting true-positive rates against the false-positive rate at various threshold settings. The precision at position 5 of the retrieved cases was 0.67 and at the top of the curve it was 0.96, both of which are very high. The mean average of precision (MAP) was 0.61 and the normalized discounted cumulative gain (NDCG) was 0.74 both of which confirmed the efficient performance of our model. All the metrics demonstrated the efficiency of our model. This methodology merits further research development to match clinical applications for designing RPDs. This paper is organized as follows. After the introduction and description of the basis for the paper, the evaluation and results are presented in Section 2. Section 3 provides a discussion of the methodology and results. Section 4 describes the details of the ontology, similarity algorithm, and application.

  15. An ontology-driven, case-based clinical decision support model for removable partial denture design.

    PubMed

    Chen, Qingxiao; Wu, Ji; Li, Shusen; Lyu, Peijun; Wang, Yong; Li, Miao

    2016-06-14

    We present the initial work toward developing a clinical decision support model for specific design of removable partial dentures (RPDs) in dentistry. We developed an ontological paradigm to represent knowledge of a patient's oral conditions and denture component parts. During the case-based reasoning process, a cosine similarity algorithm was applied to calculate similarity values between input patients and standard ontology cases. A group of designs from the most similar cases were output as the final results. To evaluate this model, the output designs of RPDs for 104 randomly selected patients were compared with those selected by professionals. An area under the curve of the receiver operating characteristic (AUC-ROC) was created by plotting true-positive rates against the false-positive rate at various threshold settings. The precision at position 5 of the retrieved cases was 0.67 and at the top of the curve it was 0.96, both of which are very high. The mean average of precision (MAP) was 0.61 and the normalized discounted cumulative gain (NDCG) was 0.74 both of which confirmed the efficient performance of our model. All the metrics demonstrated the efficiency of our model. This methodology merits further research development to match clinical applications for designing RPDs. This paper is organized as follows. After the introduction and description of the basis for the paper, the evaluation and results are presented in Section 2. Section 3 provides a discussion of the methodology and results. Section 4 describes the details of the ontology, similarity algorithm, and application.

  16. A system-of-systems modeling methodology for strategic general aviation design decision-making

    NASA Astrophysics Data System (ADS)

    Won, Henry Thome

    General aviation has long been studied as a means of providing an on-demand "personal air vehicle" that bypasses the traffic at major commercial hubs. This thesis continues this research through development of a system of systems modeling methodology applicable to the selection of synergistic product concepts, market segments, and business models. From the perspective of the conceptual design engineer, the design and selection of future general aviation aircraft is complicated by the definition of constraints and requirements, and the tradeoffs among performance and cost aspects. Qualitative problem definition methods have been utilized, although their accuracy in determining specific requirement and metric values is uncertain. In industry, customers are surveyed, and business plans are created through a lengthy, iterative process. In recent years, techniques have developed for predicting the characteristics of US travel demand based on travel mode attributes, such as door-to-door time and ticket price. As of yet, these models treat the contributing systems---aircraft manufacturers and service providers---as independently variable assumptions. In this research, a methodology is developed which seeks to build a strategic design decision making environment through the construction of a system of systems model. The demonstrated implementation brings together models of the aircraft and manufacturer, the service provider, and most importantly the travel demand. Thus represented is the behavior of the consumers and the reactive behavior of the suppliers---the manufacturers and transportation service providers---in a common modeling framework. The results indicate an ability to guide the design process---specifically the selection of design requirements---through the optimization of "capability" metrics. Additionally, results indicate the ability to find synergetic solutions, that is solutions in which two systems might collaborate to achieve a better result than acting

  17. Can we make an early 'do not resuscitate' decision in severe burn patients?

    PubMed

    Yüce, Yücel; Acar, Hakan Ahmet; Erkal, Kutlu Hakan; Tuncay, Erhan

    2017-03-01

    The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. Between January 2009 and December 2014, 29 patients (3.44%) with very severe burns were admitted to burn unit. Average total burn surface area (TBSA) was 94.24% (range: 85-100%), and in 10 patients, TBSA was 100%. Additional inhalation burns were present in 26 of the patients (89.65%). All of the patients died, despite every medical intervention. Mean survival was 4.75 days (range: 1-24 days). Total of 17 patients died within 72 hours. Lethal dose 50 (% TBSA at which certain group has 50% chance of survival) rate of our burn center is 62%. Baux indices were used for prognostic evaluation of the patients; mean total Baux score of the patients was 154.13 (range: 117-183). It is well known that numerous problems may be encountered during triage of severely burned patients in Turkey. These patients are referred to burn centers and are frequently transferred via air ambulance between cities, and even countries. They are intubated and mechanical ventilation is initiated at burn center. Many interventions are performed to treat these patients, such as escharotomy, fasciotomy, tangential or fascial excision, central venous catheterization and tracheostomy, or hemodialysis. Yet despite such interventions, these patients die, typically within 48 to 96 hours. Integrity of the body is often lost as result of aggressive intervention with no real benefit, and there are also economic costs to hospital related to use of materials, bed occupancy, and distribution of workforce. For these reasons, as well as patient comfort

  18. On the Development of a Computing Infrastructure that Facilitates IPPD from a Decision-Based Design Perspective

    NASA Technical Reports Server (NTRS)

    Hale, Mark A.; Craig, James I.; Mistree, Farrokh; Schrage, Daniel P.

    1995-01-01

    Integrated Product and Process Development (IPPD) embodies the simultaneous application of both system and quality engineering methods throughout an iterative design process. The use of IPPD results in the time-conscious, cost-saving development of engineering systems. Georgia Tech has proposed the development of an Integrated Design Engineering Simulator that will merge Integrated Product and Process Development with interdisciplinary analysis techniques and state-of-the-art computational technologies. To implement IPPD, a Decision-Based Design perspective is encapsulated in an approach that focuses on the role of the human designer in product development. The approach has two parts and is outlined in this paper. First, an architecture, called DREAMS, is being developed that facilitates design from a decision-based perspective. Second, a supporting computing infrastructure, called IMAGE, is being designed. The current status of development is given and future directions are outlined.

  19. 10 CFR 2.110 - Filing and administrative action on submittals for standard design approval or early review of...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... standard design approval or early review of site suitability issues. 2.110 Section 2.110 Energy NUCLEAR... or early review of site suitability issues. (a)(1) A submittal for a standard design approval under... provisions of appendix Q to parts 50 of this chapter, a submittal for early review of site suitability issues...

  20. 10 CFR 2.110 - Filing and administrative action on submittals for standard design approval or early review of...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... standard design approval or early review of site suitability issues. 2.110 Section 2.110 Energy NUCLEAR... or early review of site suitability issues. (a)(1) A submittal for a standard design approval under... provisions of appendix Q to parts 50 of this chapter, a submittal for early review of site suitability issues...

  1. Expression of genes involved in early cell fate decisions in human embryos and their regulation by growth factors.

    PubMed

    Kimber, S J; Sneddon, S F; Bloor, D J; El-Bareg, A M; Hawkhead, J A; Metcalfe, A D; Houghton, F D; Leese, H J; Rutherford, A; Lieberman, B A; Brison, D R

    2008-05-01

    Little is understood about the regulation of gene expression in human preimplantation embryos. We set out to examine the expression in human preimplantation embryos of a number of genes known to be critical for early development of the murine embryo. The expression profile of these genes was analysed throughout preimplantation development and in response to growth factor (GF) stimulation. Developmental expression of a number of genes was similar to that seen in murine embryos (OCT3B/4, CDX2, NANOG). However, GATA6 is expressed throughout preimplantation development in the human. Embryos were cultured in IGF-I, leukaemia inhibitory factor (LIF) or heparin-binding EGF-like growth factor (HBEGF), all of which are known to stimulate the development of human embryos. Our data show that culture in HBEGF and LIF appears to facilitate human embryo expression of a number of genes: ERBB4 (LIF) and LIFR and DSC2 (HBEGF) while in the presence of HBEGF no blastocysts expressed EOMES and when cultured with LIF only two out of nine blastocysts expressed TBN. These data improve our knowledge of the similarities between human and murine embryos and the influence of GFs on human embryo gene expression. Results from this study will improve the understanding of cell fate decisions in early human embryos, which has important implications for both IVF treatment and the derivation of human embryonic stem cells.

  2. Early detection of hospitalized patients with previously diagnosed obstructive sleep apnea using computer decision support alerts.

    PubMed

    Evans, R Scott; Flint, Vrena B; Cloward, Tom V; Beninati, William; Lloyd, James F; Megwalu, Kimberly; Simpson, Kathy J; Alsharit, Ahmed M; Balls, Shayna B; Farney, Robert J

    2013-01-01

    Obstructive sleep apnea (OSA) is a worldwide problem affecting 2-14% of the general population and most patients remain undiagnosed. OSA patients are at elevated risk for hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, stroke and death during hospitalization. Clinical screening questionnaires are used to identify hospitalized patients with OSA; especially before surgery. However, current screening questionnaires miss a significant number of patients and require more definitive testing before specific therapy can be started. Moreover, many patients are admitted to the hospital with a previous diagnosis of OSA that is not reported. Thus, many patients with OSA do not receive appropriate therapy during hospitalization due to the lack of information from previous inpatient and outpatient encounters. Large enterprise data warehouses provide the ability to monitor patient encounters over wide geographical areas. This study found that previously diagnosed OSA is highly prevalent and undertreated in hospitalized patients and the use of early computer alerts by respiratory therapists resulted in significantly more OSA patients receiving appropriate medical care (P < 0.002) which resulted in significantly fewer experiencing hypoxemia (P < 0.006). The impact was greater for non-surgery patients compared to surgery patients.

  3. A randomized trial of fellowships for early career researchers finds a high reliability in funding decisions.

    PubMed

    Clarke, Philip; Herbert, Danielle; Graves, Nick; Barnett, Adrian G

    2016-01-01

    Funding for early career researchers in Australia's largest medical research funding scheme is determined by a competitive peer-review process using a panel of four reviewers. The purpose of this experiment was to appraise the reliability of funding by duplicating applications that were considered by separate grant review panels. Sixty duplicate applications were considered by two independent grant review panels that were awarding funding for Australia's National Health and Medical Research Council. Panel members were blinded to which applications were included in the experiment and to whether it was the original or duplicate application. Scores were compared across panels using Bland-Altman plots to determine measures of agreement, including whether agreement would have impacted on actual funding. Twenty-three percent of the applicants were funded by both panels and 60 percent were not funded by both, giving an overall agreement of 83 percent [95% confidence interval (CI): 73%, 92%]. The chance-adjusted agreement was 0.75 (95% CI: 0.58, 0.92). There was a comparatively high level of agreement when compared with other types of funding schemes. Further experimental research could be used to determine if this higher agreement is due to nature of the application, the composition of the assessment panel, or the characteristics of the applicants. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Decision Support Tool Evaluation Report for Coral Reef Early Warning System (CREWS) Version 7.0

    NASA Technical Reports Server (NTRS)

    D'Sa, Eurico; Hall, Callie; Zanoni, Vicki; Holland, Donald; Blonski, Slawomir; Pagnutti, Mary; Spruce, Joseph P.

    2004-01-01

    The Coral Reef Early Warning System (CREWS) is operated by NOAA's Office of Oceanic and Atmospheric Research as part of its Coral Reef Watch program in response to the deteriorating global state of coral reef and related benthic ecosystems. In addition to sea surface temperatures (SSTs), the two most important parameters used by the CREWS network in generating coral reef bleaching alerts are 1) wind speed and direction and 2) photosynthetically available radiation (PAR). NASA remote sensing products that can enhance CREWS in these areas include SST and PAR products from the Moderate Resolution Imaging Spectroradiometer (MODIS) and wind data from the Quick Scatterometer (QuikSCAT). CREWS researchers are also interested in chlorophyll, chromophoric dissolved organic matter (CDOM), and salinity. Chlorophyll and CDOM are directly available as NASA products, while rainfall (an available NASA product) can be used as a proxy for salinity. Other potential NASA inputs include surface reflectance products from MODIS, the Advanced Spaceborne Thermal Emission and Reflection Radiometer, and Landsat. This report also identifies NASA-supported ocean circulation models and products from future satellite missions that might enchance the CREWS DST.

  5. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    ERIC Educational Resources Information Center

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  6. Design and implementation of visualization methods for the CHANGES Spatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Cristal, Irina; van Westen, Cees; Bakker, Wim; Greiving, Stefan

    2014-05-01

    The CHANGES Spatial Decision Support System (SDSS) is a web-based system aimed for risk assessment and the evaluation of optimal risk reduction alternatives at local level as a decision support tool in long-term natural risk management. The SDSS use multidimensional information, integrating thematic, spatial, temporal and documentary data. The role of visualization in this context becomes of vital importance for efficiently representing each dimension. This multidimensional aspect of the required for the system risk information, combined with the diversity of the end-users imposes the use of sophisticated visualization methods and tools. The key goal of the present work is to exploit efficiently the large amount of data in relation to the needs of the end-user, utilizing proper visualization techniques. Three main tasks have been accomplished for this purpose: categorization of the end-users, the definition of system's modules and the data definition. The graphical representation of the data and the visualization tools were designed to be relevant to the data type and the purpose of the analysis. Depending on the end-users category, each user should have access to different modules of the system and thus, to the proper visualization environment. The technologies used for the development of the visualization component combine the latest and most innovative open source JavaScript frameworks, such as OpenLayers 2.13.1, ExtJS 4 and GeoExt 2. Moreover, the model-view-controller (MVC) pattern is used in order to ensure flexibility of the system at the implementation level. Using the above technologies, the visualization techniques implemented so far offer interactive map navigation, querying and comparison tools. The map comparison tools are of great importance within the SDSS and include the following: swiping tool for comparison of different data of the same location; raster subtraction for comparison of the same phenomena varying in time; linked views for comparison

  7. Decisions, Decisions....

    ERIC Educational Resources Information Center

    White, Owen Roberts

    1985-01-01

    The author reviews systems providing objective guidelines to facilitate ongoing, daily instructional decisions, focusing on those which utilize the sensitive datum and uniform charting procedures of precision teaching. Potential users are warned that the special education teacher must remain a critical and vigilant analyst of the learning process.…

  8. Are gains in decision-making autonomy during early adolescence beneficial for emotional functioning? The case of the United States and china.

    PubMed

    Qin, Lili; Pomerantz, Eva M; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children often deem as under their authority. Children also reported on their emotional functioning. American children made greater gains over time in decision-making autonomy than did Chinese children. Initial decision-making autonomy predicted enhanced emotional functioning similarly among American and Chinese children. However, gains over time in decision-making autonomy predicted enhanced emotional functioning more in the United States (vs. China) where such gains were normative.

  9. Tech Select Decision Aide: A Mobile Application to Facilitate Just-in-Time Decision Support for Instructional Designers

    ERIC Educational Resources Information Center

    Dabbagh, Nada; Fake, Helen

    2017-01-01

    With the ubiquitous use of mobile technologies and the increasing demand for just-in-time training, there is a need to prepare and support instructional designers and educators to meet the pedagogical and technological development requirements of their target audience in the most effective and efficient way. This paper reviews the iterative…

  10. Design strategies for human & earth systems modeling to meet emerging multi-scale decision support needs

    NASA Astrophysics Data System (ADS)

    Spak, S.; Pooley, M.

    2012-12-01

    The next generation of coupled human and earth systems models promises immense potential and grand challenges as they transition toward new roles as core tools for defining and living within planetary boundaries. New frontiers in community model development include not only computational, organizational, and geophysical process questions, but also the twin objectives of more meaningfully integrating the human dimension and extending applicability to informing policy decisions on a range of new and interconnected issues. We approach these challenges by posing key policy questions that require more comprehensive coupled human and geophysical models, identify necessary model and organizational processes and outputs, and work backwards to determine design criteria in response to these needs. We find that modular community earth system model design must: * seamlessly scale in space (global to urban) and time (nowcasting to paleo-studies) and fully coupled on all component systems * automatically differentiate to provide complete coupled forward and adjoint models for sensitivity studies, optimization applications, and 4DVAR assimilation across Earth and human observing systems * incorporate diagnostic tools to quantify uncertainty in couplings, and in how human activity affects them * integrate accessible community development and application with JIT-compilation, cloud computing, game-oriented interfaces, and crowd-sourced problem-solving We outline accessible near-term objectives toward these goals, and describe attempts to incorporate these design objectives in recent pilot activities using atmosphere-land-ocean-biosphere-human models (WRF-Chem, IBIS, UrbanSim) at urban and regional scales for policy applications in climate, energy, and air quality.

  11. The relationship between early recruitment-related activities and the application decisions of new labor-market entrants: a brand equity approach to recruitment.

    PubMed

    Collins, Christopher J; Stevens, Cynthia Kay

    2002-12-01

    Theory and research from the marketing literature on customer-based brand equity were used to predict how positive exposure to 4 early recruitment-related activities-publicity, sponsorships, word-of-mouth endorsements, and advertising-may affect the application decisions of engineering students. Similar to prior marketing findings, the results suggested that early recruitment-related activities were indirectly related to intentions and decisions through 2 dimensions of employer brand image: general attitudes toward the company and perceived job attributes. The relationships between word-of-mouth endorsements and the 2 dimensions of brand image were particularly strong. In addition, it was found that early recruitment-related activities interacted with one another such that employer brand image was stronger when firms used publicity in conjunction with other early recruitment-related activities.

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

    PubMed

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

    2017-06-09

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

  13. A Unified Electronic Tool for CPR and Emergency Treatment Escalation Plans Improves Communication and Early Collaborative Decision Making for Acute Hospital Admissions.

    PubMed

    Johnson, Mae; Whyte, Martin; Loveridge, Robert; Yorke, Richard; Naleem, Shairana

    2017-01-01

    The National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) report 'Time to Intervene' (2012) stated that in a substantial number of cases, resuscitation is attempted when it was thought a 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision should have been in place. Early decisions about CPR status and advance planning about limits of care now form part of national recommendations by the UK Resuscitation Council (2016). Treatment escalation plans (TEP) document what level of treatment intervention would be appropriate if a patient were to become acutely unwell and were not previously formally in place at King's College Hospital. A unifying paper based form was successfully piloted in the Acute Medical Unit, introducing the TEP and bringing together decision making around both treatment escalation and CPR status. Subsequently an electronic order-set for CPR status and treatment escalation was launched in April 2015 which led to a highly visible CPR and escalation status banner on the main screen at the top of the patient's electronic record. Ultimately due to further iterations in the electronic process by December 2016, all escalation decisions for acutely admitted patients now have high quality supporting, explanatory documentation with 100% having TEPs in place. There is now widespread multidisciplinary engagement in the process of defining limits of care for acutely admitted medical patients within the first 14 hours of admission and a strategy for rolling this process out across all the divisions of the hospital through our Deteriorating Patient Group (DPG). The collaborative design with acute medical, palliative and intensive care teams and the high visibility provided by the electronic process in the Electronic Patient Record (EPR) has enhanced communication with these teams, patients, nursing staff and the multidisciplinary team by ensuring clarity through a universally understood process about escalation and CPR. Clarity and

  14. Decision making and executive function in male adolescents with early-onset or adolescence-onset conduct disorder and control subjects.

    PubMed

    Fairchild, Graeme; van Goozen, Stephanie H M; Stollery, Sarah J; Aitken, Michael R F; Savage, Justin; Moore, Simon C; Goodyer, Ian M

    2009-07-15

    Although conduct disorder (CD) is associated with an increased susceptibility to substance use disorders, little is known about decision-making processes or reward mechanisms in CD. This study investigated decision making under varying motivational conditions in CD. Performances on the Risky Choice Task (RCT) and the Wisconsin Card Sorting Test (WCST) were assessed in 156 adolescents (84 control subjects, 34 with adolescence-onset CD, and 38 with early-onset CD). The RCT was performed twice, once under normal motivational conditions and once under conditions of increased motivation and psychosocial stress. Increased motivation and stress led to more cautious decision making and changes in framing effects on the RCT in all groups, although such effects were least pronounced in the early-onset CD group. Participants from both CD subgroups selected the risky choice more frequently than control subjects. Under normal motivational conditions, early-onset CD participants chose the risky choice more frequently in trials occurring after small gains, relative to control subjects and adolescence-onset CD participants. Following adjustment for IQ differences, the groups did not differ significantly in terms of WCST performance. Differences in decision making between control subjects and individuals with CD suggest that the balance between sensitivity to reward and punishment is shifted in this disorder, particularly the early-onset form. Our data on modulation of decision making according to previous outcomes suggest altered reward mechanisms in early-onset CD. The WCST data suggest that impairments in global executive function do not underlie altered decision making in CD.

  15. Designs for Living and Learning: Transforming Early Childhood Environments, Second Edition

    ERIC Educational Resources Information Center

    Carter, Margie; Curtis, Deb

    2015-01-01

    You likely have dreams for your early childhood environment that are greater than rating scales, regulations, and room arrangements. "Designs for Living and Learning" has been a favorite resource among educators and caregivers for more than a decade, and this new edition is packed with even more ideas that can be used as you create…

  16. Designing Reading Instruction for Cultural Minorities: The Case of the Kamehameha Early Education Program.

    ERIC Educational Resources Information Center

    Calfee, Robert C.; And Others

    This is a report on the Kamehameha Early Education Program (KEEP), a research and development project designed to find ways of improving the school performance of educationally disadvantaged Hawaiian children. The project, implemented in a laboratory school setting and continuously monitored, is described as a reading instruction program for…

  17. Sampling design for early detection of aquatic invasive species in Great Lakes ports

    EPA Science Inventory

    We evaluated a pilot adaptive monitoring program for aquatic invasive species (AIS) early detection in Lake Superior. The monitoring program is designed to detect newly-introduced fishes, and encompasses the lake’s three major ports (Duluth-Superior, Sault Ste. Marie, Thund...

  18. Sampling design for aquatic invasive species early detection in Great Lakes ports

    EPA Science Inventory

    From 2006-2012, we evaluated a pilot aquatic invasive species (AIS) early detection monitoring program in Lake Superior that was designed to detect newly introduced fishes. We established survey protocols for three major ports (Duluth-Superior, Sault Ste. Marie, Thunder Bay) and ...

  19. Designing a Measurement Framework for Response to Intervention in Early Childhood Programs

    ERIC Educational Resources Information Center

    McConnell, Scott R.; Wackerle-Hollman, Alisha K.; Roloff, Tracy A.; Rodriguez, Michael

    2014-01-01

    The overall architecture and major components of a measurement system designed and evaluated to support Response to Intervention (RTI) in the areas of language and literacy in early childhood programs are described. Efficient and reliable measurement is essential for implementing any viable RTI system, and implementing such a system in early…

  20. Improving the Design and Implementation of In-Service Professional Development in Early Childhood Intervention

    ERIC Educational Resources Information Center

    Dunst, Carl J.

    2015-01-01

    A model for designing and implementing evidence-­based in­-service professional development in early childhood intervention as well as the key features of the model are described. The key features include professional development specialist (PDS) description and demonstration of an intervention practice, active and authentic job-­embedded…

  1. Engaging Struggling Early Readers to Promote Reading Success: A Pilot Study of Reading by Design

    ERIC Educational Resources Information Center

    Mendez, Linda M. Raffaele; Pelzmann, Catherine A.; Frank, Michael J.

    2016-01-01

    In this study, we piloted a Tier 2 intervention designed to improve reading skills among struggling early readers using an intervention that included SRA Reading Mastery, listening-while-reading activities, strategies to increase motivation and engagement in reading, and parent involvement in reading homework. The study included 6 students in…

  2. Statistical controversies in clinical research: early-phase adaptive design for combination immunotherapies.

    PubMed

    Wages, N A; Slingluff, C L; Petroni, G R

    2017-04-01

    In recent years, investigators have asserted that the 3 + 3 design lacks flexibility, making its use in modern early-phase trial settings, such as combinations and/or biological agents, inefficient. More innovative approaches are required to address contemporary research questions, such as those posed in trials involving immunotherapies. We describe the implementation of an adaptive design for identifying an optimal treatment regimen, defined by low toxicity and high immune response, in an early-phase trial of a melanoma helper peptide vaccine plus novel adjuvant combinations. Operating characteristics demonstrate the ability of the method to effectively recommend optimal regimens in a high percentage of trials with reasonable sample sizes. The proposed design is a practical, early-phase, adaptive method for use with combined immunotherapy regimens. This design can be applied more broadly to early-phase combination studies, as it was used in an ongoing study of two small molecule inhibitors in relapsed/refractory mantle cell lymphoma. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

    PubMed

    Atkins, David

    2007-10-01

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

  4. Strengthening Agricultural Decisions in Countries at Risk of Food Insecurity: The GEOGLAM Crop Monitor for Early Warning

    NASA Astrophysics Data System (ADS)

    Becker-Reshef, I.; Barker, B.; McGaughey, K.; Humber, M. L.; Sanchez, A.; Justice, C. O.; Rembold, F.; Verdin, J. P.

    2016-12-01

    Timely, reliable information on crop conditions, and prospects at the subnational scale, is critical for making informed policy and agricultural decisions for ensuring food security, particularly for the most vulnerable countries. However, such information is often incomplete or lacking. As such, the Crop Monitor for Early Warning (CM for EW) was developed with the goal to reduce uncertainty and strengthen decision support by providing actionable information on a monthly basis to national, regional and global food security agencies through timely consensus assessments of crop conditions. This information is especially critical in recent years, given the extreme weather conditions impacting food supplies including the most recent El Nino event. This initiative brings together the main international food security monitoring agencies and organizations to develop monthly crop assessments based on satellite observations, meteorological information, field observations and ground reports, which reflect an international consensus. This activity grew out of the successful Crop Monitor for the G20 Agricultural Market Information System (AMIS), which provides operational monthly crop assessments of the main producing countries of the world. The CM for EW was launched in February 2016 and has already become a trusted source of information internationally and regionally. Its assessments have been featured in a large number of news articles, reports, and press releases, including a joint statement by the USAID's FEWS NET, UN World Food Program, European Commission Joint Research Center, and the UN Food and Agriculture Organziation, on the devastating impacts of the southern African drought due to El Nino. One of the main priorities for this activity going forward is to expand its partnership with regional and national monitoring agencies, and strengthen capacity for national crop condition assessments.

  5. Investigation and design of a Project Management Decision Support System for the 4950th Test Wing.

    DTIC Science & Technology

    1986-03-01

    all decision makers is the need for memory aids (reports, hand written notes, mental memory joggers, etc.). 4. Even in similar decision making ... memories to synthesize a decision- making process based on their individual styles, skills, and knowledge (Sprague, 1982: 106). Control mechanisms...representations shown in Figures 4.9 and 4.10 provide a means to this objective. By enabling a manager to make and record reasonable changes to

  6. Analysis and Design of a Decision Support System for Silas B. Hays Army Community Hospital

    DTIC Science & Technology

    1988-09-01

    develop the DSS. This collaboration allows the user to learn about the power decision support can give to the decision maker and... projects under their control. A DSS is developed to provide decision support for a specific manager or group , and con- sequently falls under the ... It is possible the first iteration could be developed in more than one programming language and results compared . Once the first

  7. A multiobjective decision support/numerical modeling approach for design and evaluation of shallow landfill burial systems

    SciT

    Ascough, II, James Clifford

    1992-05-01

    The capability to objectively evaluate design performance of shallow landfill burial (SLB) systems is of great interest to diverse scientific disciplines, including hydrologists, engineers, environmental scientists, and SLB regulators. The goal of this work was to develop and validate a procedure for the nonsubjective evaluation of SLB designs under actual or simulated environmental conditions. A multiobjective decision module (MDM) based on scoring functions (Wymore, 1988) was implemented to evaluate SLB design performance. Input values to the MDM are provided by hydrologic models. The MDM assigns a total score to each SLB design alternative, thereby allowing for rapid and repeatable designmore » performance evaluation. The MDM was validated for a wide range of SLB designs under different climatic conditions. Rigorous assessment of SLB performance also requires incorporation of hydrologic probabilistic analysis and hydrologic risk into the overall design. This was accomplished through the development of a frequency analysis module. The frequency analysis module allows SLB design event magnitudes to be calculated based on the hydrologic return period. The multiobjective decision and freqeuncy anslysis modules were integrated in a decision support system (DSS) framework, SLEUTH (Shallow Landfill Evaluation Using Transport and Hydrology). SLEUTH is a Microsoft Windows {trademark} application, and is written in the Knowledge Pro Windows (Knowledge Garden, Inc., 1991) development language.« less

  8. An Analysis of Risk and Function Information in Early Stage Design

    NASA Technical Reports Server (NTRS)

    Barrientos, Francesca; Tumer, Irem; Grantham, Katie; VanWie, Michael; Stone, Robert

    2005-01-01

    The concept of function offers a high potential for thinking and reasoning about designs as well as providing a common thread for relating together other design information. This paper focuses specifically on the relation between function and risk by examining how this information is addressed for a design team conducting early stage design for space missions. Risk information is decomposed into a set of key attributes which are then used to scrutinize the risk information using three approaches from the pragmatics sub-field of linguistics: i) Gricean, ii) Relevance Theory, and Functional Analysis. Results of this linguistics-based approach descriptively account for the context of designer communication with respect to function and risk, and offer prescriptive guidelines for improving designer communication.

  9. The decision tree classifier - Design and potential. [for Landsat-1 data

    NASA Technical Reports Server (NTRS)

    Hauska, H.; Swain, P. H.

    1975-01-01

    A new classifier has been developed for the computerized analysis of remote sensor data. The decision tree classifier is essentially a maximum likelihood classifier using multistage decision logic. It is characterized by the fact that an unknown sample can be classified into a class using one or several decision functions in a successive manner. The classifier is applied to the analysis of data sensed by Landsat-1 over Kenosha Pass, Colorado. The classifier is illustrated by a tree diagram which for processing purposes is encoded as a string of symbols such that there is a unique one-to-one relationship between string and decision tree.

  10. SafeLand guidelines for landslide monitoring and early warning systems in Europe - Design and required technology

    NASA Astrophysics Data System (ADS)

    Bazin, S.

    2012-04-01

    Landslide monitoring means the comparison of landslide characteristics like areal extent, speed of movement, surface topography and soil humidity from different periods in order to assess landslide activity. An ultimate "universal" methodology for this purpose does not exist; every technology has its own advantages and disadvantages. End-users should carefully consider each one to select the methodologies that represent the best compromise between pros and cons, and are best suited for their needs. Besides monitoring technology, there are many factors governing the choice of an Early Warning System (EWS). A people-centred EWS necessarily comprises five key elements: (1) knowledge of the risks; (2) identification, monitoring, analysis and forecasting of the hazards; (3) operational centre; (4) communication or dissemination of alerts and warnings; and (5) local capabilities to respond to the warnings received. The expression "end-to-end warning system" is also used to emphasize that EWSs need to span all steps from hazard detection through to community response. The aim of the present work is to provide guidelines for establishing the different components for landslide EWSs. One of the main deliverables of the EC-FP7 SafeLand project addresses the technical and practical issues related to monitoring and early warning for landslides, and identifies the best technologies available in the context of both hazard assessment and design of EWSs. This deliverable targets the end-users and aims to facilitate the decision process by providing guidelines. For the purpose of sharing the globally accumulated expertise, a screening study was done on 14 EWSs from 8 different countries. On these bases, the report presents a synoptic view of existing monitoring methodologies and early-warning strategies and their applicability for different landslide types, scales and risk management steps. Several comprehensive checklists and toolboxes are also included to support informed

  11. "Doing What's Best for Kids": A Narrative Study of Early Childhood Education and the Decision-Making of Superintendents

    ERIC Educational Resources Information Center

    Heath, Eric M.

    2017-01-01

    The purpose of this qualitative narrative study is to explore how superintendents perceive the importance of early childhood education in their school districts amid the State of Illinois's continued cuts to education spending. Also, this study examines the perceptions of superintendents' decision-making processes as it relates to the funding of…

  12. Scaling the Pyramid Model across Complex Systems Providing Early Care for Preschoolers: Exploring How Models for Decision Making May Enhance Implementation Science

    ERIC Educational Resources Information Center

    Johnson, LeAnne D.

    2017-01-01

    Bringing effective practices to scale across large systems requires attending to how information and belief systems come together in decisions to adopt, implement, and sustain those practices. Statewide scaling of the Pyramid Model, a framework for positive behavior intervention and support, across different types of early childhood programs…

  13. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Astrophysics Data System (ADS)

    Hals, F. A.

    1981-03-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  14. Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

    NASA Technical Reports Server (NTRS)

    Hals, F. A.

    1981-01-01

    The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

  15. 78 FR 56706 - Decision to Evaluate a Petition to Designate a Class of Employees from the Sandia National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-13

    ...NIOSH gives notice as required by Department of Health and Human Services regulations of a decision to evaluate a petition to designate a class of employees from the Sandia National Laboratory- Livermore in Livermore, California to be included in the Special Exposure Cohort under the Energy Employees Occupational Illness Compensation Program Act of 2000.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  17. 76 FR 64948 - Decision To Evaluate a Petition To Designate a Class of Employees From Oak Ridge National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ... Employees From Oak Ridge National Laboratory (X-10), Oak Ridge, TN, To Be Included in the Special Exposure... decision to evaluate a petition to designate a class of employees from Oak Ridge National Laboratory (X-10... Laboratory (X-10) Location: Oak Ridge, Tennessee. Job Titles and/or Job Duties: All contractor employees...

  18. Design Principles for resilient cyber-physical Early Warning Systems - Challenges, Experiences, Design Patterns, and Best Practices

    NASA Astrophysics Data System (ADS)

    Gensch, S.; Wächter, J.; Schnor, B.

    2014-12-01

    Early warning systems (EWS) are safety-critical IT-infrastructures that serve the purpose of potentially saving lives or assets by observing real-world phenomena and issuing timely warning products to authorities and communities. An EWS consists of sensors, communication networks, data centers, simulation platforms, and dissemination channels. The components of this cyber-physical system may all be affected by both natural hazards and malfunctions of components alike. Resilience engineering so far has mostly been applied to safety-critical systems and processes in transportation (aviation, automobile), construction and medicine. Early warning systems need equivalent techniques to compensate for failures, and furthermore means to adapt to changing threats, emerging technology and research findings. We present threats and pitfalls from our experiences with the German and Indonesian tsunami early warning system, as well as architectural, technological and organizational concepts employed that can enhance an EWS' resilience. The current EWS is comprised of a multi-type sensor data upstream part, different processing and analysis engines, a decision support system, and various warning dissemination channels. Each subsystem requires a set of approaches towards ensuring stable functionality across system layer boundaries, including also institutional borders. Not only must services be available, but also produce correct results. Most sensors are distributed components with restricted resources, communication channels and power supply. An example for successful resilience engineering is the power capacity based functional management for buoy and tide gauge stations. We discuss various fault-models like cause and effect models on linear pathways, interaction of multiple events, complex and non-linear interaction of assumedly reliable subsystems and fault tolerance means implemented to tackle these threats.

  19. Simplified spacecraft vulnerability assessments at component level in early design phase at the European Space Agency's Concurrent Design Facility

    NASA Astrophysics Data System (ADS)

    Kempf, Scott; Schäfer, Frank K.; Cardone, Tiziana; Ferreira, Ivo; Gerené, Sam; Destefanis, Roberto; Grassi, Lilith

    2016-12-01

    During recent years, the state-of-the-art risk assessment of the threat posed to spacecraft by micrometeoroids and space debris has been expanded to the analysis of failure modes of internal spacecraft components. This method can now be used to perform risk analyses for satellites to assess various failure levels - from failure of specific sub-systems to catastrophic break-up. This new assessment methodology is based on triple-wall ballistic limit equations (BLEs), specifically the Schäfer-Ryan-Lambert (SRL) BLE, which is applicable for describing failure threshold levels for satellite components following a hypervelocity impact. The methodology is implemented in the form of the software tool Particle Impact Risk and vulnerability Analysis Tool (PIRAT). During a recent European Space Agency (ESA) funded study, the PIRAT functionality was expanded in order to provide an interface to ESA's Concurrent Design Facility (CDF). The additions include a geometry importer and an OCDT (Open Concurrent Design Tool) interface. The new interface provides both the expanded geometrical flexibility, which is provided by external computer aided design (CAD) modelling, and an ease of import of existing data without the need for extensive preparation of the model. The reduced effort required to perform vulnerability analyses makes it feasible for application during early design phase, at which point modifications to satellite design can be undertaken with relatively little extra effort. The integration of PIRAT in the CDF represents the first time that vulnerability analyses can be performed in-session in ESA's CDF and the first time that comprehensive vulnerability studies can be applied cost-effectively in early design phase in general.

  20. Efficient runner safety assessment during early design phase and root cause analysis

    NASA Astrophysics Data System (ADS)

    Liang, Q. W.; Lais, S.; Gentner, C.; Braun, O.

    2012-11-01

    Fatigue related problems in Francis turbines, especially high head Francis turbines, have been published several times in the last years. During operation the runner is exposed to various steady and unsteady hydraulic loads. Therefore the analysis of forced response of the runner structure requires a combined approach of fluid dynamics and structural dynamics. Due to the high complexity of the phenomena and due to the limitation of computer power, the numerical prediction was in the past too expensive and not feasible for the use as standard design tool. However, due to continuous improvement of the knowledge and the simulation tools such complex analysis has become part of the design procedure in ANDRITZ HYDRO. This article describes the application of most advanced analysis techniques in runner safety check (RSC), including steady state CFD analysis, transient CFD analysis considering rotor stator interaction (RSI), static FE analysis and modal analysis in water considering the added mass effect, in the early design phase. This procedure allows a very efficient interaction between the hydraulic designer and the mechanical designer during the design phase, such that a risk of failure can be detected and avoided in an early design stage.The RSC procedure can also be applied to a root cause analysis (RCA) both to find out the cause of failure and to quickly define a technical solution to meet the safety criteria. An efficient application to a RCA of cracks in a Francis runner is quoted in this article as an example. The results of the RCA are presented together with an efficient and inexpensive solution whose effectiveness could be proven again by applying the described RSC technics. It is shown that, with the RSC procedure developed and applied as standard procedure in ANDRITZ HYDRO such a failure is excluded in an early design phase. Moreover, the RSC procedure is compatible with different commercial and open source codes and can be easily adapted to apply for

  1. Group Decision Support System to Aid the Process of Design and Maintenance of Large Scale Systems

    DTIC Science & Technology

    1992-03-23

    from a fuzzy set of user requirements. The overall objective of the project is to develop a system combining the characteristics of a compact computer... AHP ) for hierarchical prioritization. 4) Individual Evaluation and Selection of Alternatives - Allows the decision maker to individually evaluate...its concept of outranking relations. The AHP method supports complex decision problems by successively decomposing and synthesizing various elements

  2. Which medical and social decision topics are important after early diagnosis of Alzheimer's Disease from the perspectives of people with Alzheimer's Disease, spouses and professionals?

    PubMed

    Bronner, Katharina; Perneczky, Robert; McCabe, Rose; Kurz, Alexander; Hamann, Johannes

    2016-03-08

    The relevance of early decision making will rise with increasing availability of early detection of Alzheimer's disease (AD) using brain imaging or biomarkers. Five people with mild AD, six relatives and 13 healthcare professionals with experience in the management of AD were interviewed in a qualitative study regarding medical and social decision topics that emerge after early diagnosis of Alzheimer's disease. Medical treatment, assistance in everyday life and legal issues emerged as the main decision topics after an early diagnosis of AD. People with AD mostly got in contact with the health and social care system through the initiative of their spouses. They were usually aware of their illness and most received antidementia drugs and/or behavioural interventions. Following diagnosis people with AD received support by their spouses. Healthcare professionals were aware of the risk of excessive demand on relatives due to supporting their family member with AD. In the opinion of healthcare professionals legal issues should be arranged in time before patients lose their decisional capacity. In addition, people with AD and spouses reported various coping strategies, in particular "carry on as normal" after diagnosis but mostly are reluctant to actively plan for future stages of the disease. Due to the common desire to "carry on as usual" after a diagnosis of AD, many people with AD and spouses may miss the opportunity to discuss and decide on important medical and social topics. A structured approach e.g. a decision aid might support people with AD and spouses in their decision making process and thereby preserve persons' with AD autonomy before they lose the capacity in decision-making.

  3. Theory-informed design of values clarification methods: a cognitive psychological perspective on patient health-related decision making.

    PubMed

    Pieterse, Arwen H; de Vries, Marieke; Kunneman, Marleen; Stiggelbout, Anne M; Feldman-Stewart, Deb

    2013-01-01

    Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have been developed. VCM intend to help patients to determine the aspects of the choices that are important to their selection of a preferred option. Several types of VCM exist. However, they are often designed without clear reference to theory, which makes it difficult for their development to be systematic and internally coherent. Our goal was to provide theory-informed recommendations for the design of VCM. Process theories of decision making specify components of decision processes, thus, identify particular processes that VCM could aim to facilitate. We conducted a review of the MEDLINE and PsycINFO databases and of references to theories included in retrieved papers, to identify process theories of decision making. We selected a theory if (a) it fulfilled criteria for a process theory; (b) provided a coherent description of the whole process of decision making; and (c) empirical evidence supports at least some of its postulates. Four theories met our criteria: Image Theory, Differentiation and Consolidation theory, Parallel Constraint Satisfaction theory, and Fuzzy-trace Theory. Based on these, we propose that VCM should: help optimize mental representations; encourage considering all potentially appropriate options; delay selection of an initially favoured option; facilitate the retrieval of relevant values from memory; facilitate the comparison of options and their attributes; and offer time to decide. In conclusion, our theory-based design recommendations are explicit and transparent, providing an opportunity to test each in a systematic manner. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Early home-based group education to support informed decision-making among patients with end-stage renal disease: a multi-centre randomized controlled trial.

    PubMed

    Massey, Emma K; Gregoor, Peter J H Smak; Nette, Robert W; van den Dorpel, Marinus A; van Kooij, Anthony; Zietse, Robert; Zuidema, Willij C; Timman, Reinier; Busschbach, Jan J; Weimar, Willem

    2016-05-01

    The aim was to test the effectiveness of early home-based group education on knowledge and communication about renal replacement therapy (RRT). We conducted a randomized controlled trial using a cross-over design among 80 end-stage renal disease (ESRD) patients. Between T0 and T1 (weeks 1-4) Group 1 received the intervention and Group 2 received standard care. Between T1 and T2 (weeks 5-8) Group 1 received standard care and Group 2 received the intervention. The intervention was a group education session on RRT options held in the patient's home given by social workers. Patients invited members from their social network to attend. Self-report questionnaires were used at T0, T1 and T2 to measure patients' knowledge and communication, and concepts from the Theory of Planned Behaviour such as attitude. Comparable questionnaires were completed pre-post intervention by 229 attendees. Primary RRT was registered up to 2 years post-intervention. Multilevel linear modelling was used to analyse patient data and paired t-tests for attendee data. Statistically significant increases in the primary targets knowledge and communication were found among patients and attendees after receiving the intervention. The intervention also had a significant effect in increasing positive attitude toward living donation and haemodialysis. Of the 80 participants, 49 underwent RRT during follow-up. Of these, 34 underwent a living donor kidney transplant, of which 22 were pre-emptive. Early home-based group education supports informed decision-making regarding primary RRT for ESRD patients and their social networks and may remove barriers to pre-emptive transplantation. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  5. Stakeholder Participation in Research Design and Decisions: Scientists, Fishers, and Mercury in Saltwater Fish

    PubMed Central

    Burger, Joanna; Gochfeld, Michael; Fote, Tom

    2015-01-01

    Individuals who fish and eat self-caught fish make decisions about where to fish, the type to eat, and the quantity to eat. Federal and state agencies often issue consumption advisories for some fish with high mercury (Hg) concentrations, but seldom provide either the actual metal levels to the general public, or identify the fish that have low contaminant levels. Community participatory research is of growing importance in defining, studying, and resolving complex exposure and risk issues, and this paper is at the intersection of traditional stakeholder approaches and community-based participatory research. The objective of this paper is to describe the process whereby stakeholders (fishers), were involved in directing and refining research questions to address their particular informational needs about mercury levels in fish, potential risks, and methods to maintain health, by balancing the risks and benefits of fish consumption. A range of stakeholders, mainly individual fishers, fishing organizations, and other scientists, were involved at nearly every stage. Community participants influenced many aspects of the design and implementation of the research, in the determination of which fish species to sample, in the collection of the samples, and in the final analyses and synthesis, as well as the communication of results and implications of the research through their fishing club publications, talks and gatherings. By involving the most interested and affected communities, the data and conclusions are relevant to their needs because the fish examined were those they ate and wanted information about, and directly address concerns about the risk from consuming self-caught fish. Although mercury levels in fish presumed to be high in mercury are known, little information was available to the fishermen on mercury levels in fish that were low and thus provided little risk to their families. While community participatory research is more time-consuming and expensive

  6. Stakeholder participation in research design and decisions: scientists, fishers, and mercury in saltwater fish.

    PubMed

    Burger, Joanna; Gochfeld, Michael; Fote, Tom

    2013-03-01

    Individuals who fish and eat self-caught fish make decisions about where to fish, the type to eat, and the quantity to eat. Federal and state agencies often issue consumption advisories for some fish with high mercury (Hg) concentrations, but seldom provide either the actual metal levels to the general public, or identify the fish that have low contaminant levels. Community participatory research is of growing importance in defining, studying, and resolving complex exposure and risk issues, and this paper is at the intersection of traditional stakeholder approaches and community-based participatory research. The objective of this paper is to describe the process whereby stakeholders (fishers), were involved in directing and refining research questions to address their particular informational needs about mercury levels in fish, potential risks, and methods to maintain health, by balancing the risks and benefits of fish consumption. A range of stakeholders, mainly individual fishers, fishing organizations, and other scientists, were involved at nearly every stage. Community participants influenced many aspects of the design and implementation of the research, in the determination of which fish species to sample, in the collection of the samples, and in the final analyses and synthesis, as well as the communication of results and implications of the research through their fishing club publications, talks and gatherings. By involving the most interested and affected communities, the data and conclusions are relevant to their needs because the fish examined were those they ate and wanted information about, and directly address concerns about the risk from consuming self-caught fish. Although mercury levels in fish presumed to be high in mercury are known, little information was available to the fishermen on mercury levels in fish that were low and thus provided little risk to their families. While community participatory research is more time-consuming and expensive

  7. Early College Designs: An Increasingly Popular College-Readiness Strategy for School Districts to Reach More Traditionally Underserved Students

    ERIC Educational Resources Information Center

    Vargas, Joel H.; Miller, Marc S.

    2011-01-01

    Once a radical concept, early college high schools are flying soundly today. The challenge today--and the excitement of those involved--centers on learning from this successful innovation and bringing the early college design to many more young people. Expansion is taking place through the creation of early college districts covering all students…

  8. Treatment of early-onset schizophrenia spectrum disorders (TEOSS): rationale, design, and methods.

    PubMed

    McClellan, Jon; Sikich, Linmarie; Findling, Robert L; Frazier, Jean A; Vitiello, Benedetto; Hlastala, Stefanie A; Williams, Emily; Ambler, Denisse; Hunt-Harrison, Tyehimba; Maloney, Ann E; Ritz, Louise; Anderson, Robert; Hamer, Robert M; Lieberman, Jeffrey A

    2007-08-01

    The Treatment of Early Onset Schizophrenia Spectrum Disorders Study is a publicly funded clinical trial designed to compare the therapeutic benefits, safety, and tolerability of risperidone, olanzapine, and molindone in youths with early-onset schizophrenia spectrum disorders. The rationale, design, and methods of the Treatment of Early Onset Schizophrenia Spectrum Disorders Study are described. Using a randomized, double-blind, parallel-group design at four sites, youths with EOSS (ages 8-19 years) were assigned to an 8-week acute trial of risperidone (0.5-6.0 mg/day), olanzapine (2.5-20 mg/day), or molindone (10-140 mg/day). Responders continued double-blind treatment for 44 weeks. The primary outcome measure was responder status at 8 weeks, defined by a 20% reduction in baseline Positive and Negative Symptom Scale scores plus ratings of significant improvement on the Clinical Global Impressions. Secondary outcome measures included assessments of psychopathology, functional impairment, quality of life, and medication safety. An intent-to-treat analytic plan was used. From February 2002 to May 2006, 476 youths were screened, 173 were further evaluated, and 119 were randomized. Several significant study modifications were required to address safety, the use of adjunctive medications, and the termination of the olanzapine treatment arm due to weight gain. The Treatment of Early Onset Schizophrenia Spectrum Disorders Study will inform clinical practice regarding the use of antipsychotic medications for youths with early-onset schizophrenia spectrum disorders. Important safety concerns emerged during the study, including higher than anticipated rates of suicidality and problems tapering thymoleptic agents before randomization.

  9. Making clinical trials more relevant: improving and validating the PRECIS tool for matching trial design decisions to trial purpose.

    PubMed

    Loudon, Kirsty; Zwarenstein, Merrick; Sullivan, Frank; Donnan, Peter; Treweek, Shaun

    2013-04-27

    If you want to know which of two or more healthcare interventions is most effective, the randomised controlled trial is the design of choice. Randomisation, however, does not itself promote the applicability of the results to situations other than the one in which the trial was done. A tool published in 2009, PRECIS (PRagmatic Explanatory Continuum Indicator Summaries) aimed to help trialists design trials that produced results matched to the aim of the trial, be that supporting clinical decision-making, or increasing knowledge of how an intervention works. Though generally positive, groups evaluating the tool have also found weaknesses, mainly that its inter-rater reliability is not clear, that it needs a scoring system and that some new domains might be needed. The aim of the study is to: Produce an improved and validated version of the PRECIS tool. Use this tool to compare the internal validity of, and effect estimates from, a set of explanatory and pragmatic trials matched by intervention. The study has four phases. Phase 1 involves brainstorming and a two-round Delphi survey of authors who cited PRECIS. In Phase 2, the Delphi results will then be discussed and alternative versions of PRECIS-2 developed and user-tested by experienced trialists. Phase 3 will evaluate the validity and reliability of the most promising PRECIS-2 candidate using a sample of 15 to 20 trials rated by 15 international trialists. We will assess inter-rater reliability, and raters' subjective global ratings of pragmatism compared to PRECIS-2 to assess convergent and face validity. Phase 4, to determine if pragmatic trials sacrifice internal validity in order to achieve applicability, will compare the internal validity and effect estimates of matched explanatory and pragmatic trials of the same intervention, condition and participants. Effect sizes for the trials will then be compared in a meta-regression. The Cochrane Risk of Bias scores will be compared with the PRECIS-2 scores of

  10. Making clinical trials more relevant: improving and validating the PRECIS tool for matching trial design decisions to trial purpose

    PubMed Central

    2013-01-01

    Background If you want to know which of two or more healthcare interventions is most effective, the randomised controlled trial is the design of choice. Randomisation, however, does not itself promote the applicability of the results to situations other than the one in which the trial was done. A tool published in 2009, PRECIS (PRagmatic Explanatory Continuum Indicator Summaries) aimed to help trialists design trials that produced results matched to the aim of the trial, be that supporting clinical decision-making, or increasing knowledge of how an intervention works. Though generally positive, groups evaluating the tool have also found weaknesses, mainly that its inter-rater reliability is not clear, that it needs a scoring system and that some new domains might be needed. The aim of the study is to: Produce an improved and validated version of the PRECIS tool. Use this tool to compare the internal validity of, and effect estimates from, a set of explanatory and pragmatic trials matched by intervention. Methods The study has four phases. Phase 1 involves brainstorming and a two-round Delphi survey of authors who cited PRECIS. In Phase 2, the Delphi results will then be discussed and alternative versions of PRECIS-2 developed and user-tested by experienced trialists. Phase 3 will evaluate the validity and reliability of the most promising PRECIS-2 candidate using a sample of 15 to 20 trials rated by 15 international trialists. We will assess inter-rater reliability, and raters’ subjective global ratings of pragmatism compared to PRECIS-2 to assess convergent and face validity. Phase 4, to determine if pragmatic trials sacrifice internal validity in order to achieve applicability, will compare the internal validity and effect estimates of matched explanatory and pragmatic trials of the same intervention, condition and participants. Effect sizes for the trials will then be compared in a meta-regression. The Cochrane Risk of Bias scores will be compared with the

  11. Evaluation of user interface and workflow design of a bedside nursing clinical decision support system.

    PubMed

    Yuan, Michael Juntao; Finley, George Mike; Long, Ju; Mills, Christy; Johnson, Ron Kim

    2013-01-31

    Clinical decision support systems (CDSS) are important tools to improve health care outcomes and reduce preventable medical adverse events. However, the effectiveness and success of CDSS depend on their implementation context and usability in complex health care settings. As a result, usability design and validation, especially in real world clinical settings, are crucial aspects of successful CDSS implementations. Our objective was to develop a novel CDSS to help frontline nurses better manage critical symptom changes in hospitalized patients, hence reducing preventable failure to rescue cases. A robust user interface and implementation strategy that fit into existing workflows was key for the success of the CDSS. Guided by a formal usability evaluation framework, UFuRT (user, function, representation, and task analysis), we developed a high-level specification of the product that captures key usability requirements and is flexible to implement. We interviewed users of the proposed CDSS to identify requirements, listed functions, and operations the system must perform. We then designed visual and workflow representations of the product to perform the operations. The user interface and workflow design were evaluated via heuristic and end user performance evaluation. The heuristic evaluation was done after the first prototype, and its results were incorporated into the product before the end user evaluation was conducted. First, we recruited 4 evaluators with strong domain expertise to study the initial prototype. Heuristic violations were coded and rated for severity. Second, after development of the system, we assembled a panel of nurses, consisting of 3 licensed vocational nurses and 7 registered nurses, to evaluate the user interface and workflow via simulated use cases. We recorded whether each session was successfully completed and its completion time. Each nurse was asked to use the National Aeronautics and Space Administration (NASA) Task Load Index to self

  12. Evaluation of User Interface and Workflow Design of a Bedside Nursing Clinical Decision Support System

    PubMed Central

    Yuan, Michael Juntao; Finley, George Mike; Mills, Christy; Johnson, Ron Kim

    2013-01-01

    Background Clinical decision support systems (CDSS) are important tools to improve health care outcomes and reduce preventable medical adverse events. However, the effectiveness and success of CDSS depend on their implementation context and usability in complex health care settings. As a result, usability design and validation, especially in real world clinical settings, are crucial aspects of successful CDSS implementations. Objective Our objective was to develop a novel CDSS to help frontline nurses better manage critical symptom changes in hospitalized patients, hence reducing preventable failure to rescue cases. A robust user interface and implementation strategy that fit into existing workflows was key for the success of the CDSS. Methods Guided by a formal usability evaluation framework, UFuRT (user, function, representation, and task analysis), we developed a high-level specification of the product that captures key usability requirements and is flexible to implement. We interviewed users of the proposed CDSS to identify requirements, listed functions, and operations the system must perform. We then designed visual and workflow representations of the product to perform the operations. The user interface and workflow design were evaluated via heuristic and end user performance evaluation. The heuristic evaluation was done after the first prototype, and its results were incorporated into the product before the end user evaluation was conducted. First, we recruited 4 evaluators with strong domain expertise to study the initial prototype. Heuristic violations were coded and rated for severity. Second, after development of the system, we assembled a panel of nurses, consisting of 3 licensed vocational nurses and 7 registered nurses, to evaluate the user interface and workflow via simulated use cases. We recorded whether each session was successfully completed and its completion time. Each nurse was asked to use the National Aeronautics and Space Administration

  13. The design of composite monitoring scheme for multilevel information in crop early diseases

    NASA Astrophysics Data System (ADS)

    Zhang, Yan; Meng, Qinglong; Shang, Jing

    2018-02-01

    It is difficult to monitor and predict the crops early diseases in that the crop disease monitoring is usually monitored by visible light images and the availabilities in early warning are poor at present. The features of common nondestructive testing technology applied to the crop diseases were analyzed in this paper. Based on the changeable characteristics of the virus from the incubation period to the onset period of crop activities, the multilevel composite information monitoring scheme were designed by applying infrared thermal imaging, visible near infrared hyperspectral imaging, micro-imaging technology to the monitoring of multilevel information of crop disease infection comprehensively. The early warning process and key monitoring parameters of compound monitoring scheme are given by taking the temperature, color, structure and texture of crops as the key monitoring characteristics of disease. With overcoming the deficiency that the conventional monitoring scheme is only suitable for the observation of diseases with naked eyes, the monitoring and early warning of the incubation and early onset of the infection crops can be realized by the composite monitoring program as mentioned in this paper.

  14. Design and characterization of a dead-time regime enhanced early photon projection imaging system

    NASA Astrophysics Data System (ADS)

    Sinha, L.; Fogarty, M.; Zhou, W.; Giudice, A.; Brankov, J. G.; Tichauer, K. M.

    2018-04-01

    Scattering of visible and near-infrared light in biological tissue reduces spatial resolution for imaging of tissues thicker than 100 μm. In this study, an optical projection imaging system is presented and characterized that exploits the dead-time characteristics typical of photon counting modules based on single photon avalanche diodes (SPADs). With this system, it is possible to attenuate the detection of more scattered late-arriving photons, such that detection of less scattered early-arriving photons can be enhanced with increased light intensity, without being impeded by the maximum count rate of the SPADs. The system has the potential to provide transmittance-based anatomical information or fluorescence-based functional information (with slight modification in the instrumentation) of biological samples with improved resolution in the mesoscopic domain (0.1-2 cm). The system design, calibration, stability, and performance were evaluated using simulation and experimental phantom studies. The proposed system allows for the detection of very-rare early-photons at a higher frequency and with a better signal-to-noise ratio. The experimental results demonstrated over a 3.4-fold improvement in the spatial resolution using early photon detection vs. conventional detection, and a 1000-fold improvement in imaging time using enhanced early detection vs. conventional early photon detection in a 4-mm thick phantom with a tissue-equivalent absorption coefficient of μa = 0.05 mm-1 and a reduced scattering coefficient of μs' = 5 mm-1.

  15. The Impact of Early Design Phase Risk Identification Biases on Space System Project Performance

    NASA Technical Reports Server (NTRS)

    Reeves, John D., Jr.; Eveleigh, Tim; Holzer, Thomas; Sarkani, Shahryar

    2012-01-01

    Risk identification during the early design phases of complex systems is commonly implemented but often fails to result in the identification of events and circumstances that truly challenge project performance. Inefficiencies in cost and schedule estimation are usually held accountable for cost and schedule overruns, but the true root cause is often the realization of programmatic risks. A deeper understanding of frequent risk identification trends and biases pervasive during space system design and development is needed, for it would lead to improved execution of existing identification processes and methods.

  16. 78 FR 39736 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ..., choosing a study population, using a control group and blinding, dose selection, treatment plans...] Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of Cellular... document entitled ``Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

  17. Feasibility and acceptability of a decision aid designed for people facing advanced or terminal illness: a pilot randomized trial.

    PubMed

    Matlock, Dan D; Keech, Tarah A E; McKenzie, Marlene B; Bronsert, Michael R; Nowels, Carolyn T; Kutner, Jean S

    2014-02-01

    Patients nearing the end of their lives face an array of difficult decisions. This study was designed to assess the feasibility and acceptability of a decision aid (DA) designed for patients facing advanced or terminal illness. We conducted a pilot randomized clinical trial of Health Dialog's Looking Ahead: choices for medical care when you're seriously ill DA (booklet and DVD) applied to patients on a hospital-based palliative care (PC) service. University of Colorado Hospital - December 2009 and May 2010. All adult, English-speaking patients or their decision makers were potentially eligible. Patients were not approached if they were in isolation, did not speak English or if any provider felt that they were not appropriate because of issues such as family conflict or actively dying. All participants received a standard PC consultation. Participants in the intervention arm also received a copy of the DA. Measurements Primary outcomes included decision conflict and knowledge. Participants in the intervention arm also completed an acceptability questionnaire and qualitative exit interviews. Of the 239 patients or decision makers, 51(21%) enrolled in the trial. The DA had no significant effect on decision conflict or knowledge. Exit interviews indicated it was acceptable and empowering, although they wished they had access to the DA earlier. While the DA was acceptable, feasibility was limited by late-life illness challenges. Future trials of this DA should be performed on patients earlier in their illness trajectory and should include additional outcome measures such as self-efficacy and confidence. © 2011 John Wiley & Sons Ltd.

  18. Preferred and Perceived Participation of Younger and Older Patients in Decision Making About Treatment for Early Breast Cancer: A Prospective Study.

    PubMed

    Hamelinck, Victoria C; Bastiaannet, Esther; Pieterse, Arwen H; van de Velde, Cornelis J H; Liefers, Gerrit-Jan; Stiggelbout, Anne M

    2018-04-01

    Older patients are believed to prefer a more passive role in treatment decision making, but studies reporting this relation were conducted over a decade ago or were retrospective. We prospectively compared younger (40-64 years) versus older (≥ 65 years) breast cancer patients' preferences for decision-making roles and their perceived actual roles. A prospective multicenter study was conducted in Leiden, The Hague, and Tilburg over a 2-year period. Early-stage breast cancer patients were surveyed about their preferred and perceived decision-making roles (active, shared, or passive) concerning surgery type (breast-conserving vs. mastectomy) (n = 74), adjuvant chemotherapy (aCT, n = 43), and adjuvant hormonal therapy (aHT, n = 39). For all decisions, both age groups most frequently preferred a shared role before consultation, except for decisions about aHT, for which younger patients more commonly preferred an active role. The proportion of patients favoring an active or passive role in each decision was lower for the older than the younger patients, but none of the differences was significant. Regarding perceived actual roles, both groups most frequently reported an active role in the surgical decision after consultation. In deciding about both aCT and aHT, a larger proportion of older patients perceived having had a passive role compared to younger patients, and a greater proportion of younger patients perceived having been active. Again, differences were not statistically significant. Most older patients preferred to decide together with their clinician, but preferences varied widely. Older patients more often than younger patients perceived they had not been involved in decisions about systemic therapy. Clinicians should invite all patients to participate in decision making and elicit their preferred role. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Design, implementation, use, and preliminary evaluation of SEBASTIAN, a standards-based Web service for clinical decision support.

    PubMed

    Kawamoto, Kensaku; Lobach, David F

    2005-01-01

    Despite their demonstrated ability to improve care quality, clinical decision support systems are not widely used. In part, this limited use is due to the difficulty of sharing medical knowledge in a machine-executable format. To address this problem, we developed a decision support Web service known as SEBASTIAN. In SEBASTIAN, individual knowledge modules define the data requirements for assessing a patient, the conclusions that can be drawn using that data, and instructions on how to generate those conclusions. Using standards-based XML messages transmitted over HTTP, client decision support applications provide patient data to SEBASTIAN and receive patient-specific assessments and recommendations. SEBASTIAN has been used to implement four distinct decision support systems; an architectural overview is provided for one of these systems. Preliminary assessments indicate that SEBASTIAN fulfills all original design objectives, including the re-use of executable medical knowledge across diverse applications and care settings, the straightforward authoring of knowledge modules, and use of the framework to implement decision support applications with significant clinical utility.

  20. Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients with Early-Stage Breast Cancer

    PubMed Central

    Jagsi, Reshma; Hawley, Sarah T.; Griffith, Kent A.; Janz, Nancy K.; Kurian, Allison W.; Ward, Kevin C.; Hamilton, Ann S.; Morrow, Monica; Katz, Steven J.

    2017-01-01

    Importance Contralateral prophylactic mastectomy (CPM) use is increasing among women with unilateral breast cancer, but little is known about treatment decision making or physician interactions in diverse patient populations. Objective To evaluate patient motivations, knowledge, and decisions, as well as the impact of surgeon recommendations, in a large, diverse sample of patients who underwent recent treatment for breast cancer. Design/Setting/Participants A survey was sent to 3631 women with newly diagnosed, unilateral stage 0, I, or II breast cancer between July 2013 and September 2014. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. Logistic and multinomial logistic regression of the data were conducted to identify factors associated with (1) CPM vs all other treatments combined, 2) CPM vs unilateral mastectomy (UM), and (3) CPM vs breast-conserving surgery (BCS). Associations between CPM receipt and surgeon recommendations were also evaluated. All statistical models and summary estimates were weighted to be representative of the target population. Main Outcome and Measures Receipt of CPM was the primary dependent variable for analysis and was measured by a woman’s self-report of her treatment. Results Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. The mean (SD) age was 61.8 (12) years at the time of the survey. Overall, 1301 (43.9%) patients considered CPM (601[24.8%] considered it very strongly or strongly; only 395 (38.1%) of them knew that CPM does not improve survival for all women with breast cancer. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received

  1. Forests and Phenology: Designing the Early Warning System to Understand Forest Change

    NASA Astrophysics Data System (ADS)

    Pierce, T.; Phillips, M. B.; Hargrove, W. W.; Dobson, G.; Hicks, J.; Hutchins, M.; Lichtenstein, K.

    2010-12-01

    Vegetative phenology is the study of plant development and changes with the seasons, such as the greening-up and browning-down of forests, and how these events are influenced by variations in climate. A National Phenology Data Set, based on Moderate Resolution Imaging Spectroradiometer satellite images covering 2002 through 2009, is now available from work by NASA, the US Forest Service, and Oak Ridge National Laboratory. This new data set provides an easily interpretable product useful for detecting changes to the landscape due to long-term factors such as climate change, as well as finding areas affected by short-term forest threats such as insects or disease. The Early Warning System (EWS) is a toolset being developed by the US Forest Service and the University of North Carolina-Asheville to support distribution and use of the National Phenology Data Set. The Early Warning System will help research scientists, US Forest Service personnel, forest and natural resources managers, decision makers, and the public in the use of phenology data to better understand unexpected change within our nation’s forests. These changes could have multiple natural sources such as insects, disease, or storm damage, or may be due to human-induced events, like thinning, harvest, forest conversion to agriculture, or residential and commercial use. The primary goal of the Early Warning System is to provide a seamless integration between monitoring, detection, early warning and prediction of these forest disturbances as observed through phenological data. The system consists of PC and web-based components that are structured to support four user stages of increasing knowledge and data sophistication. Building Literacy: This stage of the Early Warning System educates potential users about the system, why the system should be used, and the fundamentals about the data the system uses. The channels for this education include a website, interactive tutorials, pamphlets, and other technology

  2. A design process for using normative models in shared decision making: a case study in the context of prenatal testing.

    PubMed

    Rapaport, Sivan; Leshno, Moshe; Fink, Lior

    2014-12-01

    Shared decision making (SDM) encourages the patient to play a more active role in the process of medical consultation and its primary objective is to find the best treatment for a specific patient. Recent findings, however, show that patient preferences cannot be easily or accurately judged on the basis of communicative exchange during routine office visits, even for patients who seek to expand their role in medical decision making (MDM). The objective of this study is to improve the quality of patient-physician communication by developing a novel design process for SDM and then demonstrating, through a case study, the applicability of this process in enabling the use of a normative model for a specific medical situation. Our design process goes through the following stages: definition of medical situation and decision problem, development/identification of normative model, adaptation of normative model, empirical analysis and development of decision support systems (DSS) tools that facilitate the SDM process in the specific medical situation. This study demonstrates the applicability of the process through the implementation of the general normative theory of MDM under uncertainty for the medical-financial dilemma of choosing a physician to perform amniocentesis. The use of normative models in SDM raises several issues, such as the goal of the normative model, the relation between the goals of prediction and recommendation, and the general question of whether it is valid to use a normative model for people who do not behave according to the model's assumptions. © 2012 John Wiley & Sons Ltd.

  3. Multi-criteria decision analysis in conservation planning: Designing conservation area networks in San Diego County

    NASA Astrophysics Data System (ADS)

    MacDonald, Garrick Richard

    To limit biodiversity loss caused by human activity, conservation planning must protect biodiversity while considering socio-economic cost criteria. This research aimed to determine the effects of socio-economic criteria and spatial configurations on the development of CANs for three species with different distribution patterns, while simultaneously attempting to address the uncertainty and sensitivity of CANs produced by ConsNet. The socio-economic factors and spatial criteria included the cost of land, population density, agricultural output value, area, average cluster area, number of clusters, shape, and perimeter. Three sensitive mammal species with different distribution patterns were selected and included the Bobcat, Ringtail, and a custom created mammal distribution. Forty problems and the corresponding number of CANs were formulated and computed by running each predicted presence species model with and without the four different socioeconomic threshold groups at two different resolutions. Thirty-two percent less area was conserved after considering multiple socio-economic constraints and spatial configurations in comparison to CANs that did not consider multiple socio-economic constraints and spatial configurations. Without including socio-economic costs, ConsNet's ALL_CELLS heuristic solution was the highest ranking CAN. After considering multiple socio-economic costs, the number one ranking CAN was no longer the ALL_CELLS heuristic solution, but a spatially different meta-heuristic solution. The effects of multiple constraints and objectives on the design of CANs with different distribution patterns did not vary significantly across the criteria. The CANs produced by ConsNet appeared to demonstrate some uncertainty surrounding particular criteria, but did not demonstrate substantial uncertainty across all criteria used to rank the CANs. Similarly, the range of socio-economic criteria thresholds did not have a substantial impact. ConsNet was very

  4. Rational risk-based decision support for drinking water well managers by optimized monitoring designs

    NASA Astrophysics Data System (ADS)

    Enzenhöfer, R.; Geiges, A.; Nowak, W.

    2011-12-01

    Advection-based well-head protection zones are commonly used to manage the contamination risk of drinking water wells. Considering the insufficient knowledge about hazards and transport properties within the catchment, current Water Safety Plans recommend that catchment managers and stakeholders know, control and monitor all possible hazards within the catchments and perform rational risk-based decisions. Our goal is to supply catchment managers with the required probabilistic risk information, and to generate tools that allow for optimal and rational allocation of resources between improved monitoring versus extended safety margins and risk mitigation measures. To support risk managers with the indispensable information, we address the epistemic uncertainty of advective-dispersive solute transport and well vulnerability (Enzenhoefer et al., 2011) within a stochastic simulation framework. Our framework can separate between uncertainty of contaminant location and actual dilution of peak concentrations by resolving heterogeneity with high-resolution Monte-Carlo simulation. To keep computational costs low, we solve the reverse temporal moment transport equation. Only in post-processing, we recover the time-dependent solute breakthrough curves and the deduced well vulnerability criteria from temporal moments by non-linear optimization. Our first step towards optimal risk management is optimal positioning of sampling locations and optimal choice of data types to reduce best the epistemic prediction uncertainty for well-head delineation, using the cross-bred Likelihood Uncertainty Estimator (CLUE, Leube et al., 2011) for optimal sampling design. Better monitoring leads to more reliable and realistic protection zones and thus helps catchment managers to better justify smaller, yet conservative safety margins. In order to allow an optimal choice in sampling strategies, we compare the trade-off in monitoring versus the delineation costs by accounting for ill

  5. A universal hybrid decision tree classifier design for human activity classification.

    PubMed

    Chien, Chieh; Pottie, Gregory J

    2012-01-01

    A system that reliably classifies daily life activities can contribute to more effective and economical treatments for patients with chronic conditions or undergoing rehabilitative therapy. We propose a universal hybrid decision tree classifier for this purpose. The tree classifier can flexibly implement different decision rules at its internal nodes, and can be adapted from a population-based model when supplemented by training data for individuals. The system was tested using seven subjects each monitored by 14 triaxial accelerometers. Each subject performed fourteen different activities typical of daily life. Using leave-one-out cross validation, our decision tree produced average classification accuracies of 89.9%. In contrast, the MATLAB personalized tree classifiers using Gini's diversity index as the split criterion followed by optimally tuning the thresholds for each subject yielded 69.2%.

  6. Systems Analysis and Design for Decision Support Systems on Economic Feasibility of Projects

    NASA Astrophysics Data System (ADS)

    Balaji, S. Arun

    2010-11-01

    This paper discuss about need for development of the Decision Support System (DSS) software for economic feasibility of projects in Rwanda, Africa. The various economic theories needed and the corresponding formulae to compute payback period, internal rate of return and benefit cost ratio of projects are clearly given in this paper. This paper is also deals with the systems flow chart to fabricate the system in any higher level computing language. The various input requirements from the projects and the output needed for the decision makers are also included in this paper. The data dictionary used for input and output data structure is also explained.

  7. Factors influencing line officers' decisions about National Environmental Policy Act project design and development.

    Donald G. MacGregor; David N. Seesholtz

    2008-01-01

    Prior to the existence of the National Environmental Policy Act (NEPA), Forest Service district rangers had considerable latitude to make resource management decisions and execute management plans with relatively little encumbrance by documentation and process requirements. Today there appear to be differences not only in the district ranger population, but in the...

  8. Introducing Decision Making under Uncertainty and Strategic Considerations in Engineering Design

    ERIC Educational Resources Information Center

    Kosmopoulou, Georgia; Jog, Chintamani; Freeman, Margaret; Papavassiliou, Dimitrios V.

    2010-01-01

    Chemical Engineering graduates will face challenges at the workplace that even their peers who graduated a few years ago were not expected to face. One such major challenge is the management and operation of companies and plants under conditions of uncertainty and the need to make decisions in competitive situations. Modern developments in…

  9. Using a Regression Discontinuity Design to Estimate the Impact of Placement Decisions in Developmental Math

    ERIC Educational Resources Information Center

    Melguizo, Tatiana; Bos, Johannes M.; Ngo, Federick; Mills, Nicholas; Prather, George

    2016-01-01

    This study evaluates the effectiveness of math placement policies for entering community college students on these students' academic success in math. We estimate the impact of placement decisions by using a discrete-time survival model within a regression discontinuity framework. The primary conclusion that emerges is that initial placement in a…

  10. Design and Evaluation of Simulations for the Development of Complex Decision-Making Skills.

    ERIC Educational Resources Information Center

    Hartley, Roger; Varley, Glen

    2002-01-01

    Command and Control Training Using Simulation (CACTUS) is a computer digital mapping system used by police to manage large-scale public events. Audio and video records of adaptive training scenarios using CACTUS show how the simulation develops decision-making skills for strategic and tactical event management. (SK)

  11. DESIGN OF A DECISION SUPPORT SYSTEM FOR SELECTION AND PLACEMENT OF BMPS IN URBAN WATERSHEDS

    EPA Science Inventory

    The U.S. Environmental Protection Agency (USEPA) has funded the development of a decision support system for selection and placement of best management practices (BMPs) at strategic locations in urban watersheds. The primary objective of the system is to provide stormwater manag...

  12. The Process of Life Cycle Cost Analysis: Projecting Economic Consequences of Design Decisions

    ERIC Educational Resources Information Center

    AIA Journal, 1976

    1976-01-01

    Life-cycle cost analysis deals with both present and future costs and attempts to relate the two as a basis for making decisions. This article lays the groundwork for a better understanding of the techniques of life-cycle cost analysis. (Author/MLF)

  13. A Clinical Decision Support System for Integrating Tuberculosis and HIV Care in Kenya: A Human-Centered Design Approach

    PubMed Central

    Catalani, Caricia; Green, Eric; Owiti, Philip; Keny, Aggrey; Diero, Lameck; Yeung, Ada; Israelski, Dennis; Biondich, Paul

    2014-01-01

    With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context. PMID:25170939

  14. A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach.

    PubMed

    Catalani, Caricia; Green, Eric; Owiti, Philip; Keny, Aggrey; Diero, Lameck; Yeung, Ada; Israelski, Dennis; Biondich, Paul

    2014-01-01

    With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context.

  15. Study design and early result of a phase I study of SABR for early-stage glottic cancer.

    PubMed

    Yu, Tosol; Wee, Chan Woo; Choi, Noorie; Wu, Hong-Gyun; Kang, Hyun-Cheol; Park, Jong Min; Kim, Jung-In; Kim, Jin Ho; Kwon, Tack-Kyun; Chung, Eun-Jae

    2018-05-14

    Avoidance of organs at risk has become possible with advances in image-guided volumetric-modulated arc therapy (VMAT) techniques. This study was designed to evaluate the safety and feasibility of stereotactic ablative radiotherapy (SABR) for early stage glottic cancer. This report presents the preliminary result of the first and second dose level. Fraction size was increased from 3.5 gray (Gy) (total dose 59.5 Gy) to 9 Gy (total dose 45 Gy). Dose-limiting toxicities were defined as grade 3 or higher treatment-related toxicities. Voice outcome was assessed with electroglottography, and quality of life (QoL) was measured with the Head and Neck Cancer Inventory (HNCI). Seven patients received 59.5 Gy at 3.5 Gy per fraction as the first dose level, and five patients received 55 Gy at 5 Gy per fraction as the second dose level. None of the patients developed grade 3+ toxicity throughout a median follow-up of 17.5 months (range, 1.7-30.6 months). One patient in the second dose level recurred in the primary site at 4 months after radiotherapy (RT) and received total laryngectomy. The rest of participants were disease-free at locoregional and distant sites. Jitter, shimmer, mean phonation time, and noise-to-harmony ratio did not change significantly at 6 months after RT. HNCI scores between pretreatment and posttreatment were not significantly different (P = 0.221). This study revealed acceptable toxicity, voice outcome, and QoL in patients treated with hypofractionated VMAT of 3.5 Gy and 5 Gy per fraction. This phase I study is currently ongoing with a dose of 55 Gy in 11 fractions and 45 Gy in five fractions. 2b. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  16. The human early-life exposome (HELIX): project rationale and design.

    PubMed

    Vrijheid, Martine; Slama, Rémy; Robinson, Oliver; Chatzi, Leda; Coen, Muireann; van den Hazel, Peter; Thomsen, Cathrine; Wright, John; Athersuch, Toby J; Avellana, Narcis; Basagaña, Xavier; Brochot, Celine; Bucchini, Luca; Bustamante, Mariona; Carracedo, Angel; Casas, Maribel; Estivill, Xavier; Fairley, Lesley; van Gent, Diana; Gonzalez, Juan R; Granum, Berit; Gražulevičienė, Regina; Gutzkow, Kristine B; Julvez, Jordi; Keun, Hector C; Kogevinas, Manolis; McEachan, Rosemary R C; Meltzer, Helle Margrete; Sabidó, Eduard; Schwarze, Per E; Siroux, Valérie; Sunyer, Jordi; Want, Elizabeth J; Zeman, Florence; Nieuwenhuijsen, Mark J

    2014-06-01

    Developmental periods in early life may be particularly vulnerable to impacts of environmental exposures. Human research on this topic has generally focused on single exposure-health effect relationships. The "exposome" concept encompasses the totality of exposures from conception onward, complementing the genome. The Human Early-Life Exposome (HELIX) project is a new collaborative research project that aims to implement novel exposure assessment and biomarker methods to characterize early-life exposure to multiple environmental factors and associate these with omics biomarkers and child health outcomes, thus characterizing the "early-life exposome." Here we describe the general design of the project. In six existing birth cohort studies in Europe, HELIX will estimate prenatal and postnatal exposure to a broad range of chemical and physical exposures. Exposure models will be developed for the full cohorts totaling 32,000 mother-child pairs, and biomarkers will be measured in a subset of 1,200 mother-child pairs. Nested repeat-sampling panel studies (n = 150) will collect data on biomarker variability, use smartphones to assess mobility and physical activity, and perform personal exposure monitoring. Omics techniques will determine molecular profiles (metabolome, proteome, transcriptome, epigenome) associated with exposures. Statistical methods for multiple exposures will provide exposure-response estimates for fetal and child growth, obesity, neurodevelopment, and respiratory outcomes. A health impact assessment exercise will evaluate risks and benefits of combined exposures. HELIX is one of the first attempts to describe the early-life exposome of European populations and unravel its relation to omics markers and health in childhood. As proof of concept, it will form an important first step toward the life-course exposome.

  17. Decision analysis for designing marine protected areas for multiple species with uncertain fishery status.

    PubMed

    White, J Wilson; Botsford, Louis W; Moffitt, Elizabeth A; Fischer, Douglas T

    2010-09-01

    Marine protected areas (MPAs) are growing in popularity as a conservation tool, and there are increasing calls for additional MPAs. Meta-analyses indicate that most MPAs successfully meet the minimal goal of increasing biomass inside the MPA, while some do not, leaving open the important question of what makes MPAs successful. An often-overlooked aspect of this problem is that the success of fishery management outside MPA boundaries (i.e., whether a population is overfished) affects how well MPAs meet both conservation goals (e.g., increased biomass) and economic goals (e.g., minimal negative effects on fishery yield). Using a simple example of a system with homogeneous habitat and periodically spaced MPAs, we show that, as area in MPAs increases, (1) conservation value (biomass) may initially be zero, implying no benefit, then at some point increases monotonically; and (2) fishery yield may be zero, then increases monotonically to a maximum beyond which further increase in MPA area causes yield to decline. Importantly, the points at which these changes in slope occur vary among species and depend on management outside MPAs. Decision makers considering the effects of a potential system of MPAs on multiple species are confronted by a number of such cost-benefit curves, and it is usually impossible to maximize benefits and minimize costs for all species. Moreover, the precise shape of each curve is unknown due to uncertainty regarding the fishery status of each species. Here we describe a decision-analytic approach that incorporates existing information on fishery stock status to present decision makers with the range of likely outcomes of MPA implementation. To summarize results from many species whose overfishing status is uncertain, our decision-analysis approach involves weighted averages over both overfishing uncertainty and species. In an example from an MPA decision process in California, USA, an optimistic projection of future fishery management success led

  18. Cost-Utility of a Prognostic Test Guiding Adjuvant Chemotherapy Decisions in Early-Stage Non-Small Cell Lung Cancer.

    PubMed

    Stenehjem, David D; Bellows, Brandon K; Yager, Kraig M; Jones, Joshua; Kaldate, Rajesh; Siebert, Uwe; Brixner, Diana I

    2016-02-01

    A prognostic test was developed to guide adjuvant chemotherapy (ACT) decisions in early-stage non-small cell lung cancer (NSCLC) adenocarcinomas. The objective of this study was to compare the cost-utility of the prognostic test to the current standard of care (SoC) in patients with early-stage NSCLC. Lifetime costs (2014 U.S. dollars) and effectiveness (quality-adjusted life-years [QALYs]) of ACT treatment decisions were examined using a Markov microsimulation model from a U.S. third-party payer perspective. Cancer stage distribution and probability of receiving ACT with the SoC were based on data from an academic cancer center. The probability of receiving ACT with the prognostic test was estimated from a physician survey. Risk classification was based on the 5-year predicted NSCLC-related mortality. Treatment benefit with ACT was based on the prognostic score. Discounting at a 3% annual rate was applied to costs and QALYs. Deterministic one-way and probabilistic sensitivity analyses examined parameter uncertainty. Lifetime costs and effectiveness were $137,403 and 5.45 QALYs with the prognostic test and $127,359 and 5.17 QALYs with the SoC. The resulting incremental cost-effectiveness ratio for the prognostic test versus the SoC was $35,867/QALY gained. One-way sensitivity analyses indicated the model was most sensitive to the utility of patients without recurrence after ACT and the ACT treatment benefit. Probabilistic sensitivity analysis indicated the prognostic test was cost-effective in 65.5% of simulations at a willingness to pay of $50,000/QALY. The study suggests using a prognostic test to guide ACT decisions in early-stage NSCLC is potentially cost-effective compared with using the SoC based on globally accepted willingness-to-pay thresholds. Providing prognostic information to decision makers may help some patients with high-risk early stage non-small cell lung cancer receive appropriate adjuvant chemotherapy while avoiding the associated toxicities and

  19. DECISION SUPPORT SYSTEM TO ENHANCE AND ENCOURAGE SUSTAINABLE CHEMICAL PROCESS DESIGN

    EPA Science Inventory

    There is an opportunity to minimize the potential environmental impacts (PEIs) of industrial chemical processes by providing process designers with timely data nad models elucidating environmentally favorable design options. The second generation of the Waste Reduction (WAR) algo...

  20. Key Decision Points in the Careers of Geoscientists: The Role of the YES Network in Facilitating Successful Career Transitions for Early Career Geoscientists (Invited)

    NASA Astrophysics Data System (ADS)

    Venus, J. H.; Gonzales, L. M.; Yes Network

    2010-12-01

    The external influences on the decisions that geoscientists make pertaining to their careers are often assumed but not quantified. The YES Network is conducting an international study to determine the Key Decision points in the career pathways of early career geoscientists. The study aims to identify factors contributing to individual career decisions and to monitor these over a ten year period. The Initial phase of the study is now underway enabling preliminary conclusions to be drawn and will identify a group of individuals that will be tracked over the 10 year programme. The Survey will highlight reoccurring areas where Early Career Geoscientists are experiencing progression difficulties and, importantly, provide respondents with an opportunity to suggest solutions whilst also allowing general resource needs to be identified from the results as a whole. Early results show an overwhelming majority expressing job satisfaction most or all of the time (only 2 candidates reporting none). Respondents rate job satisfaction and respect highly, returning more responses than good salaries. A general frustration with administration, paper work and bureaucracy is particularly evident in those employed by government organisations. Early Career geoscientists express a frustration concerning a lack of involvement in decision making processes; interestingly several later career respondents also acknowledge a need to properly train, nurture and encourage new recruits to retain good graduates who may otherwise become disillusioned and leave the profession. The role of family in career choices has been highlighted both in survey and general feedback responses particularly by female geoscientists and those working in jobs with high levels of fieldwork; we aim to determine, to some extent, to what point these decisions are controlled by family as opposed to normal career progression. Flexible working conditions and agreed time away from field duty have been independently suggested

  1. Illuminating Tradespace Decisions Using Efficient Experimental Space-Filling Designs for the Engineered Resilient System Architecture

    DTIC Science & Technology

    2015-06-30

    7. Building Statistical Metamodels using Simulation Experimental Designs ............................................... 34 7.1. Statistical Design...system design drivers across several different domain models, our methodology uses statistical metamodeling to approximate the simulations’ behavior. A...output. We build metamodels using a number of statistical methods that include stepwise regression, boosted trees, neural nets, and bootstrap forest

  2. Illuminating Tradespace Decisions Using Efficient Experimental Space-Filling Designs for the Engineered Resilient System Architecture

    DTIC Science & Technology

    2015-06-01

    7. Building Statistical Metamodels using Simulation Experimental Designs ............................................... 34 7.1. Statistical Design...system design drivers across several different domain models, our methodology uses statistical metamodeling to approximate the simulations’ behavior. A...output. We build metamodels using a number of statistical methods that include stepwise regression, boosted trees, neural nets, and bootstrap forest

  3. Flexible design in water and wastewater engineering--definitions, literature and decision guide.

    PubMed

    Spiller, Marc; Vreeburg, Jan H G; Leusbrock, Ingo; Zeeman, Grietje

    2015-02-01

    Urban water and wastewater systems face uncertain developments including technological progress, climate change and urban development. To ensure the sustainability of these systems under dynamic conditions it has been proposed that technologies and infrastructure should be flexible, adaptive and robust. However, in literature it is often unclear what these technologies and infrastructure are. Furthermore, the terms flexible, adaptive and robust are often used interchangeably, despite important differences. In this paper we will i) define the terminology, ii) provide an overview of the status of flexible infrastructure design alternatives for water and wastewater networks and treatment, and iii) develop guidelines for the selection of flexible design alternatives. Results indicate that, with the exception of Net Present Valuation methods, there is little research available on the design and evaluation of technologies that can enable flexibility. Flexible design alternatives reviewed include robust design, phased design, modular design, modular/component platform design and design for remanufacturing. As developments in the water sector are driven by slow variables (climate change, urban development), rather than market forces, it is suggested that phased design or component platform designs are suitable for responding to change, while robust design is an option when operations face highly dynamic variability. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Design and evaluation of an imaging informatics system for analytics-based decision support in radiation therapy

    NASA Astrophysics Data System (ADS)

    Deshpande, Ruchi; DeMarco, John; Liu, Brent J.

    2015-03-01

    We have developed a comprehensive DICOM RT specific database of retrospective treatment planning data for radiation therapy of head and neck cancer. Further, we have designed and built an imaging informatics module that utilizes this database to perform data mining. The end-goal of this data mining system is to provide radiation therapy decision support for incoming head and neck cancer patients, by identifying best practices from previous patients who had the most similar tumor geometries. Since the performance of such systems often depends on the size and quality of the retrospective database, we have also placed an emphasis on developing infrastructure and strategies to encourage data sharing and participation from multiple institutions. The infrastructure and decision support algorithm have both been tested and evaluated with 51 sets of retrospective treatment planning data of head and neck cancer patients. We will present the overall design and architecture of our system, an overview of our decision support mechanism as well as the results of our evaluation.

  5. Decision aid on radioactive iodine treatment for early stage papillary thyroid cancer: update to study protocol with follow-up extension.

    PubMed

    Sawka, Anna M; Straus, Sharon; Rodin, Gary; Thorpe, Kevin E; Ezzat, Shereen; Gafni, Amiram; Goldstein, David P

    2015-07-14

    Patient decision aids (P-DAs) are used to inform patients about healthcare choices, but there is limited knowledge about their longer term effects, beyond the time period of decision-making. We developed a computerized P-DA that explains the choice of radioactive iodine (RAI) adjuvant treatment or no RAI, for patients with low risk papillary thyroid cancer after total thyroidectomy. The original protocol for a randomized controlled trial, comparing the use of the P-DA (with usual care) to usual care alone, has been published in Trials http://www.trialsjournal.com/content/11/1/81. We found that P-DA (with usual care) significantly improved patients' medical knowledge at the time of decision-making (primary outcome) compared to usual care alone (control). In this update, we present the protocol for an extended follow-up study (15 to 23 months post-randomization), including qualitative and quantitative methods. The patient outcomes evaluated using quantitative questionnaires include: the degree to which patients feel well-informed about their RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, mood, and trust in the treating physician. The qualitative component explores the experiences of RAI treatment decision-making, treatment satisfaction, and trial participation in a representative subgroup of patients. Extended follow-up study results will be described for the entire study population, and data will be compared between the P-DA and control groups. This mixed methods extended follow-up study will provide data on long term outcomes, relating to the use of a computerized P-DA in decision-making about adjuvant RAI treatment in early stage papillary thyroid cancer. Our results are intended to inform future research in this area, particularly relating to long term effects of the use of P-DAs in making healthcare choices. Clinicaltrials.gov identifier NCT01083550, registered 24 February 2010 and last updated 5 January 2015.

  6. Issues in the Design and Evaluation of Decision-Analytic Aids

    DTIC Science & Technology

    1984-01-01

    Ze! &rt s t.>.. address the issues -it each of the three interfaces DECISION-MAKIN!; ORGANIZATIN -- - -- - - -- ----------: USER DEAISID ’ in. I ENVI...user’s unique personal characteristics, and has no personal credibility in a leadership role. In order to maintain motivation and atten- tion, the...for selecting R&D projects was formally adopted but not used because the technique conflicted with the highly per- sonal leadership style of the

  7. Design Requirements for a Decision Support System for the Dynamic Retasking of Electronic Combat Assets.

    DTIC Science & Technology

    1988-03-01

    primary mission was not pursued. The question of the *t employment and retasking of EC assets is basically a question of command and control, though...The] primary function of command is deploying and maneuvering forces or other sources of potential power to be in the best possible position to...unstructured, and multivariable problem. Research Objective The primary objective of this research is to develop an initial set requirements for a decision

  8. Integration of the Response Surface Methodology with the Compromise Decision Support Problem in Developing a General Robust Design Procedure

    NASA Technical Reports Server (NTRS)

    Chen, Wei; Tsui, Kwok-Leung; Allen, Janet K.; Mistree, Farrokh

    1994-01-01

    In this paper we introduce a comprehensive and rigorous robust design procedure to overcome some limitations of the current approaches. A comprehensive approach is general enough to model the two major types of robust design applications, namely, robust design associated with the minimization of the deviation of performance caused by the deviation of noise factors (uncontrollable parameters), and robust design due to the minimization of the deviation of performance caused by the deviation of control factors (design variables). We achieve mathematical rigor by using, as a foundation, principles from the design of experiments and optimization. Specifically, we integrate the Response Surface Method (RSM) with the compromise Decision Support Problem (DSP). Our approach is especially useful for design problems where there are no closed-form solutions and system performance is computationally expensive to evaluate. The design of a solar powered irrigation system is used as an example. Our focus in this paper is on illustrating our approach rather than on the results per se.

  9. Development by Design in Colombia: Making Mitigation Decisions Consistent with Conservation Outcomes

    PubMed Central

    Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

    2013-01-01

    Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition. PMID:24339972

  10. Development by design in Colombia: making mitigation decisions consistent with conservation outcomes.

    PubMed

    Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

    2013-01-01

    Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition.

  11. Optimal cost-effective designs of Phase II proof of concept trials and associated go-no go decisions.

    PubMed

    Chen, Cong; Beckman, Robert A

    2009-01-01

    This manuscript discusses optimal cost-effective designs for Phase II proof of concept (PoC) trials. Unlike a confirmatory registration trial, a PoC trial is exploratory in nature, and sponsors of such trials have the liberty to choose the type I error rate and the power. The decision is largely driven by the perceived probability of having a truly active treatment per patient exposure (a surrogate measure to development cost), which is naturally captured in an efficiency score to be defined in this manuscript. Optimization of the score function leads to type I error rate and power (and therefore sample size) for the trial that is most cost-effective. This in turn leads to cost-effective go-no go criteria for development decisions. The idea is applied to derive optimal trial-level, program-level, and franchise-level design strategies. The study is not meant to provide any general conclusion because the settings used are largely simplified for illustrative purposes. However, through the examples provided herein, a reader should be able to gain useful insight into these design problems and apply them to the design of their own PoC trials.

  12. Comparative analysis of the conceptual design studies of potential early commercial MHD power plants (CSPEC)

    NASA Technical Reports Server (NTRS)

    Sovie, R. J.; Winter, J. M.; Juhasz, A. J.; Berg, R. D.

    1982-01-01

    A conceptual design study of the MHD/steam plant that incorporates the use of oxygen enriched air preheated in a metallic heat exchanger as the combustor oxidant showed that this plant is the most attractive for early commercial applications. The variation of performance and cost was investigated as a function of plant size. The contractors' results for the overall efficiencies are in reasonable agreement considering the slight differences in their plant designs. NASA LeRC is reviewing cost and performance results for consistency with those of previous studies, including studies of conventional steam plants. LeRC in house efforts show that there are still many tradeoffs to be considered for these oxygen enriched plants and considerable variations can be made in channel length and level of oxygen enrichment with little change in overall plant efficiency.

  13. On the Design of a Bioacoustic Sensor for the Early Detection of the Red Palm Weevil

    PubMed Central

    Rach, Miguel Martínez; Gomis, Héctor Migallón; Granado, Otoniel López; Malumbres, Manuel Perez; Campoy, Antonio Martí; Martín, Juan José Serrano

    2013-01-01

    During the last two decades Red Palm Weevil (RPW, Rynchophorus Ferrugineus) has become one of the most dangerous threats to palm trees in many parts of the World. Its early detection is difficult, since palm trees do not show visual evidence of infection until it is too late for them to recover. For this reason the development of efficient early detection mechanisms is a critical element of RPW pest management systems. One of the early detection mechanisms proposed in the literature is based on acoustic monitoring, as the activity of RPW larvae inside the palm trunk is audible for human operators under acceptable environmental noise levels (rural areas, night periods, etc.). In this work we propose the design of an autonomous bioacoustic sensor that can be installed in every palm tree under study and is able to analyze the captured audio signal during large periods of time. The results of the audio analysis would be reported wirelessly to a control station, to be subsequently processed and conveniently stored. That control station is to be accessible via the Internet. It is programmed to send warning messages when predefined alarm thresholds are reached, thereby allowing supervisors to check on-line the status and evolution of the palm tree orchards. We have developed a bioacoustic sensor prototype and performed an extensive set of experiments to measure its detection capability, achieving average detection rates over 90%. PMID:23364196

  14. Design of flood early warning system with wifi network based on smartphone

    NASA Astrophysics Data System (ADS)

    Supani, Ahyar; Andriani, Yuli; Taqwa, Ahmad

    2017-11-01

    Today, the development using internet of things enables activities surrounding us to be monitored, controlled, predicted and calculated remotely through connections to the internet network such as monitoring activities of long-distance flood warning with information technology. Applying an information technology in the field of flood early warning has been developed in the world, either connected to internet network or not. The internet network that has been done in this paper is the design of WiFi network to access data of rainfall, water level and flood status at any time with a smartphone coming from flood early warning system. The results obtained when test of data accessing with smartphone are in form of rainfall and water level graphs against time and flood status indicators consisting of 3 flood states: Standby 2, Standby 1 and Flood. It is concluded that data are from flood early warning system has been able to accessed and displayed on smartphone via WiFi network in any time and real time.

  15. On the design of a bioacoustic sensor for the early detection of the red palm weevil.

    PubMed

    Martínez Rach, Miguel; Migallón Gomis, Héctor; López Granado, Otoniel; Perez Malumbres, Manuel; Martí Campoy, Antonio; Serrano Martín, Juan José

    2013-01-30

    During the last two decades Red Palm Weevil (RPW, Rynchophorus Ferrugineus) has become one of the most dangerous threats to palm trees in many parts of the World. Its early detection is difficult, since palm trees do not show visual evidence of infection until it is too late for them to recover. For this reason the development of efficient early detection mechanisms is a critical element of RPW pest management systems. One of the early detection mechanisms proposed in the literature is based on acoustic monitoring, as the activity of RPW larvae inside the palm trunk is audible for human operators under acceptable environmental noise levels (rural areas, night periods, etc.). In this work we propose the design of an autonomous bioacoustic sensor that can be installed in every palm tree under study and is able to analyze the captured audio signal during large periods of time. The results of the audio analysis would be reported wirelessly to a control station, to be subsequently processed and conveniently stored. That control station is to be accessible via the Internet. It is programmed to send warning messages when predefined alarm thresholds are reached, thereby allowing supervisors to check on-line the status and evolution of the palm tree orchards. We have developed a bioacoustic sensor prototype and performed an extensive set of experiments to measure its detection capability, achieving average detection rates over 90%.

  16. Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

    PubMed

    Jones, Wallace; Drake, Cynthia; Mack, David; Reeder, Blaine; Trautner, Barbara; Wald, Heidi

    2017-06-20

    Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication

  17. Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer.

    PubMed

    Savelberg, Wilma; Moser, Albine; Smidt, Marjolein; Boersma, Liesbeth; Haekens, Christel; van der Weijden, Trudy

    2015-03-31

    The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients' informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. This paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid. This protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the implementation of SDM and a patient decision aid in terms of

  18. A pre-operative planning for endoprosthetic human tracheal implantation: a decision support system based on robust design of experiments.

    PubMed

    Trabelsi, O; Villalobos, J L López; Ginel, A; Cortes, E Barrot; Doblaré, M

    2014-05-01

    Swallowing depends on physiological variables that have a decisive influence on the swallowing capacity and on the tracheal stress distribution. Prosthetic implantation modifies these values and the overall performance of the trachea. The objective of this work was to develop a decision support system based on experimental, numerical and statistical approaches, with clinical verification, to help the thoracic surgeon in deciding the position and appropriate dimensions of a Dumon prosthesis for a specific patient in an optimal time and with sufficient robustness. A code for mesh adaptation to any tracheal geometry was implemented and used to develop a robust experimental design, based on the Taguchi's method and the analysis of variance. This design was able to establish the main swallowing influencing factors. The equations to fit the stress and the vertical displacement distributions were obtained. The resulting fitted values were compared to those calculated directly by the finite element method (FEM). Finally, a checking and clinical validation of the statistical study were made, by studying two cases of real patients. The vertical displacements and principal stress distribution obtained for the specific tracheal model were in agreement with those calculated by FE simulations with a maximum absolute error of 1.2 mm and 0.17 MPa, respectively. It was concluded that the resulting decision support tool provides a fast, accurate and simple tool for the thoracic surgeon to predict the stress state of the trachea and the reduction in the ability to swallow after implantation. Thus, it will help them in taking decisions during pre-operative planning of tracheal interventions.

  19. Design of early warning system for nuclear preparedness case study at Serpong

    NASA Astrophysics Data System (ADS)

    Farid, M. M.; Prawito, Susila, I. P.; Yuniarto, A.

    2017-07-01

    One effort to protect the environment from the increasing of potentially environmental radiation hazards as an impact of radiation discharge around nuclear facilities is by a continuous monitoring of the environmental radiation in real time It is important to disclose the dose rate information to public or authorities for radiological protection. In this research, we have designed a nuclear preparedness early warning system around the Serpong nuclear facility. The design is based on Arduino program, general packet radio service (GPRS) shield, and radio frequencies technology to transmit environmental radiation result of the measurement and meteorological data. Data was collected at a certain location at The Center for Informatics and Nuclear Strategic Zone Utilization BATAN Serpong. The system consistency models are defined by the quality of data and the level of radiation exposure in the deployed environment. Online users can access the website which displays the radiation dose on the environment marked on Google Map. This system is capable to issue an early warning emergency when the dose reaches three times of the background radiation exposure value, 250 nSv/hour.

  20. Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design.

    PubMed

    Zeeman, Heidi; Kendall, Elizabeth; Whitty, Jennifer A; Wright, Courtney J; Townsend, Clare; Smith, Dianne; Lakhani, Ali; Kennerley, Samantha

    2016-03-15

    Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing

  1. Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care--systematic decision aid development and study protocol.

    PubMed

    Yu, Catherine H; Stacey, Dawn; Sale, Joanna; Hall, Susan; Kaplan, David M; Ivers, Noah; Rezmovitz, Jeremy; Leung, Fok-Han; Shah, Baiju R; Straus, Sharon E

    2014-01-22

    process, the toolkit will be refined through several iterative cycles of feedback and redesign. Interprofessional shared decision-making regarding priority-setting with the use of a decision aid toolkit may help prioritize care of individuals with multiple comorbid conditions. Adhering to principles of user-centered design, we will develop and refine a toolkit to assess the feasibility of this approach.

  2. Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care - systematic decision aid development and study protocol

    PubMed Central

    2014-01-01

    refinement: Throughout the development process, the toolkit will be refined through several iterative cycles of feedback and redesign. Discussion Interprofessional shared decision-making regarding priority-setting with the use of a decision aid toolkit may help prioritize care of individuals with multiple comorbid conditions. Adhering to principles of user-centered design, we will develop and refine a toolkit to assess the feasibility of this approach. PMID:24450385

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

    PubMed

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

    2013-03-06

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

  4. Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents: Stakeholder Engagement in the Design of Web-Based Decision Aids.

    PubMed

    Wysocki, Tim; Hirschfeld, Fiona; Miller, Louis; Izenberg, Neil; Dowshen, Steven A; Taylor, Alex; Milkes, Amy; Shinseki, Michelle T; Bejarano, Carolina; Kozikowski, Chelsea; Kowal, Karen; Starr-Ashton, Penny; Ross, Judith L; Kummer, Mark; Carakushansky, Mauri; Lyness, D'Arcy; Brinkman, William; Pierce, Jessica; Fiks, Alexander; Christofferson, Jennifer; Rafalko, Jessica; Lawson, Margaret L

    2016-08-01

    This article describes the stakeholder-driven design, development, and testing of web-based, multimedia decision aids for youth with type 1 diabetes who are considering the insulin pump or continuous glucose monitoring and their parents. This is the initial phase of work designed to develop and evaluate the efficacy of these decision aids in promoting improved decision-making engagement with use of a selected device. Qualitative interviews of 36 parents and adolescents who had previously faced these decisions and 12 health care providers defined the content, format and structure of the decision aids. Experts in children's health media helped the research team to plan, create, and refine multimedia content and its presentation. A web development firm helped organize the content into a user-friendly interface and enabled tracking of decision aid utilization. Throughout, members of the research team, adolescents, parents, and 3 expert consultants offered perspectives about the website content, structure, and function until the design was complete. With the decision aid websites completed, the next phase of the project is a randomized controlled trial of usual clinical practice alone or augmented by use of the decision aid websites. Stakeholder-driven development of multimedia, web-based decision aids requires meticulous attention to detail but can yield exceptional resources for adolescents and parents contemplating major changes to their diabetes regimens. © 2016 The Author(s).

  5. Visual Analysis as a design and decision-making tool in the development of a quarry

    Randall Boyd Fitzgerald

    1979-01-01

    In order to obtain local and state government approvals, an environmental impact analysis of the mining and reclamation of a proposed hard rock quarry was required. High visibility of the proposed mining area from the adjacent community required a visual impact analysis in the planning and design of the project. The Visual Analysis defined design criteria for the...

  6. A Comparative Study of GDSS (Group Decision Support System) Use: Empirical Evidence and Model Design

    DTIC Science & Technology

    1987-09-01

    G D SS ............................................... 67 APPENDIX A: ENERGY INTERNATIONAL CASE ...................... 69 APPENDIX B: QUESTIONNAIRE...the impact of many of the disadvantages. C. DESIRABLE CHARACTERISTICS OF A GDSS The designer of a GDSS must consider the major functional requirements...592]. Alter has stated that interaction with the GDSS is not the most important aspect of the system. Instead, designers should direct their energies

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

    NASA Astrophysics Data System (ADS)

    Rosenberg, D. E.

    2008-12-01

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

  8. The development of moral emotions and decision-making from adolescence to early adulthood: a 6-year longitudinal study.

    PubMed

    Krettenauer, Tobias; Colasante, Tyler; Buchmann, Marlis; Malti, Tina

    2014-04-01

    Adolescents' emotions in the context of moral decision-making repeatedly have been shown to predict actual behaviour. However, little systematic information on developmental change regarding these emotion expectancies has been available thus far. This longitudinal study investigated anticipated moral emotions and decision-making between the ages of 15 and 21 in a representative sample of Swiss adolescents (N = 1,258; 54 % female; M = 15.30 years). Anticipated moral emotions and decision-making were assessed through a semi-structured interview procedure. Using Bernoulli hierarchical linear modeling, it was found that positive feelings after a moral transgression (i.e., "happy victimizer" responses) decreased over time, whereas positive feelings after a moral decision (i.e., "happy moralist" responses) increased. However, this pattern was contingent upon the moral scenario presented. Systematic relationships between anticipated moral emotions and moral personality characteristics of sympathy, conscientiousness, and agreeableness were found, even when controlling for socio-demographic characteristics and cognitive ability. Overall, this study demonstrates that the development of anticipated moral emotions is not limited to childhood. Furthermore, our findings suggest that moral emotions serve as an important link between moral personality development and decision-making processes that are more proximal to everyday moral behavior.

  9. Application of Decision Tree on Collision Avoidance System Design and Verification for Quadcopter

    NASA Astrophysics Data System (ADS)

    Chen, C.-W.; Hsieh, P.-H.; Lai, W.-H.

    2017-08-01

    The purpose of the research is to build a collision avoidance system with decision tree algorithm used for quadcopters. While the ultrasonic range finder judges the distance is in collision avoidance interval, the access will be replaced from operator to the system to control the altitude of the UAV. According to the former experiences on operating quadcopters, we can obtain the appropriate pitch angle. The UAS implement the following three motions to avoid collisions. Case1: initial slow avoidance stage, Case2: slow avoidance stage and Case3: Rapid avoidance stage. Then the training data of collision avoidance test will be transmitted to the ground station via wireless transmission module to further analysis. The entire decision tree algorithm of collision avoidance system, transmission data, and ground station have been verified in some flight tests. In the flight test, the quadcopter can implement avoidance motion in real-time and move away from obstacles steadily. In the avoidance area, the authority of the collision avoidance system is higher than the operator and implements the avoidance process. The quadcopter can successfully fly away from the obstacles in 1.92 meter per second and the minimum distance between the quadcopter and the obstacle is 1.05 meters.

  10. SFINX-a drug-drug interaction database designed for clinical decision support systems.

    PubMed

    Böttiger, Ylva; Laine, Kari; Andersson, Marine L; Korhonen, Tuomas; Molin, Björn; Ovesjö, Marie-Louise; Tirkkonen, Tuire; Rane, Anders; Gustafsson, Lars L; Eiermann, Birgit

    2009-06-01

    The aim was to develop a drug-drug interaction database (SFINX) to be integrated into decision support systems or to be used in website solutions for clinical evaluation of interactions. Key elements such as substance properties and names, drug formulations, text structures and references were defined before development of the database. Standard operating procedures for literature searches, text writing rules and a classification system for clinical relevance and documentation level were determined. ATC codes, CAS numbers and country-specific codes for substances were identified and quality assured to ensure safe integration of SFINX into other data systems. Much effort was put into giving short and practical advice regarding clinically relevant drug-drug interactions. SFINX includes over 8,000 interaction pairs and is integrated into Swedish and Finnish computerised decision support systems. Over 31,000 physicians and pharmacists are receiving interaction alerts through SFINX. User feedback is collected for continuous improvement of the content. SFINX is a potentially valuable tool delivering instant information on drug interactions during prescribing and dispensing.

  11. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road.

    PubMed

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on "on-demand payment" for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible.

  12. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road

    PubMed Central

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on “on-demand payment” for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible. PMID:26230400

  13. Design of a decision-support architecture for management of remotely monitored patients.

    PubMed

    Basilakis, Jim; Lovell, Nigel H; Redmond, Stephen J; Celler, Branko G

    2010-09-01

    Telehealth is the provision of health services at a distance. Typically, this occurs in unsupervised or remote environments, such as a patient's home. We describe one such telehealth system and the integration of extracted clinical measurement parameters with a decision-support system (DSS). An enterprise application-server framework, combined with a rules engine and statistical analysis tools, is used to analyze the acquired telehealth data, searching for trends and shifts in parameter values, as well as identifying individual measurements that exceed predetermined or adaptive thresholds. An overarching business process engine is used to manage the core DSS knowledge base and coordinate workflow outputs of the DSS. The primary role for such a DSS is to provide an effective means to reduce the data overload and to provide a means of health risk stratification to allow appropriate targeting of clinical resources to best manage the health of the patient. In this way, the system may ultimately influence changes in workflow by targeting scarce clinical resources to patients of most need. A single case study extracted from an initial pilot trial of the system, in patients with chronic obstructive pulmonary disease and chronic heart failure, will be reviewed to illustrate the potential benefit of integrating telehealth and decision support in the management of both acute and chronic disease.

  14. Early Experience with a Short, Tapered Titanium Porous Plasma Sprayed Stem with Updated Design.

    PubMed

    Lombardi, Adolph V; Manocchio, Antonio G; Berend, Keith R; Morris, Michael J; Adams, Joanne B

    2018-06-01

    Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up. Mean patient age at surgery was 63.2 years and body mass index (BMI) was 30.8 kg/m2. Mean stem length used was 110.3mm (range, 95-125). Mean follow-up was 4.5 years (2-6). Harris hip scores improved from 52.5 preoperatively to 84.7 at most recent. One stem was revised the same day for periprosthetic fracture. One patient with early infection was treated with single-stage exchange followed by recurrence that was treated successfully with two-stage exchange. A non-healing wound in one patient was treated with incision and debridement. Radiographic assessment demonstrated no evidence of loosening, osteolysis, distal hypertrophy, or pedestal formation in any hip, and all components appeared well fixed and in appropriate alignment. In this series of patients treated with primary THA using a short, tapered titanium porous plasma-sprayed femoral component with updated design features, good results were achieved with a low incidence of complications and revision. No aseptic loosening or osteolysis has occurred. Radiographic assessment was excellent for all patients.

  15. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  16. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  17. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  18. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  19. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  20. Decision Support System for Coastal Protection Layout Design (DSS4CPD) Using Genetic Algorithm (ga) and Multicriteria Analysis (mca)

    NASA Astrophysics Data System (ADS)

    Jinchai, Phinai; Chittaladakorn, Suwatana

    This research has its objective to develop the decision support system on GIS to be used in the coastal erosion protection management. The developed model in this research is called Decision Support System for Coastal Protection Layout Design (DSS4CPD). It has created both for systematic protection and solution measures to the problem by using Genetic Algorithm (GA) and Multicriteria Analysis (MCA) for finding the coastal structure layout optimal solution. In this research, three types of coastal structures were used as structure alternatives for the layout, which are seawall, breakwater, and groin. The coastal area in Nakornsrithammaraj, Thailand was used as the case study. The studied result has found the appropriate position of coastal structures considering the suitable rock size relied on the wave energy, and the appropriate coastal structure position based on the wave breaking line. Using GA and MCA in DSS4CPD, it found the best layout in this project. This DSS4CPD will be used by the authorized decision makers to find the most suitable erosion problem solution.

  1. Design and Development of a Sharable Clinical Decision Support System Based on a Semantic Web Service Framework.

    PubMed

    Zhang, Yi-Fan; Gou, Ling; Tian, Yu; Li, Tian-Chang; Zhang, Mao; Li, Jing-Song

    2016-05-01

    Clinical decision support (CDS) systems provide clinicians and other health care stakeholders with patient-specific assessments or recommendations to aid in the clinical decision-making process. Despite their demonstrated potential for improving health care quality, the widespread availability of CDS systems has been limited mainly by the difficulty and cost of sharing CDS knowledge among heterogeneous healthcare information systems. The purpose of this study was to design and develop a sharable clinical decision support (S-CDS) system that meets this challenge. The fundamental knowledge base consists of independent and reusable knowledge modules (KMs) to meet core CDS needs, wherein each KM is semantically well defined based on the standard information model, terminologies, and representation formalisms. A semantic web service framework was developed to identify, access, and leverage these KMs across diverse CDS applications and care settings. The S-CDS system has been validated in two distinct client CDS applications. Model-level evaluation results confirmed coherent knowledge representation. Application-level evaluation results reached an overall accuracy of 98.66 % and a completeness of 96.98 %. The evaluation results demonstrated the technical feasibility and application prospect of our approach. Compared with other CDS engineering efforts, our approach facilitates system development and implementation and improves system maintainability, scalability and efficiency, which contribute to the widespread adoption of effective CDS within the healthcare domain.

  2. Confirmatory versus explorative endpoint analysis: Decision-making on the basis of evidence available from market authorization and early benefit assessment for oncology drugs.

    PubMed

    Niehaus, Ines; Dintsios, Charalabos-Markos

    2018-06-01

    The early benefit assessment of pharmaceuticals in Germany and their preceding market authorization pursue different objectives. This is reflected by the inclusion of varying confirmatory endpoints within the evaluation of oncology drugs in early benefit assessment versus market authorization, with both relying on the same evidence. Data from assessments up to July 2015 are used to estimate the impact of explorative in comparison to confirmatory endpoints on market authorization and early benefit assessment by contrasting the benefit-risk ratio of EMA and the benefit-harm balance of the HTA jurisdiction. Agreement between market authorization and early benefit assessment is examined by Cohen's kappa (k). 21 of 41 assessments were considered in the analysis. Market authorization is more confirmatory than early benefit assessment because it includes a higher proportion of primary endpoints. The latter implies a primary endpoint to be relevant for the benefit-harm balance in only 67% of cases (0.078). Explorative mortality endpoints reached the highest agreement regarding the mutual consideration for the risk-benefit ratio and the benefit-harm balance (0.000). For explorative morbidity endpoints (-0.600), quality of life (-0.600) and side effects (-0.949) no agreement is ascertainable. To warrant a broader confirmatory basis for decisions supported by HTA, closer inter-institutional cooperation of approval authorities and HTA jurisdictions by means of reliable joint advice for manufacturers regarding endpoint definition would be favorable. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. [Application of decision curve on evaluation of MRI predictive model for early assessing pathological complete response to neoadjuvant therapy in breast cancer].

    PubMed

    He, Y J; Li, X T; Fan, Z Q; Li, Y L; Cao, K; Sun, Y S; Ouyang, T

    2018-01-23

    Objective: To construct a dynamic enhanced MR based predictive model for early assessing pathological complete response (pCR) to neoadjuvant therapy in breast cancer, and to evaluate the clinical benefit of the model by using decision curve. Methods: From December 2005 to December 2007, 170 patients with breast cancer treated with neoadjuvant therapy were identified and their MR images before neoadjuvant therapy and at the end of the first cycle of neoadjuvant therapy were collected. Logistic regression model was used to detect independent factors for predicting pCR and construct the predictive model accordingly, then receiver operating characteristic (ROC) curve and decision curve were used to evaluate the predictive model. Results: ΔArea(max) and Δslope(max) were independent predictive factors for pCR, OR =0.942 (95% CI : 0.918-0.967) and 0.961 (95% CI : 0.940-0.987), respectively. The area under ROC curve (AUC) for the constructed model was 0.886 (95% CI : 0.820-0.951). Decision curve showed that in the range of the threshold probability above 0.4, the predictive model presented increased net benefit as the threshold probability increased. Conclusions: The constructed predictive model for pCR is of potential clinical value, with an AUC>0.85. Meanwhile, decision curve analysis indicates the constructed predictive model has net benefit from 3 to 8 percent in the likely range of probability threshold from 80% to 90%.

  4. Clinical utility of gene expression profiling data for clinical decision-making regarding adjuvant therapy in early stage, node-negative breast cancer: a case report.

    PubMed

    Schuster, Steven R; Pockaj, Barbara A; Bothe, Mary R; David, Paru S; Northfelt, Donald W

    2012-09-10

    Breast cancer is the most common malignancy among women in the United States with the second highest incidence of cancer-related death following lung cancer. The decision-making process regarding adjuvant therapy is a time intensive dialogue between the patient and her oncologist. There are multiple tools that help individualize the treatment options for a patient. Population-based analysis with Adjuvant! Online and genomic profiling with Oncotype DX are two commonly used tools in patients with early stage, node-negative breast cancer. This case report illustrates a situation in which the population-based prognostic and predictive information differed dramatically from that obtained from genomic profiling and affected the patient's decision. In light of this case, we discuss the benefits and limitations of these tools.

  5. Compatibility and consistency in display-control systems - Implications for aircraft decision aid design

    NASA Technical Reports Server (NTRS)

    Andre, Anthony D.; Wickens, Christopher D.

    1992-01-01

    In this study we contrast display-control movement relations defined in terms of stimulus-response (physical) compatibility with those defined by stimulus-cognitive compatibility, and we relate these findings to the issue of command versus status levels of decision aid support. A second issue addressed is the cost of inconsistency across multiple display-control mappings. Subjects performed a flight control task while responding to one to four analog indicators, formatted as either command or status displays. The results suggest that there is an advantage for the status format when subjects are required to verbally report the state of the indicator(s), but no advantage was found for either format when subjects were required to manually correct the indicated state. The data point to the importance of display-control consistency and suggest that it may even outweigh that of compatibility.

  6. Design and implementation of expert decision system in Yellow River Irrigation

    NASA Astrophysics Data System (ADS)

    Fuping, Wang; Bingbing, Lei; Jie, Pan

    2018-03-01

    How to make full use of water resources in the Yellow River irrigation is a problem needed to be solved urgently. On account of the different irrigation strategies in various growth stages of wheat, this paper proposes a novel irrigation expert decision system basing on fuzzy control technique. According to the control experience, expert knowledge and MATLAB simulation optimization, we obtain the irrigation fuzzy control table stored in the computer memory. The controlling irrigation is accomplished by reading the data from fuzzy control table. The experimental results show that the expert system can be used in the production of wheat to achieve timely and appropriate irrigation, and ensure that wheat growth cycle is always in the best growth environment.

  7. Early Validation of Failure Detection, Isolation, and Recovery Design Using Heterogeneous Modelling and Simulation

    NASA Astrophysics Data System (ADS)

    van der Plas, Peter; Guerriero, Suzanne; Cristiano, Leorato; Rugina, Ana

    2012-08-01

    Modelling and simulation can support a number of use cases across the spacecraft development life-cycle. Given the increasing complexity of space missions, the observed general trend is for a more extensive usage of simulation already in the early phases. A major perceived advantage is that modelling and simulation can enable the validation of critical aspects of the spacecraft design before the actual development is started, as such reducing the risk in later phases.Failure Detection, Isolation, and Recovery (FDIR) is one of the areas with a high potential to benefit from early modelling and simulation. With the increasing level of required spacecraft autonomy, FDIR specifications can grow in such a way that the traditional document-based review process soon becomes inadequate.This paper shows that FDIR modelling and simulation in a system context can provide a powerful tool to support the FDIR verification process. It is highlighted that FDIR modelling at this early stage requires heterogeneous modelling tools and languages, in order to provide an adequate functional description of the different components (i.e. FDIR functions, environment, equipment, etc.) to be modelled.For this reason, an FDIR simulation framework is proposed in this paper. This framework is based on a number of tools already available in the Avionics Systems Laboratory at ESTEC, which are the Avionics Test Bench Functional Engineering Simulator (ATB FES), Matlab/Simulink, TASTE, and Real Time Developer Studio (RTDS).The paper then discusses the application of the proposed simulation framework to a real case-study, i.e. the FDIR modelling of a satellite in support of actual ESA mission. Challenges and benefits of the approach are described. Finally, lessons learned and the generality of the proposed approach are discussed.

  8. Predicting Early Death Among Elderly Dialysis Patients: Development and Validation of a Risk Score to Assist Shared Decision Making for Dialysis Initiation.

    PubMed

    Thamer, Mae; Kaufman, James S; Zhang, Yi; Zhang, Qian; Cotter, Dennis J; Bang, Heejung

    2015-12-01

    A shared decision-making tool could help elderly patients with advanced chronic kidney disease decide about initiating dialysis therapy. Because mortality may be high in the first few months after initiating dialysis therapy, incorporating early mortality predictors in such a tool would be important for an informed decision. Our objective is to derive and validate a predictive risk score for early mortality after initiating dialysis therapy. Retrospective observational cohort, with development and validation cohorts. US Renal Data System and claims data from the Centers for Medicare & Medicaid Services for 69,441 (aged ≥67 years) patients with end-stage renal disease with a previous 2-year Medicare history who initiated dialysis therapy from January 1, 2009, to December 31, 2010. Demographics, predialysis care, laboratory data, functional limitations, and medical history. All-cause mortality in the first 3 and 6 months. Predicted mortality by logistic regression. The simple risk score (total score, 0-9) included age (0-3 points), low albumin level, assistance with daily living, nursing home residence, cancer, heart failure, and hospitalization (1 point each), and showed area under the receiver operating characteristic curve (AUROC)=0.69 in the validation sample. A comprehensive risk score with additional predictors was also developed (with AUROC=0.72, high concordance between predicted vs observed risk). Mortality probabilities were estimated from these models, with the median score of 3 indicating 12% risk in 3 months and 20% in 6 months, and the highest scores (≥8) indicating 39% risk in 3 months and 55% in 6 months. Patients who did not choose dialysis therapy and did not have a 2-year Medicare history were excluded. Routinely available information can be used by patients with chronic kidney disease, families, and their nephrologists to estimate the risk of early mortality after dialysis therapy initiation, which may facilitate informed decision making

  9. An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

    PubMed

    Toonstra, Amy L; Nelliot, Archana; Aronson Friedman, Lisa; Zanni, Jennifer M; Hodgson, Carol; Needham, Dale M

    2017-06-01

    Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session. Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline. An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

  10. Treatment decisions and the impact of adverse events before and during extended endocrine therapy in postmenopausal early breast cancer.

    PubMed

    Blok, Erik J; Kroep, Judith R; Meershoek-Klein Kranenbarg, Elma; Duijm-de Carpentier, Marjolijn; Putter, Hein; Liefers, Gerrit-Jan; Nortier, Johan W R; Rutgers, Emiel J Th; Seynaeve, Caroline M; van de Velde, Cornelis J H

    2018-05-01

    Extended endocrine therapy beyond 5 years for postmenopausal breast cancer has been studied within multiple phase III trials. Treatment compliance in these trials is generally poor. In this analysis, we aimed to determine factors that were associated with participation in the phase III Investigation on the Duration of Extended Adjuvant Letrozole (IDEAL) trial and with early treatment discontinuation, and how this influenced survival outcome. In the IDEAL trial, postmenopausal patients were randomised between 2.5 or 5 years of extended letrozole, after completing 5 years of endocrine therapy for hormone receptor-positive early breast cancer. A subgroup of this population participated earlier in the Tamoxifen Exemestane Adjuvant Multinational trial (5 years of exemestane or 2.5 years of tamoxifen followed by exemestane as primary adjuvant therapy) in which we explored which factors were determinative for enrolment in the IDEAL study. In the IDEAL cohort, we evaluated which factors predicted for early treatment discontinuation and the effect of early treatment discontinuation on disease-free survival (DFS). Nodal status, younger age and adjuvant chemotherapy were significantly associated with higher enrolment in the IDEAL trial. In the IDEAL cohort, adverse events (AEs), the type of primary endocrine therapy and the interval between primary and extended therapy were associated with early treatment discontinuation. Among the reported AEs, depressive feelings (56%) were most frequently associated with early treatment discontinuation. Early treatment discontinuation was not associated with worse DFS (hazard ratio [HR] = 1.02, 95% confidence interval = 0.76-1.37). In this analysis, we found that risk factors were most strongly associated enrolment in the IDEAL trial. In contrast, patient experiences were the most significant factors leading to early treatment discontinuation, with no effect on DFS. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Conceptual Plural Information Is Used to Guide Early Parsing Decisions: Evidence from Garden-Path Sentences with Reciprocal Verbs

    ERIC Educational Resources Information Center

    Patson, Nikole D.; Ferreira, Fernanda

    2009-01-01

    In three eyetracking studies, we investigated the role of conceptual plurality in initial parsing decisions in temporarily ambiguous sentences with reciprocal verbs (e.g., "While the lovers kissed the baby played alone"). We varied the subject of the first clause using three types of plural noun phrases: conjoined noun phrases ("the bride and the…

  12. Youth Activity Involvement, Neighborhood Adult Support, Individual Decision Making Skills, and Early Adolescent Delinquent Behaviors: Testing a Conceptual Model

    ERIC Educational Resources Information Center

    Crean, Hugh F.

    2012-01-01

    This study examines a cross-sectional structural equation model of participation in youth activities, neighborhood adult support, individual decision making skills, and delinquent behavior in urban middle school youths (n = 2611). Results indicate extracurricular activity participation had both direct and indirect associations with delinquent…

  13. Perceived Costs of Combining Career and Family Roles: The Influence of Early Family History on Adult Role Decisions.

    ERIC Educational Resources Information Center

    Berson, Janet S.

    This study attempts to clarify part of the decision-making process centering around combining family and career. There are two aspects of the study. In the first, perceived costs of combining roles are assessed and evaluated in light of mother's employment history. The subjects in this part of the study were 141 single women and 43 married women.…

  14. Adaptation of the quality by design concept in early pharmaceutical development of an intranasal nanosized formulation.

    PubMed

    Pallagi, Edina; Ambrus, Rita; Szabó-Révész, Piroska; Csóka, Ildikó

    2015-08-01

    Regulatory science based pharmaceutical development and product manufacturing is highly recommended by the authorities nowadays. The aim of this study was to adapt regulatory science even in the nano-pharmaceutical early development. Authors applied the quality by design (QbD) concept in the early development phase of nano-systems, where the illustration material was meloxicam. The meloxicam nanoparticles produced by co-grinding method for nasal administration were studied according to the QbD policy and the QbD based risk assessment (RA) was performed. The steps were implemented according to the relevant regulatory guidelines (quality target product profile (QTPP) determination, selection of critical quality attributes (CQAs) and critical process parameters (CPPs)) and a special software (Lean QbD Software(®)) was used for the RA, which represents a novelty in this field. The RA was able to predict and identify theoretically the factors (e.g. sample composition, production method parameters, etc.) which have the highest impact on the desired meloxicam-product quality. The results of the practical research justified the theoretical prediction. This method can improve pharmaceutical nano-developments by achieving shorter development time, lower cost, saving human resource efforts and more effective target-orientation. It makes possible focusing the resources on the selected parameters and area during the practical product development. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Analytical and CASE study on Limited Search, ID3, CHAID, C4.5, Improved C4.5 and OVA Decision Tree Algorithms to design Decision Support System

    NASA Astrophysics Data System (ADS)

    Kaur, Parneet; Singh, Sukhwinder; Garg, Sushil; Harmanpreet

    2010-11-01

    In this paper we study about classification algorithms for farm DSS. By applying classification algorithms i.e. Limited search, ID3, CHAID, C4.5, Improved C4.5 and One VS all Decision Tree on common data set of crop with specified class, results are obtained. The tool used to derive results is SPINA. The graphical results obtained from tool are compared to suggest best technique to develop farm Decision Support System. This analysis would help to researchers to design effective and fast DSS for farmer to take decision for enhancing their yield.

  16. Teaching clinical reasoning and decision-making skills to nursing students: Design, development, and usability evaluation of a serious game.

    PubMed

    Johnsen, Hege Mari; Fossum, Mariann; Vivekananda-Schmidt, Pirashanthie; Fruhling, Ann; Slettebø, Åshild

    2016-10-01

    Serious games (SGs) are a type of simulation technology that may provide nursing students with the opportunity to practice their clinical reasoning and decision-making skills in a safe and authentic environment. Despite the growing number of SGs developed for healthcare professionals, few SGs are video based or address the domain of home health care. This paper aims to describe the design, development, and usability evaluation of a video based SG for teaching clinical reasoning and decision-making skills to nursing students who care for patients with chronic obstructive pulmonary disease (COPD) in home healthcare settings. A prototype SG was developed. A unified framework of usability called TURF (Task, User, Representation, and Function) and SG theory were employed to ensure a user-centered design. The educational content was based on the clinical decision-making model, Bloom's taxonomy, and a Bachelor of Nursing curriculum. A purposeful sample of six participants evaluated the SG prototype in a usability laboratory. Cognitive walkthrough evaluations, a questionnaire, and individual interviews were used for the usability evaluation. The data were analyzed using qualitative deductive content analysis based on the TURF framework elements and related usability heuristics. The SG was perceived as being realistic, clinically relevant, and at an adequate level of complexity for the intended users. Usability issues regarding functionality and the user-computer interface design were identified. However, the SG was perceived as being easy to learn, and participants suggested that the SG could serve as a supplement to traditional training in laboratory and clinical settings. Using video based scenarios with an authentic COPD patient and a home healthcare registered nurse as actors contributed to increased realism. Using different theoretical approaches in the SG design was considered an advantage of the design process. The SG was perceived as being useful, usable, and

  17. The role of integrating natural and social science concepts for risk governance and the design of people-centred early warning systems. Case study from the German-Indonesian Tsunami Early Warning System Project (GITEWS)

    NASA Astrophysics Data System (ADS)

    Gebert, Niklas; Post, Joachim

    2010-05-01

    The development of early warning systems are one of the key domains of adaptation to global environmental change and contribute very much to the development of societal reaction and adaptive capacities to deal with extreme events. Especially, Indonesia is highly exposed to tsunami. In average every three years small and medium size tsunamis occur in the region causing damage and death. In the aftermath of the Indian Ocean Tsunami 2004, the German and Indonesian government agreed on a joint cooperation to develop a People Centered End-to-End Early Warning System (GITEWS). The analysis of risk and vulnerability, as an important step in risk (and early warning) governance, is a precondition for the design of effective early warning structures by delivering the knowledge base for developing institutionalized quick response mechanisms of organizations involved in the issuing of a tsunami warning, and of populations exposed to react to warnings and to manage evacuation before the first tsunami wave hits. Thus, a special challenge for developing countries is the governance of complex cross-sectoral and cross-scale institutional, social and spatial processes and requirements for the conceptualization, implementation and optimization of a people centered tsunami early warning system. In support of this, the risk and vulnerability assessment of the case study aims at identifying those factors that constitute the causal structure of the (dis)functionality between the technological warning and the social response system causing loss of life during an emergency situation: Which social groups are likely to be less able to receive and respond to an early warning alert? And, are people able to evacuate in due time? Here, only an interdisciplinary research approach is capable to analyze the socio-spatial and environmental conditions of vulnerability and risk and to produce valuable results for decision makers and civil society to manage tsunami risk in the early warning context

  18. Propulsion Airframe Aeroacoustics Technology Evaluation and Selection Using a Multi-Attribute Decision Making Process and Non-Deterministic Design

    NASA Technical Reports Server (NTRS)

    Burg, Cecile M.; Hill, Geoffrey A.; Brown, Sherilyn A.; Geiselhart, Karl A.

    2004-01-01

    The Systems Analysis Branch at NASA Langley Research Center has investigated revolutionary Propulsion Airframe Aeroacoustics (PAA) technologies and configurations for a Blended-Wing-Body (BWB) type aircraft as part of its research for NASA s Quiet Aircraft Technology (QAT) Project. Within the context of the long-term NASA goal of reducing the perceived aircraft noise level by a factor of 4 relative to 1997 state of the art, major configuration changes in the propulsion airframe integration system were explored with noise as a primary design consideration. An initial down-select and assessment of candidate PAA technologies for the BWB was performed using a Multi-Attribute Decision Making (MADM) process consisting of organized brainstorming and decision-making tools. The assessments focused on what effect the PAA technologies had on both the overall noise level of the BWB and what effect they had on other major design considerations such as weight, performance and cost. A probabilistic systems analysis of the PAA configurations that presented the best noise reductions with the least negative impact on the system was then performed. Detailed results from the MADM study and the probabilistic systems analysis will be published in the near future.

  19. Community-based participatory research and user-centered design in a diabetes medication information and decision tool.

    PubMed

    Henderson, Vida A; Barr, Kathryn L; An, Lawrence C; Guajardo, Claudia; Newhouse, William; Mase, Rebecca; Heisler, Michele

    2013-01-01

    Together, community-based participatory research (CBPR), user-centered design (UCD), and health information technology (HIT) offer promising approaches to improve health disparities in low-resource settings. This article describes the application of CBPR and UCD principles to the development of iDecide/Decido, an interactive, tailored, web-based diabetes medication education and decision support tool delivered by community health workers (CHWs) to African American and Latino participants with diabetes in Southwest and Eastside Detroit. The decision aid is offered in English or Spanish and is delivered on an iPad in participants' homes. The overlapping principles of CBPR and UCD used to develop iDecide/Decido include a user-focused or community approach, equitable academic and community partnership in all study phases, an iterative development process that relies on input from all stakeholders, and a program experience that is specified, adapted, and implemented with the target community. Collaboration between community members, researchers, and developers is especially evident in the program's design concept, animations, pictographs, issue cards, goal setting, tailoring, and additional CHW tools. The principles of CBPR and UCD can be successfully applied in developing health information tools that are easy to use and understand, interactive, and target health disparities.

  20. Information Engineering and Workflow Design in a Clinical Decision Support System for Colorectal Cancer Screening in Iran.

    PubMed

    Maserat, Elham; Seied Farajollah, Seiede Sedigheh; Safdari, Reza; Ghazisaeedi, Marjan; Aghdaei, Hamid Asadzadeh; Zali, Mohammad Reza

    2015-01-01

    Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectal cancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system (CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based information system that improves the delivery of preventive care services. The aim of this article was to detail engineering of information requirements and work flow design of CDSS for a colorectal cancer screening program. In the first stage a screening minimum data set was determined. Developed and developing countries were analyzed for identifying this data set. Then information deficiencies and gaps were determined by check list. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15 users and stakeholders' perspectives about workflow of CDSS were studied. Finally workflow of DSS of control program was designed by standard clinical practice guidelines and perspectives. Screening minimum data set of national colorectal cancer screening program was defined in five sections, including colonoscopy data set, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Then we designed a work process standard of screening. Finally workflow of DSS and entry stage were determined. A CDSS facilitates complex decision making for screening and has key roles in designing optimal interactions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful to identify data reconciliation strategies to address documentation gaps. Following recommendations of CDSS should improve quality of colorectal cancer screening.

  1. Adapting Nielsen's Design Heuristics to Dual Processing for Clinical Decision Support.

    PubMed

    Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

    2016-01-01

    The study objective was to improve the applicability of Nielson's standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access.

  2. Adapting Nielsen’s Design Heuristics to Dual Processing for Clinical Decision Support

    PubMed Central

    Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

    2016-01-01

    The study objective was to improve the applicability of Nielson’s standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access. PMID:28269915

  3. Designing a Relational Database to Facilitate Military Family Housing Utilization Decisions

    DTIC Science & Technology

    2001-06-01

    TOOLS 73 A. INTRODUCTION Z"*73 B. MICROSOFT ACCESS TOOLS 74 C. GEOGRAPHIC INFORMATION SYSTEM 77 D. SUMMARY 90 VIII. CONCLUSIONS AND...FAMILYMEMBER Objects 36 Figure 5-1. The Design View for the "Find duplicates" Query 46 Figure 5-2. MS Access Design View of the Housing Inventory...55 Figure 5-6. Access Query to Weed Out Null Appliance Rows 58 Figure 6-1. HATS Main Menu (Switchboard Form) 62 Figure 6-2. Using Drop-down Menus on

  4. Clinical decision support systems at the Vienna General Hospital using Arden Syntax: Design, implementation, and integration.

    PubMed

    Schuh, Christian; de Bruin, Jeroen S; Seeling, Walter

    2015-12-01

    The Allgemeines Krankenhaus Informations Management (AKIM) project was started at the Vienna General Hospital (VGH) several years ago. This led to the introduction of a new hospital information system (HIS), and the installation of the expert system platform (EXP) for the integration of Arden-Syntax-based clinical decision support systems (CDSSs). In this report we take a look at the milestones achieved and the challenges faced in the creation and modification of CDSSs, and their integration into the HIS over the last three years. We introduce a three-stage development method, which is followed in nearly all CDSS projects at the Medical University of Vienna and the VGH. Stage one comprises requirements engineering and system conception. Stage two focuses on the implementation and testing of the system. Finally, stage three describes the deployment and integration of the system in the VGH HIS. The HIS provides a clinical work environment for healthcare specialists using customizable graphical interfaces known as parametric medical documents. Multiple Arden Syntax servers are employed to host and execute the CDSS knowledge bases: two embedded in the EXP for production and development, and a further three in clinical routine for production, development, and quality assurance. Three systems are discussed; the systems serve different purposes in different clinical areas, but are all implemented with Arden Syntax. MONI-ICU is an automated surveillance system for monitoring healthcare-associated infections in the intensive care setting. TSM-CDS is a CDSS used for risk prediction in the formation of cutaneous melanoma metastases. Finally, TacroDS is a CDSS for the manipulation of dosages for tacrolimus, an immunosuppressive agent used after kidney transplantation. Problems in development and integration were related to data quality or availability, although organizational difficulties also caused delays in development and integration. Since the inception of the AKIM

  5. Designing Effective Projects: Decision Options for Maximizing Learning and Project Success

    ERIC Educational Resources Information Center

    Volkema, Roger J.

    2010-01-01

    In recent years, more and more business schools have introduced team-based projects into their curricula as a means of addressing corporate, small business, and community-service issues while teaching students a variety of project management skills (technical and sociocultural). In designing a project-oriented course, an instructor has a number of…

  6. Academic Libraries as High-Tech Gateways: A Guide to Design & Space Decisions. Second Edition.

    ERIC Educational Resources Information Center

    Bazillion, Richard J.; Braun, Connie L.

    This book, based on research about libraries around the country, provides tools that can be used for planning and building an academic library space that streamlines access to information. It explains how to incorporate the latest innovations in academic library facility design; how to make the facility flexible for changing information technology…

  7. Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer.

    PubMed

    de Boer, Pieter T; Frederix, Geert W J; Feenstra, Talitha L; Vemer, Pepijn

    2016-09-01

    Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of model validation efforts in the overall health economic literature. A literature search was performed in Pubmed and Embase to retrieve health economic modelling studies published between 2008 and 2014. Reporting on model validation was evaluated by checking for the word validation, and by using AdViSHE (Assessment of the Validation Status of Health Economic decision models), a tool containing a structured list of relevant items for validation. Additionally, we contacted corresponding authors to ask whether more validation efforts were performed other than those reported in the manuscripts. A total of 53 studies on seasonal influenza and 41 studies on early breast cancer were included in our review. The word validation was used in 16 studies (30 %) on seasonal influenza and 23 studies (56 %) on early breast cancer; however, in a minority of studies, this referred to a model validation technique. Fifty-seven percent of seasonal influenza studies and 71 % of early breast cancer studies reported one or more validation techniques. Cross-validation of study outcomes was found most often. A limited number of studies reported on model validation efforts, although good examples were identified. Author comments indicated that more validation techniques were performed than those reported in the manuscripts. Although validation is deemed important by many researchers, this is not reflected in the reporting habits of health economic modelling studies. Systematic reporting of validation efforts would be desirable to further enhance decision makers' confidence in health economic models and their outcomes.

  8. An integrated decision-making framework for transportation architectures: Application to aviation systems design

    NASA Astrophysics Data System (ADS)

    Lewe, Jung-Ho

    The National Transportation System (NTS) is undoubtedly a complex system-of-systems---a collection of diverse 'things' that evolve over time, organized at multiple levels, to achieve a range of possibly conflicting objectives, and never quite behaving as planned. The purpose of this research is to develop a virtual transportation architecture for the ultimate goal of formulating an integrated decision-making framework. The foundational endeavor begins with creating an abstraction of the NTS with the belief that a holistic frame of reference is required to properly study such a multi-disciplinary, trans-domain system. The culmination of the effort produces the Transportation Architecture Field (TAF) as a mental model of the NTS, in which the relationships between four basic entity groups are identified and articulated. This entity-centric abstraction framework underpins the construction of a virtual NTS couched in the form of an agent-based model. The transportation consumers and the service providers are identified as adaptive agents that apply a set of preprogrammed behavioral rules to achieve their respective goals. The transportation infrastructure and multitude of exogenous entities (disruptors and drivers) in the whole system can also be represented without resorting to an extremely complicated structure. The outcome is a flexible, scalable, computational model that allows for examination of numerous scenarios which involve the cascade of interrelated effects of aviation technology, infrastructure, and socioeconomic changes throughout the entire system.

  9. Interactive Genetic Algorithm - An Adaptive and Interactive Decision Support Framework for Design of Optimal Groundwater Monitoring Plans

    NASA Astrophysics Data System (ADS)

    Babbar-Sebens, M.; Minsker, B. S.

    2006-12-01

    In the water resources management field, decision making encompasses many kinds of engineering, social, and economic constraints and objectives. Representing all of these problem dependant criteria through models (analytical or numerical) and various formulations (e.g., objectives, constraints, etc.) within an optimization- simulation system can be a very non-trivial issue. Most models and formulations utilized for discerning desirable traits in a solution can only approximate the decision maker's (DM) true preference criteria, and they often fail to consider important qualitative and incomputable phenomena related to the management problem. In our research, we have proposed novel decision support frameworks that allow DMs to actively participate in the optimization process. The DMs explicitly indicate their true preferences based on their subjective criteria and the results of various simulation models and formulations. The feedback from the DMs is then used to guide the search process towards solutions that are "all-rounders" from the perspective of the DM. The two main research questions explored in this work are: a) Does interaction between the optimization algorithm and a DM assist the system in searching for groundwater monitoring designs that are robust from the DM's perspective?, and b) How can an interactive search process be made more effective when human factors, such as human fatigue and cognitive learning processes, affect the performance of the algorithm? The application of these frameworks on a real-world groundwater long-term monitoring (LTM) case study in Michigan highlighted the following salient advantages: a) in contrast to the non-interactive optimization methodology, the proposed interactive frameworks were able to identify low cost monitoring designs whose interpolation maps respected the expected spatial distribution of the contaminants, b) for many same-cost designs, the interactive methodologies were able to propose multiple alternatives

  10. Gene expression profiling for guiding adjuvant chemotherapy decisions in women with early breast cancer: an evidence-based and economic analysis.

    PubMed

    2010-01-01

    In February 2010, the Medical Advisory Secretariat (MAS) began work on evidence-based reviews of published literature surrounding three pharmacogenomic tests. This project came about when Cancer Care Ontario (CCO) asked MAS to provide evidence-based analyses on the effectiveness and cost-effectiveness of three oncology pharmacogenomic tests currently in use in Ontario.Evidence-based analyses have been prepared for each of these technologies. These have been completed in conjunction with internal and external stakeholders, including a Provincial Expert Panel on Pharmacogenomics (PEPP). Within the PEPP, subgroup committees were developed for each disease area. For each technology, an economic analysis was also completed by the Toronto Health Economics and Technology Assessment Collaborative (THETA) and is summarized within the reports.THE FOLLOWING REPORTS CAN BE PUBLICLY ACCESSED AT THE MAS WEBSITE AT: www.health.gov.on.ca/mas or at www.health.gov.on.ca/english/providers/program/mas/mas_about.htmlGENE EXPRESSION PROFILING FOR GUIDING ADJUVANT CHEMOTHERAPY DECISIONS IN WOMEN WITH EARLY BREAST CANCER: An Evidence-Based and Economic AnalysisEpidermal Growth Factor Receptor Mutation (EGFR) Testing for Prediction of Response to EGFR-Targeting Tyrosine Kinase Inhibitor (TKI) Drugs in Patients with Advanced Non-Small-Cell Lung Cancer: An Evidence-Based and Ecopnomic AnalysisK-RAS testing in Treatment Decisions for Advanced Colorectal Cancer: an Evidence-Based and Economic Analysis To review and synthesize the available evidence regarding the laboratory performance, prognostic value, and predictive value of Oncotype-DX for the target population. CONDITION AND TARGET POPULATION The target population of this review is women with newly diagnosed early stage (stage I-IIIa) invasive breast cancer that is estrogen-receptor (ER) positive and/or progesterone-receptor (PR) positive. Much of this review, however, is relevant for women with early stage (I and II) invasive breast

  11. A Design Architecture for an Integrated Training System Decision Support System

    DTIC Science & Technology

    1990-07-01

    Sensory modes include visual, auditory, tactile, or kinesthetic; performance categories include time to complete , speed of response, or correct action ...procedures, and finally application and examples from the aviation proponency with emphasis on the LHX program. Appendix B is a complete bibliography...integrated analysis of ITS development. The approach was designed to provide an accurate and complete representation of the ITS development process and

  12. Dynamic one-dimensional modeling of secondary settling tanks and design impacts of sizing decisions.

    PubMed

    Li, Ben; Stenstrom, Michael K

    2014-03-01

    As one of the most significant components in the activated sludge process (ASP), secondary settling tanks (SSTs) can be investigated with mathematical models to optimize design and operation. This paper takes a new look at the one-dimensional (1-D) SST model by analyzing and considering the impacts of numerical problems, especially the process robustness. An improved SST model with Yee-Roe-Davis technique as the PDE solver is proposed and compared with the widely used Takács model to show its improvement in numerical solution quality. The improved and Takács models are coupled with a bioreactor model to reevaluate ASP design basis and several popular control strategies for economic plausibility, contaminant removal efficiency and system robustness. The time-to-failure due to rising sludge blanket during overloading, as a key robustness indicator, is analyzed to demonstrate the differences caused by numerical issues in SST models. The calculated results indicate that the Takács model significantly underestimates time to failure, thus leading to a conservative design. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Study of a co-designed decision feedback equalizer, deinterleaver, and decoder

    NASA Technical Reports Server (NTRS)

    Peile, Robert E.; Welch, Loyd

    1990-01-01

    A technique that promises better quality data from band limited channels at lower received power in digital transmission systems is presented. Data transmission, in such systems often suffers from intersymbol interference (ISI) and noise. Two separate techniques, channel coding and equalization, have caused considerable advances in the state of communication systems and both concern themselves with removing the undesired effects of a communication channel. Equalizers mitigate the ISI whereas coding schemes are used to incorporate error-correction. In the past, most of the research in these two areas has been carried out separately. However, the individual techniques have strengths and weaknesses that are complementary in many applications: an integrated approach realizes gains in excess to that of a simple juxtaposition. Coding schemes have been successfully used in cascade with linear equalizers which in the absence of ISI provide excellent performance. However, when both ISI and the noise level are relatively high, nonlinear receivers like the decision feedback equalizer (DFE) perform better. The DFE has its drawbacks: it suffers from error propagation. The technique presented here takes advantage of interleaving to integrate the two approaches so that the error propagation in DFE can be reduced with the help of error correction provided by the decoder. The results of simulations carried out for both, binary, and non-binary, channels confirm that significant gain can be obtained by codesigning equalizer and decoder. Although, systems with time-invariant channels and simple DFE having linear filters were looked into, the technique is fairly general and can easily be modified for more sophisticated equalizers to obtain even larger gains.

  14. Freedom of Speech as Protected by the States: A Review of Late Nineteenth and Early Twentieth Century State Court Decisions.

    ERIC Educational Resources Information Center

    Herbeck, Dale A.

    While some analysts have asserted that the First Amendment was intended to prohibit laws against seditious libel (speech overtly critical of the government), the judicial record reveals a willingness to tolerate some onerous infringements on free expression. In the late 19th and early 20th centuries, 25 states passed "sedition" or…

  15. Designing Effective Interactions for Concordance around End-of-Life Care Decisions: Lessons from Hospice Admission Nurses

    PubMed Central

    Candrian, Carey; Tate, Channing; Broadfoot, Kirsten; Tsantes, Alexandra; Matlock, Daniel; Kutner, Jean

    2017-01-01

    Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual’s acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable. One goal of these interactions is ensuring patients and families have accurate and clear information about hospice care to facilitate informed decisions. So inconsistent are practices across hospices in consenting patients that a 2016 report from the Office of Inspector General (OIG) entitled “Hospices should improve their election statements and certifications of terminal illness” called for complete and accurate election statements to ensure that hospice patients and their caregivers can make informed decisions and understand the costs and benefits of choosing hospice care. Whether complete and accurate information at initial admission visits improves interactions and outcomes is unknown. Our recent qualitative work investigating interactions between patients, caregivers, and hospice nurses has uncovered diverse and often diverging stakeholder-specific expectations and perceptions which if not addressed can create discordance and inhibit decision-making. This paper focuses on better understanding the communication dynamics and practices involved in hospice admission interactions in order to design more effective interactions and support the mandate from the OIG to provide hospice patients and their caregivers with accurate and complete information. This clarity is particularly important when discussing the non-curative nature of hospice care, and the choice patients make

  16. Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline.

    PubMed

    Harris, Lyndsay N; Ismaila, Nofisat; McShane, Lisa M; Andre, Fabrice; Collyar, Deborah E; Gonzalez-Angulo, Ana M; Hammond, Elizabeth H; Kuderer, Nicole M; Liu, Minetta C; Mennel, Robert G; Van Poznak, Catherine; Bast, Robert C; Hayes, Daniel F

    2016-04-01

    To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer. A literature search and prospectively defined study selection sought systematic reviews, meta-analyses, randomized controlled trials, prospective-retrospective studies, and prospective comparative observational studies published from 2006 through 2014. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert panel members used informal consensus to develop evidence-based guideline recommendations. The literature search identified 50 relevant studies. One randomized clinical trial and 18 prospective-retrospective studies were found to have evaluated the clinical utility, as defined by the guideline, of specific biomarkers for guiding decisions on the need for adjuvant systemic therapy. No studies that met guideline criteria for clinical utility were found to guide choice of specific treatments or regimens. In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2, the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. Treatment decisions should also consider disease stage, comorbidities, and patient preferences. © 2016 by American Society of Clinical Oncology.

  17. Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline

    PubMed Central

    Harris, Lyndsay N.; McShane, Lisa M.; Andre, Fabrice; Collyar, Deborah E.; Gonzalez-Angulo, Ana M.; Hammond, Elizabeth H.; Kuderer, Nicole M.; Liu, Minetta C.; Mennel, Robert G.; Van Poznak, Catherine; Bast, Robert C.; Hayes, Daniel F.

    2016-01-01

    Purpose To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer. Methods A literature search and prospectively defined study selection sought systematic reviews, meta-analyses, randomized controlled trials, prospective-retrospective studies, and prospective comparative observational studies published from 2006 through 2014. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert panel members used informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 50 relevant studies. One randomized clinical trial and 18 prospective-retrospective studies were found to have evaluated the clinical utility, as defined by the guideline, of specific biomarkers for guiding decisions on the need for adjuvant systemic therapy. No studies that met guideline criteria for clinical utility were found to guide choice of specific treatments or regimens. Recommendations In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2, the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. Treatment decisions should also consider disease stage, comorbidities, and patient preferences. PMID:26858339

  18. Development and Validation of a Decision Tool for Early Identification of Adult Patients with Severe and Complex Eating Disorder Psychopathology in Need of Highly Specialized Care.

    PubMed

    Dingemans, Alexandra E; Goorden, Maartje; Lötters, Freek J B; Bouwmans, Clazien; Danner, Unna N; van Elburg, Annemarie A; van Furth, Eric F; Hakkaart-van Roijen, Leona

    2017-09-01

    Patients with complex and severe eating disorders often receive a number of ineffective or/and insufficient treatments. Direct referral of these patients to highly specialized tertiary treatment facilities in an earlier stage of the disorder is likely to be more (cost)-effective. The aim of the study was to develop a decision tool that aids clinicians in early identification of these patients. After identification of criteria that were indicative of severity and complexity of eating disorder psychopathology by means of a systematic review of literature and consultation of a focus group, a Delphi method was applied to obtain consensus from experts on the list of relevant criteria. Finally, the decision tool was validated in clinical practice, and cut-off criteria were established. The tool demonstrated good feasibility and validity to identify patients for highly specialized tertiary care. The final decision tool consisted of five criteria that can easily be implemented in clinical practice. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. Designing Decision Support System to Detect Drug Interactions Type 2 Diabetes

    PubMed Central

    Rasoolimoghadam, Mehdi; Safdari, Reza; Ghazisaeidi, Marjan; Maharanitehrani, MohammadReza; Tahmasebiyan, Shahram

    2015-01-01

    Background and Aim: Type II Diabetes is the most common diseases of metabolic disorders and the treatment of oral anti-diabetic drug use takes place But The problem of using multi-drug and interactions at the same time is an issue that has always been a major challenge And diagnosis of drug interactions, particularly in Diabetic patients due to the problem with the disease is very important. The purpose of this studying is, to design a clinical assistant decided to use this approach to determine the type II diabetes drug interactions this makes it easy for those who are active in the field. Materials and Methods: Study is Developmental that to determine the content of the system a self-made checklist was used. Checklist Validity and reliability has been confirmed by four professors. The Research community to determine the content of the system was country endocrine that are 124 people. The sample size was calculated using Cochran that was 57 people. The Score of checklist was calculated in SPSS version 20 .finally, the checklist was approved by at least 70% points. The system by using Microsoft SQL server 2008 and visual Studio 2012 development environment was designed in C#.net. In the end, In order to evaluate the software to determine the level of satisfaction, usability and ease of use, designed systems sharing with all Medical Informatics students of Tehran University of Medical Sciences. For this purpose a self-made questionnaire was used. Questionnaire Validity has been confirmed by four professors and reliability was assessed by Cronbach method. Results: The results of the survey are showing that the majority of students found out and believed the software is useful and easy to use and generally expressed their satisfaction software. Conclusions: The methodology provides a suitable approach for analysis and modeling of data in the medical field and the performance is good. PMID:26862240

  20. Designing Decision Support System to Detect Drug Interactions Type 2 Diabetes.

    PubMed

    Rasoolimoghadam, Mehdi; Safdari, Reza; Ghazisaeidi, Marjan; Maharanitehrani, MohammadReza; Tahmasebiyan, Shahram

    2015-12-01

    Type II Diabetes is the most common diseases of metabolic disorders and the treatment of oral anti-diabetic drug use takes place But The problem of using multi-drug and interactions at the same time is an issue that has always been a major challenge And diagnosis of drug interactions, particularly in Diabetic patients due to the problem with the disease is very important. The purpose of this studying is, to design a clinical assistant decided to use this approach to determine the type II diabetes drug interactions this makes it easy for those who are active in the field. Study is Developmental that to determine the content of the system a self-made checklist was used. Checklist Validity and reliability has been confirmed by four professors. The Research community to determine the content of the system was country endocrine that are 124 people. The sample size was calculated using Cochran that was 57 people. The Score of checklist was calculated in SPSS version 20 .finally, the checklist was approved by at least 70% points. The system by using Microsoft SQL server 2008 and visual Studio 2012 development environment was designed in C#.net. In the end, In order to evaluate the software to determine the level of satisfaction, usability and ease of use, designed systems sharing with all Medical Informatics students of Tehran University of Medical Sciences. For this purpose a self-made questionnaire was used. Questionnaire Validity has been confirmed by four professors and reliability was assessed by Cronbach method. The results of the survey are showing that the majority of students found out and believed the software is useful and easy to use and generally expressed their satisfaction software. The methodology provides a suitable approach for analysis and modeling of data in the medical field and the performance is good.

  1. Decision on the number of turns in the eRHIC Nov15 design

    SciT

    Brooks, S.

    2015-12-01

    When moving from the “Jun’15” to the “Nov’15” eRHIC FFAG design, the number of accelerating passes through the linac was reduced from 16 to 12. There are an equal number of decelerating passes, so the total reduced from 32 to 24. At the same time, the linac energy was increased from 1.322GeV to 1.665GeV and the RF frequency changed from 422MHz to 647MHz. The maximum beam energy remained approximately constant, changing from 21.164GeV to exactly 20GeV.

  2. Participatory design in the development of an early therapy intervention for perinatal stroke.

    PubMed

    Basu, Anna Purna; Pearse, Janice Elizabeth; Baggaley, Jessica; Watson, Rose Mary; Rapley, Tim

    2017-01-23

    Perinatal stroke is the leading cause of unilateral (hemiparetic) cerebral palsy, with life-long personal, social and financial consequences. Translational research findings indicate that early therapy intervention has the potential for significant improvements in long-term outcome in terms of motor function. By involving families and health professionals in the development and design stage, we aimed to produce a therapy intervention which they would engage with. Nine parents of children with hemiparesis and fourteen health professionals involved in the care of infants with perinatal stroke took part in peer review and focus groups to discuss evolving therapy materials, with revisions made iteratively. The materials and approach were also discussed at a meeting of the London Child Stroke Research Reference Group. Focus group data were coded using Normalisation Process Theory constructs to explore potential barriers and facilitators to routine uptake of the intervention. We developed the Early Therapy in Perinatal Stroke (eTIPS) program - a parent-delivered, home-based complex intervention addressing a current gap in practice for infants in the first 6 months of life after unilateral perinatal stroke and with the aim of improving motor outcome. Parents and health professionals saw the intervention as different from usual practice, and valuable (high coherence). They were keen to engage (high cognitive participation). They considered the tasks for parents to be achievable (high collective action). They demonstrated trust in the approach and felt that parents would undertake the recommended activities (high collective action). They saw the approach as flexible and adaptable (high reflexive monitoring). Following suggestions made, we added a section on involving the extended family, and obtained funding for a website and videos to supplement written materials. Focus groups with parents and health professionals provided meaningful feedback to iteratively improve the

  3. Development and pilot testing of a Decision Aid (DA) for women with early-stage breast cancer considering contralateral prophylactic mastectomy.

    PubMed

    Ager, B; Jansen, J; Porter, D; Phillips, K A; Glassey, R; Butow, P

    2018-05-22

    Describe the development, acceptability and feasibility of a Decision Aid (DA) for women with early-stage breast cancer (BC) at average contralateral breast cancer (CBC) risk considering contralateral prophylactic mastectomy (CPM). The DA was developed using the International Patient Decision Aid Standards (IPDAS) and the Ottawa Decision Support Framework. It provides evidence-based information about CPM in a booklet format combining text, graphs and images of surgical options. Twenty-three women with a history of early-stage breast cancer were interviewed in person or over the phone using a 'think aloud approach'. Framework analysis was used to code and analyse data. Twenty-three women participated in the study. Mean age of participants was 58.6 years and time since diagnosis ranged from 14 months to 21 years. Five women had CPM and eighteen had not. Women strongly endorsed the DA. Many felt validated by a section on appearance and found information on average risk of recurrence and metastases helpful, however, noted the importance of discussing personal risk with their surgeon. Many requested more information on surgery details (time taken, recovery) and costs of the different options. The DA was acceptable to women, including the format, content and proposed implementation strategies. Practical and financial issues are important to women in considering treatment options. Women appreciate information about CPM at diagnosis and emphasised the importance of discussing potential downsides of the procedure in addition to benefits. The DA was considered acceptable to facilitate such discussions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. How do women trade-off benefits and risks in chemotherapy treatment decisions based on gene expression profiling for early-stage breast cancer? A discrete choice experiment.

    PubMed

    Marshall, Deborah A; Deal, Ken; Bombard, Yvonne; Leighl, Natasha; MacDonald, Karen V; Trudeau, Maureen

    2016-06-02

    Gene expression profiling (GEP) of tumours informs baseline risk prediction, potentially affecting adjuvant chemotherapy decisions for women with early-stage breast cancer. Since only 15% will experience a recurrence, concerns have been raised about potential harms from overtreatment and high GEP costs in publicly funded healthcare systems. We aimed to estimate preferences and personal utility of GEP testing information and benefit-risk trade-offs in chemotherapy treatment decisions. Based on literature review and findings from our qualitative research (focus groups, interviews with patients with breast cancer and medical oncologists), we developed a discrete choice experiment (DCE) survey and administered it via an internet panel. The DCE included 12 choice tasks with 5 attributes and 3 alternatives considering orthogonality, D-efficiency and level balance. The DCE survey was administered to 1004 Canadian women from the general population. Preferences were analysed using conditional logit and hierarchical Bayes and evaluated for goodness of fit. We conducted simulation analyses for alternative scenarios. GEP test score indicating likely benefit from chemotherapy was the most important attribute. Doctor's clinical estimate of the risk of cancer returning, trust in your cancer doctor and side effects of chemotherapy (temporary and permanent) were relatively less important but showed significant differences among levels. In the scenario analyses, 78% were likely to choose chemotherapy in a high-risk scenario, 55% in a moderate-risk scenario and 33% in a low-risk scenario, with the other attributes held constant. A high GEP score was more important in influencing the choice of chemotherapy for those at intermediate clinical risk. GEP testing information influences chemotherapy treatment decisions in early-stage breast cancer and varies depending on clinical risk. Clinicians should be aware of these differences and tailor the use of GEP testing accordingly. Published

  5. An Oral History Study of Foreign Design Experts' Influence on Taiwanese Early Design Education from 1963 to 1966

    ERIC Educational Resources Information Center

    Lai, Chien-Tu Jeff

    2013-01-01

    There are documented accounts of the influential role of U.S. aid in the development of Taiwanese design education. Missing from the historical records of design education, however, are the perspectives of local design practitioners who participated in the design workshops during the period of U.S. aid to Taiwan, 1963 to 1966. Using face-to-face…

  6. Application of best practice approaches for designing decision support tools: The preparatory education about clinical trials (PRE-ACT) study

    PubMed Central

    Fleisher, Linda; Ruggieri, Dominique G.; Miller, Suzanne M.; Manne, Sharon; Albrecht, Terrance; Buzaglo, Joanne; Collins, Michael A.; Katz, Michael; Kinzy, Tyler G.; Liu, Tasnuva; Manning, Cheri; Charap, Ellen Specker; Millard, Jennifer; Miller, Dawn M.; Poole, David; Raivitch, Stephanie; Roach, Nancy; Ross, Eric A.; Meropol, Neal J.

    2014-01-01

    Objective This article describes the rigorous development process and initial feedback of the PRE-ACT (Preparatory Education About Clinical Trials) web-based- intervention designed to improve preparation for decision making in cancer clinical trials. Methods The multi-step process included stakeholder input, formative research, user testing and feedback. Diverse teams (researchers, advocates and developers) participated including content refinement, identification of actors, and development of video scripts. Patient feedback was provided in the final production period and through a vanguard group (N = 100) from the randomized trial. Results Patients/advocates confirmed barriers to cancer clinical trial participation, including lack of awareness and knowledge, fear of side effects, logistical concerns, and mistrust. Patients indicated they liked the tool’s user-friendly nature, the organized and comprehensive presentation of the subject matter, and the clarity of the videos. Conclusion The development process serves as an example of operationalizing best practice approaches and highlights the value of a multi-disciplinary team to develop a theory-based, sophisticated tool that patients found useful in their decision making process. Practice implications Best practice approaches can be addressed and are important to ensure evidence-based tools that are of value to patients and supports the usefulness of a process map in the development of e-health tools. PMID:24813474

  7. Incorporating location, routing, and inventory decisions in a bi-objective supply chain design problem with risk-pooling

    NASA Astrophysics Data System (ADS)

    Tavakkoli-Moghaddam, Reza; Forouzanfar, Fateme; Ebrahimnejad, Sadoullah

    2013-07-01

    This paper considers a single-sourcing network design problem for a three-level supply chain. For the first time, a novel mathematical model is presented considering risk-pooling, the inventory existence at distribution centers (DCs) under demand uncertainty, the existence of several alternatives to transport the product between facilities, and routing of vehicles from distribution centers to customer in a stochastic supply chain system, simultaneously. This problem is formulated as a bi-objective stochastic mixed-integer nonlinear programming model. The aim of this model is to determine the number of located distribution centers, their locations, and capacity levels, and allocating customers to distribution centers and distribution centers to suppliers. It also determines the inventory control decisions on the amount of ordered products and the amount of safety stocks at each opened DC, selecting a type of vehicle for transportation. Moreover, it determines routing decisions, such as determination of vehicles' routes starting from an opened distribution center to serve its allocated customers and returning to that distribution center. All are done in a way that the total system cost and the total transportation time are minimized. The Lingo software is used to solve the presented model. The computational results are illustrated in this paper.

  8. Systems modelling and simulation in health service design, delivery and decision making.

    PubMed

    Pitt, Martin; Monks, Thomas; Crowe, Sonya; Vasilakis, Christos

    2016-01-01

    The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service

    PubMed Central

    Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee

    2015-01-01

    Objectives To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. Methods We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. Results The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. Conclusions We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs. PMID:25995962

  10. Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service.

    PubMed

    Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee; Yoo, Sooyoung

    2015-04-01

    To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.

  11. Cost-effectiveness of the Decipher Genomic Classifier to Guide Individualized Decisions for Early Radiation Therapy After Prostatectomy for Prostate Cancer.

    PubMed

    Lobo, Jennifer M; Trifiletti, Daniel M; Sturz, Vanessa N; Dicker, Adam P; Buerki, Christine; Davicioni, Elai; Cooperberg, Matthew R; Karnes, R Jeffrey; Jenkins, Robert B; Den, Robert B; Showalter, Timothy N

    2017-06-01

    Controversy exists regarding the effectiveness of early adjuvant versus salvage radiation therapy after prostatectomy for prostate cancer. Estimates of prostate cancer progression from the Decipher genomic classifier (GC) could guide informed decision-making and improve the outcomes for patients. We developed a Markov model to compare the costs and quality-adjusted life years (QALYs) associated with GC-based treatment decisions regarding adjuvant therapy after prostatectomy with those of 2 control strategies: usual care (determined from patterns of care studies) and the alternative of 100% adjuvant radiation therapy. Using the bootstrapping method of sampling with replacement, the cases of 10,000 patients were simulated during a 10-year time horizon, with each subject having individual estimates for cancer progression (according to GC findings) and noncancer mortality (according to age). GC-based care was more effective and less costly than 100% adjuvant radiation therapy and resulted in cost savings up to an assay cost of $11,402. Compared with usual care, GC-based care resulted in more QALYs. Assuming a $4000 assay cost, the incremental cost-effectiveness ratio was $90,833 per QALY, assuming a 7% usage rate of adjuvant radiation therapy. GC-based care was also associated with a 16% reduction in the percentage of patients with distant metastasis at 5 years compared with usual care. The Decipher GC could be a cost-effective approach for genomics-driven cancer treatment decisions after prostatectomy, with improvements in estimated clinical outcomes compared with usual care. The individualized decision analytic framework applied in the present study offers a flexible approach to estimate the potential utility of genomic assays for personalized cancer medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer

    PubMed Central

    Peate, M; Meiser, B; Cheah, B C; Saunders, C; Butow, P; Thewes, B; Hart, R; Phillips, K-A; Hickey, M; Friedlander, M

    2012-01-01

    Background: Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA). Methods: A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18–40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models. Results: Compared with usual care, women who received the DA had reduced decisional conflict (β=−1.51; 95%CI: −2.54 to 0.48; P=0.004) and improved knowledge (β=0.09; 95%CI: 0.01–0.16; P=0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (β=−3.73; 95%CI: −7.12 to −0.35; P=0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P<0.001), fertility options (P=0.005), and rated it more helpful (P=0.002), than those who received standard care. Conclusion: These findings support widespread use of this DA shortly after diagnosis (before chemotherapy) among younger breast cancer patients who have not completed their families. PMID:22415294

  13. Interdisciplinary Interactions During R&D and Early Design of Large Engineered Systems

    NASA Technical Reports Server (NTRS)

    McGowan, Anna-Maria Rivas

    2014-01-01

    Designing Large-Scale Complex Engineered Systems (LaCES) such as aircraft and submarines requires the input of thousands of engineers and scientists whose work is proximate in neither time nor space. Comprehensive knowledge of the system is dispersed among specialists whose expertise is in typically one system component or discipline. This study examined the interactive work practices among such specialists seeking to improve engineering practice through a rigorous and theoretical understanding of current practice. This research explored current interdisciplinary practices and perspectives during R&D and early LaCES design and identified why these practices and perspectives prevail and persist. The research design consisted of a three-fold, integrative approach that combined an open-ended survey, semi-structured interviews, and ethnography. Significant empirical data from experienced engineers and scientists in a large engineering organization were obtained and integrated with theories from organization science and engineering. Qualitative analysis was used to obtain a holistic, contextualized understanding. The over-arching finding is that issues related to cognition, organization, and social interrelations mostly dominate interactions across disciplines. Engineering issues, such as the integration of hardware or physics-based models, are not as significant. For example, organization culture is an important underlying factor that guided researchers more toward individual sovereignty over cross-disciplinarity. The organization structure and the engineered system architecture also serve as constraints to the engineering work. Many differences in work practices were observed, including frequency and depth of interactions, definition or co-construction of requirements, clarity or creation of the system architecture, work group proximity, and cognitive challenges. Practitioners are often unaware of these differences resulting in confusion and incorrect assumptions

  14. A Design Case of the T.E.C.H. Playground: Decisions and Challenges in Creating a Space/Place to Transform Education through Creative Habits

    ERIC Educational Resources Information Center

    Stansberry, Susan L.

    2016-01-01

    This design case (Boling, 2010) includes the challenges, considerations, and decisions associated with the design and development of a learning space/place (Dourish, 2006; Harrison & Dourish, 1996) focused on innovative, creative, and imaginative ways to transform teaching and learning with technology. The T.E.C.H. Playground in the College of…

  15. Development of decision- making mechanism in engineering design of phased coal mines technical upgrade

    NASA Astrophysics Data System (ADS)

    Kulak, V. Yu; Petrova, T. V.; Novichikhin, A. V.

    2017-09-01

    The approach to a choice of a new mine design and technical upgrade of operating coal mines is substantiated. The choice of the option is made in the following way: the elements of the mine technological system are defined, for each element of the system two levels of costs are allocated - capital and operational; a graph of alternative options of the system is formed by matrix enumeration taking into account the possibility of simultaneous application of different elements, up to 10 000 scenarios are formed; capital and operating costs of options are estimated in the form of coefficients as the cost-to-cost ratio in the base variant, which has already been implemented and the costs of which are already known; ranking of the options at the level of costs and the definition of the 10 preferred are performed. It is established that the application of partial enumeration allows the costs relative to the base variant to be reduced by 10 %; the main constraint of costs reduction is the need to comply with all conditions that ensure industrial safety.

  16. Design and performance of optical endoscopes for the early detection of cancer

    NASA Astrophysics Data System (ADS)

    Keenan, Maureen Molly

    Cancer is a multistage, heterogeneous disease that develops through a series of genetic mutations. Early stage cancer is most responsive to treatment but can be the hardest to detect due to its small size, lack of definitive symptoms and potential location deep in the body. Whole body imaging methods, MRI/CT/PET, lack the necessary resolution to detect cellular level abnormalities. Optical methods, which have sufficient resolution, can be miniaturized into endoscopes, which are necessary to overcome limited penetration of light into tissue. By combining optical coherence tomography (OCT) and fluorescence imaging methods it is possible to create endoscopes sensitive to molecular and structural changes. I applied a dual-modality 2mm diameter rigid endoscope to the study of the natural history of colon cancer in a mouse model, and later applied this knowledge to the design and characterization of a 0.8 mm dual-modality flexible probe for use in human fallopian tubes. By using this endoscope, which is introduced through the natural orifice and is compatible with existing hysteroscopes, high-risk women could be screened in a procedure at a similar level of invasiveness as a colonoscopy. Therefore, the endoscope fills this gap in clinical care for women at high-risk for ovarian cancer.

  17. Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress.

    PubMed

    Bartholomeusz, M Dillwyn; Bolton, Philip S; Callister, Robin; Skinner, Virginia; Hodgson, Deborah

    2017-09-01

    There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS) upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS) responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5) participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS.

  18. Lidar Technique for Early Forest Fire Detection : Design and Development Aspects

    NASA Astrophysics Data System (ADS)

    Traïche, M.; Bourai, K.; Moussaoui, N.; Beggar, R.; Almabouada, F.; Louhibi, D.

    2008-09-01

    Many countries suffer from forest fires every summer, a phenomenon which wreaks havoc on both local and global environment. As well, it causes enormous damage to public health especially for people living in surrounding areas. For fighting against forest fires, ocular surveillance, in spite of its wide use, is not efficient owing to the costly mobilization of a great number of forest agents and to the fact that most of forest regions are not accessible. Other passive techniques such as infrared camera remote sensing are neither efficient under unfavorable weather conditions. An efficient way to early detect forest fires even under worse environmental conditions and in inaccessible mountainous regions uses the backscattering Lidar technique. This consists of the emission of monowavelength laser pulses spanning azimuthally the entire region subject to surveillance and the detection of the backscattered signal. The detection parameter is the signal to noise ration SNR. In this contribution, we will deal with approach and design aspects inherent to the development task of such a Lidar.

  19. Training Early Career Scientists in Flight Instrument Design Through Experiential Learning: NASA Goddard's Planetary Science Winter School.

    NASA Technical Reports Server (NTRS)

    Bleacher, L. V.; Lakew, B.; Bracken, J.; Brown, T.; Rivera, R.

    2017-01-01

    The NASA Goddard Planetary Science Winter School (PSWS) is a Goddard Space Flight Center-sponsored training program, managed by Goddard's Solar System Exploration Division (SSED), for Goddard-based postdoctoral fellows and early career planetary scientists. Currently in its third year, the PSWS is an experiential training program for scientists interested in participating on future planetary science instrument teams. Inspired by the NASA Planetary Science Summer School, Goddard's PSWS is unique in that participants learn the flight instrument lifecycle by designing a planetary flight instrument under actual consideration by Goddard for proposal and development. They work alongside the instrument Principal Investigator (PI) and engineers in Goddard's Instrument Design Laboratory (IDL; idc.nasa.gov), to develop a science traceability matrix and design the instrument, culminating in a conceptual design and presentation to the PI, the IDL team and Goddard management. By shadowing and working alongside IDL discipline engineers, participants experience firsthand the science and cost constraints, trade-offs, and teamwork that are required for optimal instrument design. Each PSWS is collaboratively designed with representatives from SSED, IDL, and the instrument PI, to ensure value added for all stakeholders. The pilot PSWS was held in early 2015, with a second implementation in early 2016. Feedback from past participants was used to design the 2017 PSWS, which is underway as of the writing of this abstract.

  20. Designing a spatial decision-support system to improve urban resilience to floods

    NASA Astrophysics Data System (ADS)

    Heinzlef, Charlotte; Ganz, François; Becue, Vincent; Serre, Damien

    2017-04-01

    increase of these observatories (Dolique, 2013), observatories which are focused on different fields as, risk observation (PACA regional risks observatory), environmental observation (Environmental virtual observatory), ecological observation (National ecological observatory), etc. Usually, an observatory focuses either on a scale (generally national or regional) or on a fact (risks, environment, energy, economy, etc) Our objective is to develop an observatory tested on the territory of Avignon, to design a tool for analyzing resilience according to indicators which would measure technical resilience (urban and suburban networks), urban resilience (buildings and critical infrastructures) and social resilience (knowledge of risk, memory of the disaster, perception of vulnerability). Our tool would be designed with the help of our socio-economic partner which is the city of Avignon, and would provide a clearer picture of the resilience for managers and inhabitants. It would be participatory and social insofar as, following the assessment of the existing resilience thanks to the indicators, it would be make the territory more resilient thanks to expert advices and participatory workshops for the inhabitants and managers.

  1. Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients With Early-Stage Breast Cancer.

    PubMed

    Jagsi, Reshma; Hawley, Sarah T; Griffith, Kent A; Janz, Nancy K; Kurian, Allison W; Ward, Kevin C; Hamilton, Ann S; Morrow, Monica; Katz, Steven J

    2017-03-01

    Contralateral prophylactic mastectomy (CPM) use is increasing among women with unilateral breast cancer, but little is known about treatment decision making or physician interactions in diverse patient populations. To evaluate patient motivations, knowledge, and decisions, as well as the impact of surgeon recommendations, in a large, diverse sample of patients who underwent recent treatment for breast cancer. A survey was sent to 3631 women with newly diagnosed, unilateral stage 0, I, or II breast cancer between July 2013 and September 2014. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. Logistic and multinomial logistic regression of the data were conducted to identify factors associated with (1) CPM vs all other treatments combined, (2) CPM vs unilateral mastectomy (UM), and (3) CPM vs breast-conserving surgery (BCS). Associations between CPM receipt and surgeon recommendations were also evaluated. All statistical models and summary estimates were weighted to be representative of the target population. Receipt of CPM was the primary dependent variable for analysis and was measured by a woman's self-report of her treatment. Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. The mean (SD) age was 61.8 (12) years at the time of the survey. Overall, 1301 (43.9%) patients considered CPM (601 [24.8%] considered it very strongly or strongly); only 395 (38.1%) of them knew that CPM does not improve survival for all women with breast cancer. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received CPM. On multivariable analysis, factors associated with CPM included younger age

  2. Enhancing the Design Process for Complex Space Systems through Early Integration of Risk and Variable-Fidelity Modeling

    NASA Technical Reports Server (NTRS)

    Mavris, Dimitri; Osburg, Jan

    2005-01-01

    An important enabler of the new national Vision for Space Exploration is the ability to rapidly and efficiently develop optimized concepts for the manifold future space missions that this effort calls for. The design of such complex systems requires a tight integration of all the engineering disciplines involved, in an environment that fosters interaction and collaboration. The research performed under this grant explored areas where the space systems design process can be enhanced: by integrating risk models into the early stages of the design process, and by including rapid-turnaround variable-fidelity tools for key disciplines. Enabling early assessment of mission risk will allow designers to perform trades between risk and design performance during the initial design space exploration. Entry into planetary atmospheres will require an increased emphasis of the critical disciplines of aero- and thermodynamics. This necessitates the pulling forward of EDL disciplinary expertise into the early stage of the design process. Radiation can have a large potential impact on overall mission designs, in particular for the planned nuclear-powered robotic missions under Project Prometheus and for long-duration manned missions to the Moon, Mars and beyond under Project Constellation. This requires that radiation and associated risk and hazards be assessed and mitigated at the earliest stages of the design process. Hence, RPS is another discipline needed to enhance the engineering competencies of conceptual design teams. Researchers collaborated closely with NASA experts in those disciplines, and in overall space systems design, at Langley Research Center and at the Jet Propulsion Laboratory. This report documents the results of this initial effort.

  3. Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns).

    PubMed

    Stocker, Martin; van Herk, Wendy; El Helou, Salhab; Dutta, Sourabh; Fontana, Matteo S; Schuerman, Frank A B A; van den Tooren-de Groot, Rita K; Wieringa, Jantien W; Janota, Jan; van der Meer-Kappelle, Laura H; Moonen, Rob; Sie, Sintha D; de Vries, Esther; Donker, Albertine E; Zimmerman, Urs; Schlapbach, Luregn J; de Mol, Amerik C; Hoffman-Haringsma, Angelique; Roy, Madan; Tomaske, Maren; Kornelisse, René F; van Gijsel, Juliette; Visser, Eline G; Willemsen, Sten P; van Rossum, Annemarie M C

    2017-08-26

    Up to 7% of term and late-preterm neonates in high-income countries receive antibiotics during the first 3 days of life because of suspected early-onset sepsis. The prevalence of culture-proven early-onset sepsis is 0·1% or less in high-income countries, suggesting substantial overtreatment. We assess whether procalcitonin-guided decision making for suspected early-onset sepsis can safely reduce the duration of antibiotic treatment. We did this randomised controlled intervention trial in Dutch (n=11), Swiss (n=4), Canadian (n=2), and Czech (n=1) hospitals. Neonates of gestational age 34 weeks or older, with suspected early-onset sepsis requiring antibiotic treatment were stratified into four risk categories by their treating physicians and randomly assigned [1:1] using a computer-generated list stratified per centre to procalcitonin-guided decision making or standard care-based antibiotic treatment. Neonates who underwent surgery within the first week of life or had major congenital malformations that would have required hospital admission were excluded. Only principal investigators were masked for group assignment. Co-primary outcomes were non-inferiority for re-infection or death in the first month of life (margin 2·0%) and superiority for duration of antibiotic therapy. Intention-to-treat and per-protocol analyses were done. This trial was registered with ClinicalTrials.gov, number NCT00854932. Between May 21, 2009, and Feb 14, 2015, we screened 2440 neonates with suspected early-onset sepsis. 622 infants were excluded due to lack of parental consent, 93 were ineligible for reasons unknown (68), congenital malformation (22), or surgery in the first week of life (3). 14 neonates were excluded as 100% data monitoring or retrieval was not feasible, and one neonate was excluded because their procalcitonin measurements could not be taken. 1710 neonates were enrolled and randomly assigned to either procalcitonin-guided therapy (n=866) or standard therapy (n=844

  4. Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.

    PubMed

    Kwakkel, Gert; Meskers, Carel G M; van Wegen, Erwin E; Lankhorst, Guus J; Geurts, Alexander C H; van Kuijk, Annet A; Lindeman, Eline; Visser-Meily, Anne; de Vlugt, Erwin; Arendzen, J Hans

    2008-12-17

    Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity. 180 participants suffering from an acute, first-ever ischemic stroke will be recruited. Functional prognosis at the end of the first week post stroke is used to stratify patient into a poor prognosis group for upper limb recovery (N = 120, A2 project) and a group with a favourable prognosis (N = 60, A1 project). Both groups will be randomized to an experimental arm receiving respectively modified CIMT (favourable prognosis) or EMG-NMS (poor prognosis) for 3 weeks or to a control arm receiving usual care. Primary outcome variable will be the Action Research Arm Test (ARAT), assessed at 1,2,3,4,5, 8, 12 and 26 weeks post stroke. To study the impact of modified CIMT or EMG-NMS on stroke recovery mechanisms i.e. neuroplasticity, compensatory movements and upper limb neuromechanics, 60 patients randomly selected from projects A1 and A2 will undergo TMS, kinematical and haptic robotic measurements within a repeated measurement design. Additionally, 30 patients from the A1 project will undergo fMRI at baseline, 5 and 26 weeks post stroke. EXPLICIT stroke is a 5 year translational research programme which main aim is to investigate the effects of early applied intensive intervention for regaining dexterity and to explore the underlying mechanisms that are

  5. Design and methods for evaluating an early childhood obesity prevention program in the childcare center setting

    PubMed Central

    2013-01-01

    Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present). The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US). The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children’s nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2) intervention arm schools received a combination of (1) implementing a daily curricula for teachers/parents (the nutritional gatekeepers); (2) implementing a daily curricula for children; (3) technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4) creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Discussion Although few

  6. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis

    PubMed Central

    Pieterse, Arwen H.; de Vries, Marieke

    2011-01-01

    Abstract Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference‐sensitive health‐care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic‐based VCMs. Objective  To critically analyse the suitability of the ‘take the best’ (TTB) and ‘tallying’ fast and frugal heuristics in the context of patient decision making. Strategy  Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. Conclusion  The specific nature of patient preference‐sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. PMID:21902770

  7. Designing a Decision Support System (DSS) for Academic Library Managers Using Preprogrammed Application Software on a Microcomputer.

    ERIC Educational Resources Information Center

    McDonald, Joseph

    1986-01-01

    Focusing on management decisions in academic libraries, this article compares management information systems (MIS) with decision support systems (DSS) and discusses the decision-making process, information needs of library managers, sources of data, reasons for choosing microcomputer, preprogrammed application software, prototyping a system, and…

  8. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

    PubMed

    Pieterse, Arwen H; de Vries, Marieke

    2013-09-01

    Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

  9. Logical design of a decision support system to forecast technology, prices and costs for the national communications system

    NASA Astrophysics Data System (ADS)

    Williams, K. A.; Partridge, E. C., III

    1984-09-01

    Originally envisioned as a means to integrate the many systems found throughout the government, the general mission of the NCS continues to be to ensure the survivability of communications during and subsequent to any national emergency. In order to accomplish this mission the NCS is an arrangement of heterogeneous telecommunications systems which are provided by their sponsor Federal agencies. The physical components of Federal telecommunications systems and networks include telephone and digital data switching facilities and primary common user communications centers; Special purpose local delivery message switching and exchange facilities; Government owned or leased radio systems; Technical control facilities which are under exclusive control of a government agency. This thesis describes the logical design of a proposed decision support system for use by the National Communications System in forecasting technology, prices, and costs. It is general in nature and only includes those forecasting models which are suitable for computer implementation. Because it is a logical design it can be coded and applied in many different hardware and/or software configurations.

  10. Optical design of an optical coherence tomography and multispectral fluorescence imaging endoscope to detect early stage ovarian cancer

    NASA Astrophysics Data System (ADS)

    Tate, Tyler; Keenan, Molly; Swan, Elizabeth; Black, John; Utzinger, Urs; Barton, Jennifer

    2014-12-01

    The five year survival rate for ovarian cancer is over 90% if early detection occurs, yet no effective early screening method exists. We have designed and are constructing a dual modality Optical Coherence Tomography (OCT) and Multispectral Fluorescence Imaging (MFI) endoscope to optically screen the Fallopian tube and ovary for early stage cancer. The endoscope reaches the ovary via the natural pathway of the vagina, cervix, uterus and Fallopian tube. In order to navigate the Fallopian tube the endoscope must have an outer diameter of 600 μm, be highly flexible, steerable, tracking and nonperforating. The imaging systems consists of six optical subsystems, two from OCT and four from MFI. The optical subsystems have independent and interrelated design criteria. The endoscope will be tested on realistic tissue models and ex vivo tissue to prove feasibility of future human trials. Ultimately the project aims to provide women the first effective ovarian cancer screening technique.

  11. Valuing Evaluation: A Practical Approach to Designing an Evaluation That Works for You. Working Papers in Early Childhood Development 26.

    ERIC Educational Resources Information Center

    Thomas, Alain

    This paper synthesizes a 1-day workshop held in Israel in May 1997 on behalf of the National Council for the Child with the support of the Bernard van Leer Foundation and attended by representatives of projects and organizations involved in promoting early childhood development. The goal of the workshop was to help participants design and carry…

  12. 78 FR 69690 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... and Gene Therapy Products; Extension of Comment Period AGENCY: Food and Drug Administration, HHS...: Considerations for the Design of Early-Phase Clinical Trials of Cellular and Gene Therapy Products'' that... sponsors of Investigational New Drug Applications for cellular therapy (CT) and gene therapy (GT) products...

  13. Promoting Career Development and Life Design in the Early Years of a Person's Life

    ERIC Educational Resources Information Center

    Maree, Jacobus G.

    2018-01-01

    The article discusses the changing world of work and the attendant uncertainty and loss of work-life identity. Little research has been done on career development and life design in the early years of a person's life, especially in developing countries characterized by disadvantage. The underlying theoretical models of career development are…

  14. 10 CFR 2.110 - Filing and administrative action on submittals for standard design approval or early review of...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., Office of New Reactors, or Director, Office of Nuclear Reactor Regulation, as appropriate shall publish... Nuclear Reactor Regulation, as appropriate shall publish in the Federal Register a determination as to... standard design approval or early review of site suitability issues. 2.110 Section 2.110 Energy NUCLEAR...

  15. 10 CFR 2.110 - Filing and administrative action on submittals for standard design approval or early review of...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., Office of Nuclear Reactor Regulation, as appropriate shall publish in the Federal Register a notice of... Director, Office of New Reactors or Director, Office of Nuclear Reactor Regulation, as appropriate shall... standard design approval or early review of site suitability issues. 2.110 Section 2.110 Energy NUCLEAR...

  16. 10 CFR 2.110 - Filing and administrative action on submittals for standard design approval or early review of...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., Office of Nuclear Reactor Regulation, as appropriate shall publish in the Federal Register a notice of... Director, Office of New Reactors or Director, Office of Nuclear Reactor Regulation, as appropriate shall... standard design approval or early review of site suitability issues. 2.110 Section 2.110 Energy NUCLEAR...

  17. Conceptual plural information is used to guide early parsing decisions: Evidence from garden-path sentences with reciprocal verbs.

    PubMed

    Patson, Nikole D; Ferreira, Fernanda

    2009-05-01

    In three eyetracking studies, we investigated the role of conceptual plura