An All-Fragments Grammar for Simple and Accurate Parsing

DTIC Science & Technology

2012-03-21

Tsujii. Probabilistic CFG with latent annotations. In Proceedings of ACL, 2005. Slav Petrov and Dan Klein. Improved Inference for Unlexicalized Parsing. In...Proceedings of NAACL-HLT, 2007. Slav Petrov and Dan Klein. Sparse Multi-Scale Grammars for Discriminative Latent Variable Parsing. In Proceedings of...EMNLP, 2008. Slav Petrov, Leon Barrett, Romain Thibaux, and Dan Klein. Learning Accurate, Compact, and Interpretable Tree Annotation. In Proceedings

High-frequency neural activity predicts word parsing in ambiguous speech streams

PubMed Central

Basirat, Anahita; Azizi, Leila; van Wassenhove, Virginie

2016-01-01

During speech listening, the brain parses a continuous acoustic stream of information into computational units (e.g., syllables or words) necessary for speech comprehension. Recent neuroscientific hypotheses have proposed that neural oscillations contribute to speech parsing, but whether they do so on the basis of acoustic cues (bottom-up acoustic parsing) or as a function of available linguistic representations (top-down linguistic parsing) is unknown. In this magnetoencephalography study, we contrasted acoustic and linguistic parsing using bistable speech sequences. While listening to the speech sequences, participants were asked to maintain one of the two possible speech percepts through volitional control. We predicted that the tracking of speech dynamics by neural oscillations would not only follow the acoustic properties but also shift in time according to the participant's conscious speech percept. Our results show that the latency of high-frequency activity (specifically, beta and gamma bands) varied as a function of the perceptual report. In contrast, the phase of low-frequency oscillations was not strongly affected by top-down control. Whereas changes in low-frequency neural oscillations were compatible with the encoding of prelexical segmentation cues, high-frequency activity specifically informed on an individual's conscious speech percept. PMID:27605528

High-frequency neural activity predicts word parsing in ambiguous speech streams.

PubMed

Kösem, Anne; Basirat, Anahita; Azizi, Leila; van Wassenhove, Virginie

2016-12-01

During speech listening, the brain parses a continuous acoustic stream of information into computational units (e.g., syllables or words) necessary for speech comprehension. Recent neuroscientific hypotheses have proposed that neural oscillations contribute to speech parsing, but whether they do so on the basis of acoustic cues (bottom-up acoustic parsing) or as a function of available linguistic representations (top-down linguistic parsing) is unknown. In this magnetoencephalography study, we contrasted acoustic and linguistic parsing using bistable speech sequences. While listening to the speech sequences, participants were asked to maintain one of the two possible speech percepts through volitional control. We predicted that the tracking of speech dynamics by neural oscillations would not only follow the acoustic properties but also shift in time according to the participant's conscious speech percept. Our results show that the latency of high-frequency activity (specifically, beta and gamma bands) varied as a function of the perceptual report. In contrast, the phase of low-frequency oscillations was not strongly affected by top-down control. Whereas changes in low-frequency neural oscillations were compatible with the encoding of prelexical segmentation cues, high-frequency activity specifically informed on an individual's conscious speech percept. Copyright © 2016 the American Physiological Society.

Integrating high dimensional bi-directional parsing models for gene mention tagging.

PubMed

Hsu, Chun-Nan; Chang, Yu-Ming; Kuo, Cheng-Ju; Lin, Yu-Shi; Huang, Han-Shen; Chung, I-Fang

2008-07-01

Tagging gene and gene product mentions in scientific text is an important initial step of literature mining. In this article, we describe in detail our gene mention tagger participated in BioCreative 2 challenge and analyze what contributes to its good performance. Our tagger is based on the conditional random fields model (CRF), the most prevailing method for the gene mention tagging task in BioCreative 2. Our tagger is interesting because it accomplished the highest F-scores among CRF-based methods and second over all. Moreover, we obtained our results by mostly applying open source packages, making it easy to duplicate our results. We first describe in detail how we developed our CRF-based tagger. We designed a very high dimensional feature set that includes most of information that may be relevant. We trained bi-directional CRF models with the same set of features, one applies forward parsing and the other backward, and integrated two models based on the output scores and dictionary filtering. One of the most prominent factors that contributes to the good performance of our tagger is the integration of an additional backward parsing model. However, from the definition of CRF, it appears that a CRF model is symmetric and bi-directional parsing models will produce the same results. We show that due to different feature settings, a CRF model can be asymmetric and the feature setting for our tagger in BioCreative 2 not only produces different results but also gives backward parsing models slight but constant advantage over forward parsing model. To fully explore the potential of integrating bi-directional parsing models, we applied different asymmetric feature settings to generate many bi-directional parsing models and integrate them based on the output scores. Experimental results show that this integrated model can achieve even higher F-score solely based on the training corpus for gene mention tagging. Data sets, programs and an on-line service of our gene

Parsing the Practice of Teaching

ERIC Educational Resources Information Center

Kennedy, Mary

2016-01-01

Teacher education programs typically teach novices about one part of teaching at a time. We might offer courses on different topics--cultural foundations, learning theory, or classroom management--or we may parse teaching practice itself into a set of discrete techniques, such as core teaching practices, that can be taught individually. Missing…

High-content image informatics of the structural nuclear protein NuMA parses trajectories for stem/progenitor cell lineages and oncogenic transformation

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

Vega, Sebastián L.; Liu, Er; Arvind, Varun

Stem and progenitor cells that exhibit significant regenerative potential and critical roles in cancer initiation and progression remain difficult to characterize. Cell fates are determined by reciprocal signaling between the cell microenvironment and the nucleus; hence parameters derived from nuclear remodeling are ideal candidates for stem/progenitor cell characterization. Here we applied high-content, single cell analysis of nuclear shape and organization to examine stem and progenitor cells destined to distinct differentiation endpoints, yet undistinguishable by conventional methods. Nuclear descriptors defined through image informatics classified mesenchymal stem cells poised to either adipogenic or osteogenic differentiation, and oligodendrocyte precursors isolated from different regionsmore » of the brain and destined to distinct astrocyte subtypes. Nuclear descriptors also revealed early changes in stem cells after chemical oncogenesis, allowing the identification of a class of cancer-mitigating biomaterials. To capture the metrology of nuclear changes, we developed a simple and quantitative “imaging-derived” parsing index, which reflects the dynamic evolution of the high-dimensional space of nuclear organizational features. A comparative analysis of parsing outcomes via either nuclear shape or textural metrics of the nuclear structural protein NuMA indicates the nuclear shape alone is a weak phenotypic predictor. In contrast, variations in the NuMA organization parsed emergent cell phenotypes and discerned emergent stages of stem cell transformation, supporting a prognosticating role for this protein in the outcomes of nuclear functions. - Highlights: • High-content analysis of nuclear shape and organization classify stem and progenitor cells poised for distinct lineages. • Early oncogenic changes in mesenchymal stem cells (MSCs) are also detected with nuclear descriptors. • A new class of cancer-mitigating biomaterials was identified based on

ParseCNV integrative copy number variation association software with quality tracking

PubMed Central

Glessner, Joseph T.; Li, Jin; Hakonarson, Hakon

2013-01-01

A number of copy number variation (CNV) calling algorithms exist; however, comprehensive software tools for CNV association studies are lacking. We describe ParseCNV, unique software that takes CNV calls and creates probe-based statistics for CNV occurrence in both case–control design and in family based studies addressing both de novo and inheritance events, which are then summarized based on CNV regions (CNVRs). CNVRs are defined in a dynamic manner to allow for a complex CNV overlap while maintaining precise association region. Using this approach, we avoid failure to converge and non-monotonic curve fitting weaknesses of programs, such as CNVtools and CNVassoc, and although Plink is easy to use, it only provides combined CNV state probe-based statistics, not state-specific CNVRs. Existing CNV association methods do not provide any quality tracking information to filter confident associations, a key issue which is fully addressed by ParseCNV. In addition, uncertainty in CNV calls underlying CNV associations is evaluated to verify significant results, including CNV overlap profiles, genomic context, number of probes supporting the CNV and single-probe intensities. When optimal quality control parameters are followed using ParseCNV, 90% of CNVs validate by polymerase chain reaction, an often problematic stage because of inadequate significant association review. ParseCNV is freely available at http://parsecnv.sourceforge.net. PMID:23293001

ParseCNV integrative copy number variation association software with quality tracking.

PubMed

Glessner, Joseph T; Li, Jin; Hakonarson, Hakon

2013-03-01

A number of copy number variation (CNV) calling algorithms exist; however, comprehensive software tools for CNV association studies are lacking. We describe ParseCNV, unique software that takes CNV calls and creates probe-based statistics for CNV occurrence in both case-control design and in family based studies addressing both de novo and inheritance events, which are then summarized based on CNV regions (CNVRs). CNVRs are defined in a dynamic manner to allow for a complex CNV overlap while maintaining precise association region. Using this approach, we avoid failure to converge and non-monotonic curve fitting weaknesses of programs, such as CNVtools and CNVassoc, and although Plink is easy to use, it only provides combined CNV state probe-based statistics, not state-specific CNVRs. Existing CNV association methods do not provide any quality tracking information to filter confident associations, a key issue which is fully addressed by ParseCNV. In addition, uncertainty in CNV calls underlying CNV associations is evaluated to verify significant results, including CNV overlap profiles, genomic context, number of probes supporting the CNV and single-probe intensities. When optimal quality control parameters are followed using ParseCNV, 90% of CNVs validate by polymerase chain reaction, an often problematic stage because of inadequate significant association review. ParseCNV is freely available at http://parsecnv.sourceforge.net.

Simultaneous Translation: Idiom Interpretation and Parsing Heuristics.

ERIC Educational Resources Information Center

McDonald, Janet L.; Carpenter, Patricia A.

1981-01-01

Presents a model of interpretation, parsing and error recovery in simultaneous translation using two experts and two amateur German-English bilingual translators orally translating from English to German. Argues that the translator first comprehends the text in English and divides it into meaningful units before translating. Study also…

Parsing and Tagging of Bilingual Dictionary

DTIC Science & Technology

2003-09-01

LAMP-TR-106 CAR-TR-991 CS-TR-4529 UMIACS-TR-2003-97 PARSING ANS TAGGING OF BILINGUAL DICTIONARY Huanfeng Ma1,2, Burcu Karagol-Ayan1,2, David... dictionaries hold great potential as a source of lexical resources for training and testing automated systems for optical character recognition, machine...translation, and cross-language information retrieval. In this paper, we describe a system for extracting term lexicons from printed bilingual dictionaries

Parsing English. Course Notes for a Tutorial on Computational Semantics, March 17-22, 1975.

ERIC Educational Resources Information Center

Wilks, Yorick

The course in parsing English is essentially a survey and comparison of several of the principal systems used for understanding natural language. The basic procedure of parsing is described. The discussion of the principal systems is based on the idea that "meaning is procedures," that is, that the procedures of application give a parsed…

A Semantic Parsing Method for Mapping Clinical Questions to Logical Forms

PubMed Central

Roberts, Kirk; Patra, Braja Gopal

2017-01-01

This paper presents a method for converting natural language questions about structured data in the electronic health record (EHR) into logical forms. The logical forms can then subsequently be converted to EHR-dependent structured queries. The natural language processing task, known as semantic parsing, has the potential to convert questions to logical forms with extremely high precision, resulting in a system that is usable and trusted by clinicians for real-time use in clinical settings. We propose a hybrid semantic parsing method, combining rule-based methods with a machine learning-based classifier. The overall semantic parsing precision on a set of 212 questions is 95.6%. The parser’s rules furthermore allow it to “know what it does not know”, enabling the system to indicate when unknown terms prevent it from understanding the question’s full logical structure. When combined with a module for converting a logical form into an EHR-dependent query, this high-precision approach allows for a question answering system to provide a user with a single, verifiably correct answer. PMID:29854217

Parsing GML data based on integrative GML syntactic and semantic schemas database

NASA Astrophysics Data System (ADS)

Miao, Lizhi; Zhang, Shuliang; Lu, Guonian; Gao, Xiaoli; Jiao, Donglai; Gan, Jiayan

2007-06-01

This paper proposes a new method to parse various application schemas of Geography Markup Language (GML) for understanding syntax and semantic of their element and type in order to implement uniform interpretation of the same GML instance data among diverse users. The proposed method generates an Integrative GML Syntactic and Semantic Schemas Database (IGSSSDB) from GML3.1 core schemas and corresponding application schema. This paper parses GML data based on IGSSSDB, which is composed of syntactic and semantic information, nesting information and mapping rules of GML core schemas and application schemas. Three kinds of relational tables are designed for storing information from schemas when constructing IGSSSDB. Those are info tables for schemas included and namespace imported in application schemas, tables for information related to schemas and catalog tables of core schemas. In relational tables, we propose to use homologous regular expression to describe model of elements and complex types in schemas, which can ensure model complete and readable. Based on IGSSSDB, we design and develop many APIs to implement GML data parsing, and can process syntactic and semantic information of GML data from diverse fields and users. At the latter part of this paper, test study is implemented to show that the proposed method is feasible and appropriate for parsing GML data. Also, it founds a good basis for future GML data studies such as storage, index and query etc.

Error-Correcting Parsing for Syntactic Pattern Recognition

DTIC Science & Technology

1977-08-01

1971. 55. Slromoney, G., Slromoney, R., and K. Krlthlvasan, "Abstract Families of Matrices and Picture Langauges," Computer Graphic and Image...T112 111X1 121 Tine USLO FOR LINXirjG A THtt .186 SEC "INPUT CHARACTER IS A DISTANCE PORN N0*flAL A IS_ 3 TINE USED FOX PARSING S.l&l SEC

Perceiving Event Dynamics and Parsing Hollywood Films

ERIC Educational Resources Information Center

Cutting, James E.; Brunick, Kaitlin L.; Candan, Ayse

2012-01-01

We selected 24 Hollywood movies released from 1940 through 2010 to serve as a film corpus. Eight viewers, three per film, parsed them into events, which are best termed subscenes. While watching a film a second time, viewers scrolled through frames and recorded the frame number where each event began. Viewers agreed about 90% of the time. We then…

Time-Driven Effects on Parsing during Reading

ERIC Educational Resources Information Center

Roll, Mikael; Lindgren, Magnus; Alter, Kai; Horne, Merle

2012-01-01

The phonological trace of perceived words starts fading away in short-term memory after a few seconds. Spoken utterances are usually 2-3 s long, possibly to allow the listener to parse the words into coherent prosodic phrases while they still have a clear representation. Results from this brain potential study suggest that even during silent…

Applications of Parsing Theory to Computer-Assisted Instruction.

ERIC Educational Resources Information Center

Markosian, Lawrence Z.; Ager, Tryg A.

1983-01-01

Applications of an LR-1 parsing algorithm to intelligent programs for computer assisted instruction in symbolic logic and foreign languages are discussed. The system has been adequately used for diverse instructional applications, including analysis of student input, generation of pattern drills, and modeling the student's understanding of the…

"gnparser": a powerful parser for scientific names based on Parsing Expression Grammar.

PubMed

Mozzherin, Dmitry Y; Myltsev, Alexander A; Patterson, David J

2017-05-26

Scientific names in biology act as universal links. They allow us to cross-reference information about organisms globally. However variations in spelling of scientific names greatly diminish their ability to interconnect data. Such variations may include abbreviations, annotations, misspellings, etc. Authorship is a part of a scientific name and may also differ significantly. To match all possible variations of a name we need to divide them into their elements and classify each element according to its role. We refer to this as 'parsing' the name. Parsing categorizes name's elements into those that are stable and those that are prone to change. Names are matched first by combining them according to their stable elements. Matches are then refined by examining their varying elements. This two stage process dramatically improves the number and quality of matches. It is especially useful for the automatic data exchange within the context of "Big Data" in biology. We introduce Global Names Parser (gnparser). It is a Java tool written in Scala language (a language for Java Virtual Machine) to parse scientific names. It is based on a Parsing Expression Grammar. The parser can be applied to scientific names of any complexity. It assigns a semantic meaning (such as genus name, species epithet, rank, year of publication, authorship, annotations, etc.) to all elements of a name. It is able to work with nested structures as in the names of hybrids. gnparser performs with ≈99% accuracy and processes 30 million name-strings/hour per CPU thread. The gnparser library is compatible with Scala, Java, R, Jython, and JRuby. The parser can be used as a command line application, as a socket server, a web-app or as a RESTful HTTP-service. It is released under an Open source MIT license. Global Names Parser (gnparser) is a fast, high precision tool for biodiversity informaticians and biologists working with large numbers of scientific names. It can replace expensive and error

Domain Adaption of Parsing for Operative Notes

PubMed Central

Wang, Yan; Pakhomov, Serguei; Ryan, James O.; Melton, Genevieve B.

2016-01-01

Background Full syntactic parsing of clinical text as a part of clinical natural language processing (NLP) is critical for a wide range of applications, such as identification of adverse drug reactions, patient cohort identification, and gene interaction extraction. Several robust syntactic parsers are publicly available to produce linguistic representations for sentences. However, these existing parsers are mostly trained on general English text and often require adaptation for optimal performance on clinical text. Our objective was to adapt an existing general English parser for the clinical text of operative reports via lexicon augmentation, statistics adjusting, and grammar rules modification based on a set of biomedical text. Method The Stanford unlexicalized probabilistic context-free grammar (PCFG) parser lexicon was expanded with SPECIALIST lexicon along with statistics collected from a limited set of operative notes tagged with a two of POS taggers (GENIA tagger and MedPost). The most frequently occurring verb entries of the SPECIALIST lexicon were adjusted based on manual review of verb usage in operative notes. Stanford parser grammar production rules were also modified based on linguistic features of operative reports. An analogous approach was then applied to the GENIA corpus to test the generalizability of this approach to biomedical text. Results The new unlexicalized PCFG parser extended with the extra lexicon from SPECIALIST along with accurate statistics collected from an operative note corpus tagged with GENIA POS tagger improved the parser performance by 2.26% from 87.64% to 89.90%. There was a progressive improvement with the addition of multiple approaches. Most of the improvement occurred with lexicon augmentation combined with statistics from the operative notes corpus. Application of this approach on the GENIA corpus showed that parsing performance was boosted by 3.81% with a simple new grammar and the addition of the GENIA corpus lexicon

Performance evaluation of continuity of care records (CCRs): parsing models in a mobile health management system.

PubMed

Chen, Hung-Ming; Liou, Yong-Zan

2014-10-01

In a mobile health management system, mobile devices act as the application hosting devices for personal health records (PHRs) and the healthcare servers construct to exchange and analyze PHRs. One of the most popular PHR standards is continuity of care record (CCR). The CCR is expressed in XML formats. However, parsing is an expensive operation that can degrade XML processing performance. Hence, the objective of this study was to identify different operational and performance characteristics for those CCR parsing models including the XML DOM parser, the SAX parser, the PULL parser, and the JSON parser with regard to JSON data converted from XML-based CCR. Thus, developers can make sensible choices for their target PHR applications to parse CCRs when using mobile devices or servers with different system resources. Furthermore, the simulation experiments of four case studies are conducted to compare the parsing performance on Android mobile devices and the server with large quantities of CCR data.

The effect of recognizability on figure-ground processing: does it affect parsing or only figure selection?

PubMed

Navon, David

2011-03-01

Though figure-ground assignment has been shown to be probably affected by recognizability, it appears sensible that object recognition must follow at least the earlier process of figure-ground segregation. To examine whether or not rudimentary object recognition could, counterintuitively, start even before the completion of the stage of parsing in which figure-ground segregation is done, participants were asked to respond, in a go/no-go fashion, whenever any out of 16 alternative connected patterns (that constituted familiar stimuli in the upright orientation) appeared. The white figure of the to-be-attended stimulus-target or foil-could be segregated from the white ambient ground only by means of a frame surrounding it. Such a frame was absent until the onset of target display. Then, to manipulate organizational quality, the greyness of the frame was either gradually increased from zero (in Experiment 1) or changed abruptly to a stationary level whose greyness was varied between trials (in Experiments 2 and 3). Stimulus recognizability was manipulated by orientation angle. In all three experiments the effect of recognizability was found to be considerably larger when organizational quality was minimal due to an extremely faint frame. This result is argued to be incompatible with any version of a serial thesis suggesting that processing aimed at object recognition starts only with a good enough level of organizational quality. The experiments rather provide some support to the claim, termed here "early interaction hypothesis", positing interaction between early recognition processing and preassignment parsing processes.

Perception of object trajectory: parsing retinal motion into self and object movement components.

PubMed

Warren, Paul A; Rushton, Simon K

2007-08-16

A moving observer needs to be able to estimate the trajectory of other objects moving in the scene. Without the ability to do so, it would be difficult to avoid obstacles or catch a ball. We hypothesized that neural mechanisms sensitive to the patterns of motion generated on the retina during self-movement (optic flow) play a key role in this process, "parsing" motion due to self-movement from that due to object movement. We investigated this "flow parsing" hypothesis by measuring the perceived trajectory of a moving probe placed within a flow field that was consistent with movement of the observer. In the first experiment, the flow field was consistent with an eye rotation; in the second experiment, it was consistent with a lateral translation of the eyes. We manipulated the distance of the probe in both experiments and assessed the consequences. As predicted by the flow parsing hypothesis, manipulating the distance of the probe had differing effects on the perceived trajectory of the probe in the two experiments. The results were consistent with the scene geometry and the type of simulated self-movement. In a third experiment, we explored the contribution of local and global motion processing to the results of the first two experiments. The data suggest that the parsing process involves global motion processing, not just local motion contrast. The findings of this study support a role for optic flow processing in the perception of object movement during self-movement.

The Parsing Syllable Envelopes Test for Assessment of Amplitude Modulation Discrimination Skills in Children: Development, Normative Data, and Test-Retest Reliability Studies.

PubMed

Cameron, Sharon; Chong-White, Nicky; Mealings, Kiri; Beechey, Tim; Dillon, Harvey; Young, Taegan

2018-02-01

Intensity peaks and valleys in the acoustic signal are salient cues to syllable structure, which is accepted to be a crucial early step in phonological processing. As such, the ability to detect low-rate (envelope) modulations in signal amplitude is essential to parse an incoming speech signal into smaller phonological units. The Parsing Syllable Envelopes (ParSE) test was developed to quantify the ability of children to recognize syllable boundaries using an amplitude modulation detection paradigm. The envelope of a 750-msec steady-state /a/ vowel is modulated into two or three pseudo-syllables using notches with modulation depths varying between 0% and 100% along an 11-step continuum. In an adaptive three-alternative forced-choice procedure, the participant identified whether one, two, or three pseudo-syllables were heard. Development of the ParSE stimuli and test protocols, and collection of normative and test-retest reliability data. Eleven adults (aged 23 yr 10 mo to 50 yr 9 mo, mean 32 yr 10 mo) and 134 typically developing, primary-school children (aged 6 yr 0 mo to 12 yr 4 mo, mean 9 yr 3 mo). There were 73 males and 72 females. Data were collected using a touchscreen computer. Psychometric functions (PFs) were automatically fit to individual data by the ParSE software. Performance was related to the modulation depth at which syllables can be detected with 88% accuracy (referred to as the upper boundary of the uncertainty region [UBUR]). A shallower PF slope reflected a greater level of uncertainty. Age effects were determined based on raw scores. z Scores were calculated to account for the effect of age on performance. Outliers, and individual data for which the confidence interval of the UBUR exceeded a maximum allowable value, were removed. Nonparametric tests were used as the data were skewed toward negative performance. Across participants, the performance criterion (UBUR) was met with a median modulation depth of 42%. The effect of age on the UBUR was

High-content image informatics of the structural nuclear protein NuMA parses trajectories for stem/progenitor cell lineages and oncogenic transformation.

PubMed

Vega, Sebastián L; Liu, Er; Arvind, Varun; Bushman, Jared; Sung, Hak-Joon; Becker, Matthew L; Lelièvre, Sophie; Kohn, Joachim; Vidi, Pierre-Alexandre; Moghe, Prabhas V

2017-02-01

Stem and progenitor cells that exhibit significant regenerative potential and critical roles in cancer initiation and progression remain difficult to characterize. Cell fates are determined by reciprocal signaling between the cell microenvironment and the nucleus; hence parameters derived from nuclear remodeling are ideal candidates for stem/progenitor cell characterization. Here we applied high-content, single cell analysis of nuclear shape and organization to examine stem and progenitor cells destined to distinct differentiation endpoints, yet undistinguishable by conventional methods. Nuclear descriptors defined through image informatics classified mesenchymal stem cells poised to either adipogenic or osteogenic differentiation, and oligodendrocyte precursors isolated from different regions of the brain and destined to distinct astrocyte subtypes. Nuclear descriptors also revealed early changes in stem cells after chemical oncogenesis, allowing the identification of a class of cancer-mitigating biomaterials. To capture the metrology of nuclear changes, we developed a simple and quantitative "imaging-derived" parsing index, which reflects the dynamic evolution of the high-dimensional space of nuclear organizational features. A comparative analysis of parsing outcomes via either nuclear shape or textural metrics of the nuclear structural protein NuMA indicates the nuclear shape alone is a weak phenotypic predictor. In contrast, variations in the NuMA organization parsed emergent cell phenotypes and discerned emergent stages of stem cell transformation, supporting a prognosticating role for this protein in the outcomes of nuclear functions. Copyright © 2017 Elsevier Inc. All rights reserved.

Locating and parsing bibliographic references in HTML medical articles

PubMed Central

Zou, Jie; Le, Daniel; Thoma, George R.

2010-01-01

The set of references that typically appear toward the end of journal articles is sometimes, though not always, a field in bibliographic (citation) databases. But even if references do not constitute such a field, they can be useful as a preprocessing step in the automated extraction of other bibliographic data from articles, as well as in computer-assisted indexing of articles. Automation in data extraction and indexing to minimize human labor is key to the affordable creation and maintenance of large bibliographic databases. Extracting the components of references, such as author names, article title, journal name, publication date and other entities, is therefore a valuable and sometimes necessary task. This paper describes a two-step process using statistical machine learning algorithms, to first locate the references in HTML medical articles and then to parse them. Reference locating identifies the reference section in an article and then decomposes it into individual references. We formulate this step as a two-class classification problem based on text and geometric features. An evaluation conducted on 500 articles drawn from 100 medical journals achieves near-perfect precision and recall rates for locating references. Reference parsing identifies the components of each reference. For this second step, we implement and compare two algorithms. One relies on sequence statistics and trains a Conditional Random Field. The other focuses on local feature statistics and trains a Support Vector Machine to classify each individual word, followed by a search algorithm that systematically corrects low confidence labels if the label sequence violates a set of predefined rules. The overall performance of these two reference-parsing algorithms is about the same: above 99% accuracy at the word level, and over 97% accuracy at the chunk level. PMID:20640222

Locating and parsing bibliographic references in HTML medical articles.

PubMed

Zou, Jie; Le, Daniel; Thoma, George R

2010-06-01

The set of references that typically appear toward the end of journal articles is sometimes, though not always, a field in bibliographic (citation) databases. But even if references do not constitute such a field, they can be useful as a preprocessing step in the automated extraction of other bibliographic data from articles, as well as in computer-assisted indexing of articles. Automation in data extraction and indexing to minimize human labor is key to the affordable creation and maintenance of large bibliographic databases. Extracting the components of references, such as author names, article title, journal name, publication date and other entities, is therefore a valuable and sometimes necessary task. This paper describes a two-step process using statistical machine learning algorithms, to first locate the references in HTML medical articles and then to parse them. Reference locating identifies the reference section in an article and then decomposes it into individual references. We formulate this step as a two-class classification problem based on text and geometric features. An evaluation conducted on 500 articles drawn from 100 medical journals achieves near-perfect precision and recall rates for locating references. Reference parsing identifies the components of each reference. For this second step, we implement and compare two algorithms. One relies on sequence statistics and trains a Conditional Random Field. The other focuses on local feature statistics and trains a Support Vector Machine to classify each individual word, followed by a search algorithm that systematically corrects low confidence labels if the label sequence violates a set of predefined rules. The overall performance of these two reference-parsing algorithms is about the same: above 99% accuracy at the word level, and over 97% accuracy at the chunk level.

Parsing Protocols Using Problem Solving Grammars. AI Memo 385.

ERIC Educational Resources Information Center

Miller, Mark L.; Goldstein, Ira P.

A theory of the planning and debugging of computer programs is formalized as a context free grammar, which is used to reveal the constituent structure of problem solving episodes by parsing protocols in which programs are written, tested, and debugged. This is illustrated by the detailed analysis of an actual session with a beginning student…

Perception of scene-relative object movement: Optic flow parsing and the contribution of monocular depth cues.

PubMed

Warren, Paul A; Rushton, Simon K

2009-05-01

We have recently suggested that the brain uses its sensitivity to optic flow in order to parse retinal motion into components arising due to self and object movement (e.g. Rushton, S. K., & Warren, P. A. (2005). Moving observers, 3D relative motion and the detection of object movement. Current Biology, 15, R542-R543). Here, we explore whether stereo disparity is necessary for flow parsing or whether other sources of depth information, which could theoretically constrain flow-field interpretation, are sufficient. Stationary observers viewed large field of view stimuli containing textured cubes, moving in a manner that was consistent with a complex observer movement through a stationary scene. Observers made speeded responses to report the perceived direction of movement of a probe object presented at different depths in the scene. Across conditions we varied the presence or absence of different binocular and monocular cues to depth order. In line with previous studies, results consistent with flow parsing (in terms of both perceived direction and response time) were found in the condition in which motion parallax and stereoscopic disparity were present. Observers were poorer at judging object movement when depth order was specified by parallax alone. However, as more monocular depth cues were added to the stimulus the results approached those found when the scene contained stereoscopic cues. We conclude that both monocular and binocular static depth information contribute to flow parsing. These findings are discussed in the context of potential architectures for a model of the flow parsing mechanism.

Applying Semantic-based Probabilistic Context-Free Grammar to Medical Language Processing – A Preliminary Study on Parsing Medication Sentences

PubMed Central

Xu, Hua; AbdelRahman, Samir; Lu, Yanxin; Denny, Joshua C.; Doan, Son

2011-01-01

Semantic-based sublanguage grammars have been shown to be an efficient method for medical language processing. However, given the complexity of the medical domain, parsers using such grammars inevitably encounter ambiguous sentences, which could be interpreted by different groups of production rules and consequently result in two or more parse trees. One possible solution, which has not been extensively explored previously, is to augment productions in medical sublanguage grammars with probabilities to resolve the ambiguity. In this study, we associated probabilities with production rules in a semantic-based grammar for medication findings and evaluated its performance on reducing parsing ambiguity. Using the existing data set from 2009 i2b2 NLP (Natural Language Processing) challenge for medication extraction, we developed a semantic-based CFG (Context Free Grammar) for parsing medication sentences and manually created a Treebank of 4,564 medication sentences from discharge summaries. Using the Treebank, we derived a semantic-based PCFG (probabilistic Context Free Grammar) for parsing medication sentences. Our evaluation using a 10-fold cross validation showed that the PCFG parser dramatically improved parsing performance when compared to the CFG parser. PMID:21856440

Text-to-phonemic transcription and parsing into mono-syllables of English text

NASA Astrophysics Data System (ADS)

Jusgir Mullick, Yugal; Agrawal, S. S.; Tayal, Smita; Goswami, Manisha

2004-05-01

The present paper describes a program that converts the English text (entered through the normal computer keyboard) into its phonemic representation and then parses it into mono-syllables. For every letter a set of context based rules is defined in lexical order. A default rule is also defined separately for each letter. Beginning from the first letter of the word the rules are checked and the most appropriate rule is applied on the letter to find its actual orthographic representation. If no matching rule is found, then the default rule is applied. Current rule sets the next position to be analyzed. Proceeding in the same manner orthographic representation for each word can be found. For example, ``reading'' is represented as ``rEdiNX'' by applying the following rules: r-->r move 1 position ahead ead-->Ed move 3 position ahead i-->i move 1 position ahead ng-->NX move 2 position ahead, i.e., end of word. The phonemic representations obtained from the above procedure are parsed to get mono-syllabic representation for various combinations such as CVC, CVCC, CV, CVCVC, etc. For example, the above phonemic representation will be parsed as rEdiNX---> /rE/ /diNX/. This study is a part of developing TTS for Indian English.

'Visual’ parsing can be taught quickly without visual experience during critical periods

PubMed Central

Reich, Lior; Amedi, Amir

2015-01-01

Cases of invasive sight-restoration in congenital blind adults demonstrated that acquiring visual abilities is extremely challenging, presumably because visual-experience during critical-periods is crucial for learning visual-unique concepts (e.g. size constancy). Visual rehabilitation can also be achieved using sensory-substitution-devices (SSDs) which convey visual information non-invasively through sounds. We tested whether one critical concept – visual parsing, which is highly-impaired in sight-restored patients – can be learned using SSD. To this end, congenitally blind adults participated in a unique, relatively short (~70 hours), SSD-‘vision’ training. Following this, participants successfully parsed 2D and 3D visual objects. Control individuals naïve to SSDs demonstrated that while some aspects of parsing with SSD are intuitive, the blind’s success could not be attributed to auditory processing alone. Furthermore, we had a unique opportunity to compare the SSD-users’ abilities to those reported for sight-restored patients who performed similar tasks visually, and who had months of eyesight. Intriguingly, the SSD-users outperformed the patients on most criteria tested. These suggest that with adequate training and technologies, key high-order visual features can be quickly acquired in adulthood, and lack of visual-experience during critical-periods can be somewhat compensated for. Practically, these highlight the potential of SSDs as standalone-aids or combined with invasive restoration approaches. PMID:26482105

Revise and resubmit: How real-time parsing limitations influence grammar acquisition

PubMed Central

Pozzan, Lucia; Trueswell, John C.

2015-01-01

We present the results from a three-day artificial language learning study on adults. The study examined whether sentence-parsing limitations, in particular, difficulties revising initial syntactic/semantic commitments during comprehension, shape learners’ ability to acquire a language. Findings show that both comprehension and production of morphology pertaining to sentence argument structure are delayed when this morphology consistently appears at the end, rather than at the beginning, of sentences in otherwise identical grammatical systems. This suggests that real-time processing constraints impact acquisition; morphological cues that tend to guide linguistic analyses are easier to learn than cues that revise these analyses. Parallel performance in production and comprehension indicates that parsing constraints affect grammatical acquisition, not just real-time commitments. Properties of the linguistic system (e.g., ordering of cues within a sentence) interact with the properties of the cognitive system (cognitive control and conflict-resolution abilities) and together affect language acquisition. PMID:26026607

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.

Pippi — Painless parsing, post-processing and plotting of posterior and likelihood samples

NASA Astrophysics Data System (ADS)

Scott, Pat

2012-11-01

Interpreting samples from likelihood or posterior probability density functions is rarely as straightforward as it seems it should be. Producing publication-quality graphics of these distributions is often similarly painful. In this short note I describe pippi, a simple, publicly available package for parsing and post-processing such samples, as well as generating high-quality PDF graphics of the results. Pippi is easily and extensively configurable and customisable, both in its options for parsing and post-processing samples, and in the visual aspects of the figures it produces. I illustrate some of these using an existing supersymmetric global fit, performed in the context of a gamma-ray search for dark matter. Pippi can be downloaded and followed at http://github.com/patscott/pippi.

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…

Automated vocabulary discovery for geo-parsing online epidemic intelligence.

PubMed

Keller, Mikaela; Freifeld, Clark C; Brownstein, John S

2009-11-24

Automated surveillance of the Internet provides a timely and sensitive method for alerting on global emerging infectious disease threats. HealthMap is part of a new generation of online systems designed to monitor and visualize, on a real-time basis, disease outbreak alerts as reported by online news media and public health sources. HealthMap is of specific interest for national and international public health organizations and international travelers. A particular task that makes such a surveillance useful is the automated discovery of the geographic references contained in the retrieved outbreak alerts. This task is sometimes referred to as "geo-parsing". A typical approach to geo-parsing would demand an expensive training corpus of alerts manually tagged by a human. Given that human readers perform this kind of task by using both their lexical and contextual knowledge, we developed an approach which relies on a relatively small expert-built gazetteer, thus limiting the need of human input, but focuses on learning the context in which geographic references appear. We show in a set of experiments, that this approach exhibits a substantial capacity to discover geographic locations outside of its initial lexicon. The results of this analysis provide a framework for future automated global surveillance efforts that reduce manual input and improve timeliness of reporting.

The Effect of Exposure on Syntactic Parsing in Spanish-English Bilinguals

ERIC Educational Resources Information Center

Dussias, Paola E.; Sagarra, Nuria

2007-01-01

An eye tracking experiment examined how exposure to a second language (L2) influences sentence parsing in the first language. Forty-four monolingual Spanish speakers, 24 proficient Spanish-English bilinguals with limited immersion experience in the L2 environment and 20 proficient Spanish-English bilinguals with extensive L2 immersion experience…

Parsing and Quantification of Raw Orbitrap Mass Spectrometer Data Using RawQuant.

PubMed

Kovalchik, Kevin A; Moggridge, Sophie; Chen, David D Y; Morin, Gregg B; Hughes, Christopher S

2018-06-01

Effective analysis of protein samples by mass spectrometry (MS) requires careful selection and optimization of a range of experimental parameters. As the output from the primary detection device, the "raw" MS data file can be used to gauge the success of a given sample analysis. However, the closed-source nature of the standard raw MS file can complicate effective parsing of the data contained within. To ease and increase the range of analyses possible, the RawQuant tool was developed to enable parsing of raw MS files derived from Thermo Orbitrap instruments to yield meta and scan data in an openly readable text format. RawQuant can be commanded to export user-friendly files containing MS 1 , MS 2 , and MS 3 metadata as well as matrices of quantification values based on isobaric tagging approaches. In this study, the utility of RawQuant is demonstrated in several scenarios: (1) reanalysis of shotgun proteomics data for the identification of the human proteome, (2) reanalysis of experiments utilizing isobaric tagging for whole-proteome quantification, and (3) analysis of a novel bacterial proteome and synthetic peptide mixture for assessing quantification accuracy when using isobaric tags. Together, these analyses successfully demonstrate RawQuant for the efficient parsing and quantification of data from raw Thermo Orbitrap MS files acquired in a range of common proteomics experiments. In addition, the individual analyses using RawQuant highlights parametric considerations in the different experimental sets and suggests targetable areas to improve depth of coverage in identification-focused studies and quantification accuracy when using isobaric tags.

A hierarchical methodology for urban facade parsing from TLS point clouds

NASA Astrophysics Data System (ADS)

Li, Zhuqiang; Zhang, Liqiang; Mathiopoulos, P. Takis; Liu, Fangyu; Zhang, Liang; Li, Shuaipeng; Liu, Hao

2017-01-01

The effective and automated parsing of building facades from terrestrial laser scanning (TLS) point clouds of urban environments is an important research topic in the GIS and remote sensing fields. It is also challenging because of the complexity and great variety of the available 3D building facade layouts as well as the noise and data missing of the input TLS point clouds. In this paper, we introduce a novel methodology for the accurate and computationally efficient parsing of urban building facades from TLS point clouds. The main novelty of the proposed methodology is that it is a systematic and hierarchical approach that considers, in an adaptive way, the semantic and underlying structures of the urban facades for segmentation and subsequent accurate modeling. Firstly, the available input point cloud is decomposed into depth planes based on a data-driven method; such layer decomposition enables similarity detection in each depth plane layer. Secondly, the labeling of the facade elements is performed using the SVM classifier in combination with our proposed BieS-ScSPM algorithm. The labeling outcome is then augmented with weak architectural knowledge. Thirdly, least-squares fitted normalized gray accumulative curves are applied to detect regular structures, and a binarization dilation extraction algorithm is used to partition facade elements. A dynamic line-by-line division is further applied to extract the boundaries of the elements. The 3D geometrical façade models are then reconstructed by optimizing facade elements across depth plane layers. We have evaluated the performance of the proposed method using several TLS facade datasets. Qualitative and quantitative performance comparisons with several other state-of-the-art methods dealing with the same facade parsing problem have demonstrated its superiority in performance and its effectiveness in improving segmentation accuracy.

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

Parsing the Effects Violence Exposure in Early Childhood: Modeling Developmental Pathways

PubMed Central

Carter, Alice S.; Ford, Julian D.

2012-01-01

Objective To prospectively examine pathways from early childhood violence exposure and trauma-related symptoms to school-age emotional health. Methods A longitudinal, birth cohort (N = 437) was assessed with parent reports of lifetime violence exposure and trauma-related symptoms at 3 years of age and later, internalizing and externalizing symptoms, and social competence at school age. Results Early family and neighborhood violence correlated significantly with early trauma-related symptoms and also significantly predicted school-age internalizing and externalizing symptoms and poorer competence, independent of sociodemographic risk and past-year violence exposure. Longitudinal pathways were significantly mediated by arousal and avoidance symptoms at 3 years of age, which increased risk for clinically significant emotional problems and lower competence at school age (adjusted odds ratios = 3.1–6.1, p < 0.01). Conclusions Trauma-related symptoms may mediate developmental pathways from early violence exposure to later emotional health. Interventions that prevent or reduce early trauma-related symptoms may ameliorate the long-term deleterious impact of violence exposure. PMID:21903730

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.

Incremental Learning of Context Free Grammars by Parsing-Based Rule Generation and Rule Set Search

NASA Astrophysics Data System (ADS)

Nakamura, Katsuhiko; Hoshina, Akemi

This paper discusses recent improvements and extensions in Synapse system for inductive inference of context free grammars (CFGs) from sample strings. Synapse uses incremental learning, rule generation based on bottom-up parsing, and the search for rule sets. The form of production rules in the previous system is extended from Revised Chomsky Normal Form A→βγ to Extended Chomsky Normal Form, which also includes A→B, where each of β and γ is either a terminal or nonterminal symbol. From the result of bottom-up parsing, a rule generation mechanism synthesizes minimum production rules required for parsing positive samples. Instead of inductive CYK algorithm in the previous version of Synapse, the improved version uses a novel rule generation method, called ``bridging,'' which bridges the lacked part of the derivation tree for the positive string. The improved version also employs a novel search strategy, called serial search in addition to minimum rule set search. The synthesis of grammars by the serial search is faster than the minimum set search in most cases. On the other hand, the size of the generated CFGs is generally larger than that by the minimum set search, and the system can find no appropriate grammar for some CFL by the serial search. The paper shows experimental results of incremental learning of several fundamental CFGs and compares the methods of rule generation and search strategies.

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...

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...

Learning for Semantic Parsing with Kernels under Various Forms of Supervision

DTIC Science & Technology

2007-08-01

natural language sentences to their formal executable meaning representations. This is a challenging problem and is critical for developing computing...sentences are semantically tractable. This indi- cates that Geoquery is more challenging domain for semantic parsing than ATIS. In the past, there have been a...Combining parsers. In Proceedings of the Conference on Em- pirical Methods in Natural Language Processing and Very Large Corpora (EMNLP/ VLC -99), pp. 187–194

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…

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,…

Effects of Prosodic and Lexical Constraints on Parsing in Young Children (and Adults)

ERIC Educational Resources Information Center

Snedeker, Jesse; Yuan, Sylvia

2008-01-01

Prior studies of ambiguity resolution in young children have found that children rely heavily on lexical information but persistently fail to use referential constraints in online parsing [Trueswell, J.C., Sekerina, I., Hill, N.M., & Logrip, M.L, (1999). The kindergarten-path effect: Studying on-line sentence processing in young children.…

KEGGParser: parsing and editing KEGG pathway maps in Matlab.

PubMed

Arakelyan, Arsen; Nersisyan, Lilit

2013-02-15

KEGG pathway database is a collection of manually drawn pathway maps accompanied with KGML format files intended for use in automatic analysis. KGML files, however, do not contain the required information for complete reproduction of all the events indicated in the static image of a pathway map. Several parsers and editors of KEGG pathways exist for processing KGML files. We introduce KEGGParser-a MATLAB based tool for KEGG pathway parsing, semiautomatic fixing, editing, visualization and analysis in MATLAB environment. It also works with Scilab. The source code is available at http://www.mathworks.com/matlabcentral/fileexchange/37561.

A novel argument for the Universality of Parsing principles.

PubMed

Grillo, Nino; Costa, João

2014-10-01

Previous work on Relative Clause attachment has overlooked a crucial grammatical distinction across both the languages and structures tested: the selective availability of Pseudo Relatives. We reconsider the literature in light of this observation and argue that, all else being equal, local attachment is found with genuine Relative Clauses and that non-local attachment emerges when their surface identical imposters, Pseudo Relatives, are available. Hence, apparent cross-linguistic variation in parsing preferences is reducible to grammatical factors. The results from two novel experiments in Italian are presented in support of these conclusions. Copyright © 2014 Elsevier B.V. All rights reserved.

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

FastaValidator: an open-source Java library to parse and validate FASTA formatted sequences.

PubMed

Waldmann, Jost; Gerken, Jan; Hankeln, Wolfgang; Schweer, Timmy; Glöckner, Frank Oliver

2014-06-14

Advances in sequencing technologies challenge the efficient importing and validation of FASTA formatted sequence data which is still a prerequisite for most bioinformatic tools and pipelines. Comparative analysis of commonly used Bio*-frameworks (BioPerl, BioJava and Biopython) shows that their scalability and accuracy is hampered. FastaValidator represents a platform-independent, standardized, light-weight software library written in the Java programming language. It targets computer scientists and bioinformaticians writing software which needs to parse quickly and accurately large amounts of sequence data. For end-users FastaValidator includes an interactive out-of-the-box validation of FASTA formatted files, as well as a non-interactive mode designed for high-throughput validation in software pipelines. The accuracy and performance of the FastaValidator library qualifies it for large data sets such as those commonly produced by massive parallel (NGS) technologies. It offers scientists a fast, accurate and standardized method for parsing and validating FASTA formatted sequence data.

PyParse: a semiautomated system for scoring spoken recall data.

PubMed

Solway, Alec; Geller, Aaron S; Sederberg, Per B; Kahana, Michael J

2010-02-01

Studies of human memory often generate data on the sequence and timing of recalled items, but scoring such data using conventional methods is difficult or impossible. We describe a Python-based semiautomated system that greatly simplifies this task. This software, called PyParse, can easily be used in conjunction with many common experiment authoring systems. Scored data is output in a simple ASCII format and can be accessed with the programming language of choice, allowing for the identification of features such as correct responses, prior-list intrusions, extra-list intrusions, and repetitions.

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.

Motion based parsing for video from observational psychology

NASA Astrophysics Data System (ADS)

Kokaram, Anil; Doyle, Erika; Lennon, Daire; Joyeux, Laurent; Fuller, Ray

2006-01-01

In Psychology it is common to conduct studies involving the observation of humans undertaking some task. The sessions are typically recorded on video and used for subjective visual analysis. The subjective analysis is tedious and time consuming, not only because much useless video material is recorded but also because subjective measures of human behaviour are not necessarily repeatable. This paper presents tools using content based video analysis that allow automated parsing of video from one such study involving Dyslexia. The tools rely on implicit measures of human motion that can be generalised to other applications in the domain of human observation. Results comparing quantitative assessment of human motion with subjective assessment are also presented, illustrating that the system is a useful scientific tool.

Parsing partial molar volumes of small molecules: a molecular dynamics study.

PubMed

Patel, Nisha; Dubins, David N; Pomès, Régis; Chalikian, Tigran V

2011-04-28

We used molecular dynamics (MD) simulations in conjunction with the Kirkwood-Buff theory to compute the partial molar volumes for a number of small solutes of various chemical natures. We repeated our computations using modified pair potentials, first, in the absence of the Coulombic term and, second, in the absence of the Coulombic and the attractive Lennard-Jones terms. Comparison of our results with experimental data and the volumetric results of Monte Carlo simulation with hard sphere potentials and scaled particle theory-based computations led us to conclude that, for small solutes, the partial molar volume computed with the Lennard-Jones potential in the absence of the Coulombic term nearly coincides with the cavity volume. On the other hand, MD simulations carried out with the pair interaction potentials containing only the repulsive Lennard-Jones term produce unrealistically large partial molar volumes of solutes that are close to their excluded volumes. Our simulation results are in good agreement with the reported schemes for parsing partial molar volume data on small solutes. In particular, our determined interaction volumes() and the thickness of the thermal volume for individual compounds are in good agreement with empirical estimates. This work is the first computational study that supports and lends credence to the practical algorithms of parsing partial molar volume data that are currently in use for molecular interpretations of volumetric data.

On the Early Left-Anterior Negativity (ELAN) in Syntax Studies

ERIC Educational Resources Information Center

Steinhauer, Karsten; Drury, John E.

2012-01-01

Within the framework of Friederici's (2002) neurocognitive model of sentence processing, the early left anterior negativity (ELAN) in event-related potentials (ERPs) has been claimed to be a brain marker of syntactic first-pass parsing. As ELAN components seem to be exclusively elicited by word category violations (phrase structure violations),…

Parsing interindividual drug variability: an emerging role for systems pharmacology

PubMed Central

Turner, Richard M; Park, B Kevin; Pirmohamed, Munir

2015-01-01

There is notable interindividual heterogeneity in drug response, affecting both drug efficacy and toxicity, resulting in patient harm and the inefficient utilization of limited healthcare resources. Pharmacogenomics is at the forefront of research to understand interindividual drug response variability, but although many genotype-drug response associations have been identified, translation of pharmacogenomic associations into clinical practice has been hampered by inconsistent findings and inadequate predictive values. These limitations are in part due to the complex interplay between drug-specific, human body and environmental factors influencing drug response and therefore pharmacogenomics, whilst intrinsically necessary, is by itself unlikely to adequately parse drug variability. The emergent, interdisciplinary and rapidly developing field of systems pharmacology, which incorporates but goes beyond pharmacogenomics, holds significant potential to further parse interindividual drug variability. Systems pharmacology broadly encompasses two distinct research efforts, pharmacologically-orientated systems biology and pharmacometrics. Pharmacologically-orientated systems biology utilizes high throughput omics technologies, including next-generation sequencing, transcriptomics and proteomics, to identify factors associated with differential drug response within the different levels of biological organization in the hierarchical human body. Increasingly complex pharmacometric models are being developed that quantitatively integrate factors associated with drug response. Although distinct, these research areas complement one another and continual development can be facilitated by iterating between dynamic experimental and computational findings. Ultimately, quantitative data-derived models of sufficient detail will be required to help realize the goal of precision medicine. WIREs Syst Biol Med 2015, 7:221–241. doi: 10.1002/wsbm.1302 PMID:25950758

Attribute And-Or Grammar for Joint Parsing of Human Pose, Parts and Attributes.

PubMed

Park, Seyoung; Nie, Xiaohan; Zhu, Song-Chun

2017-07-25

This paper presents an attribute and-or grammar (A-AOG) model for jointly inferring human body pose and human attributes in a parse graph with attributes augmented to nodes in the hierarchical representation. In contrast to other popular methods in the current literature that train separate classifiers for poses and individual attributes, our method explicitly represents the decomposition and articulation of body parts, and account for the correlations between poses and attributes. The A-AOG model is an amalgamation of three traditional grammar formulations: (i)Phrase structure grammar representing the hierarchical decomposition of the human body from whole to parts; (ii)Dependency grammar modeling the geometric articulation by a kinematic graph of the body pose; and (iii)Attribute grammar accounting for the compatibility relations between different parts in the hierarchy so that their appearances follow a consistent style. The parse graph outputs human detection, pose estimation, and attribute prediction simultaneously, which are intuitive and interpretable. We conduct experiments on two tasks on two datasets, and experimental results demonstrate the advantage of joint modeling in comparison with computing poses and attributes independently. Furthermore, our model obtains better performance over existing methods for both pose estimation and attribute prediction tasks.

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.

Machine learning to parse breast pathology reports in Chinese.

PubMed

Tang, Rong; Ouyang, Lizhi; Li, Clara; He, Yue; Griffin, Molly; Taghian, Alphonse; Smith, Barbara; Yala, Adam; Barzilay, Regina; Hughes, Kevin

2018-06-01

Large structured databases of pathology findings are valuable in deriving new clinical insights. However, they are labor intensive to create and generally require manual annotation. There has been some work in the bioinformatics community to support automating this work via machine learning in English. Our contribution is to provide an automated approach to construct such structured databases in Chinese, and to set the stage for extraction from other languages. We collected 2104 de-identified Chinese benign and malignant breast pathology reports from Hunan Cancer Hospital. Physicians with native Chinese proficiency reviewed the reports and annotated a variety of binary and numerical pathologic entities. After excluding 78 cases with a bilateral lesion in the same report, 1216 cases were used as a training set for the algorithm, which was then refined by 405 development cases. The Natural language processing algorithm was tested by using the remaining 405 cases to evaluate the machine learning outcome. The model was used to extract 13 binary entities and 8 numerical entities. When compared to physicians with native Chinese proficiency, the model showed a per-entity accuracy from 91 to 100% for all common diagnoses on the test set. The overall accuracy of binary entities was 98% and of numerical entities was 95%. In a per-report evaluation for binary entities with more than 100 training cases, 85% of all the testing reports were completely correct and 11% had an error in 1 out of 22 entities. We have demonstrated that Chinese breast pathology reports can be automatically parsed into structured data using standard machine learning approaches. The results of our study demonstrate that techniques effective in parsing English reports can be scaled to other languages.

Parsing Citations in Biomedical Articles Using Conditional Random Fields

PubMed Central

Zhang, Qing; Cao, Yong-Gang; Yu, Hong

2011-01-01

Citations are used ubiquitously in biomedical full-text articles and play an important role for representing both the rhetorical structure and the semantic content of the articles. As a result, text mining systems will significantly benefit from a tool that automatically extracts the content of a citation. In this study, we applied the supervised machine-learning algorithms Conditional Random Fields (CRFs) to automatically parse a citation into its fields (e.g., Author, Title, Journal, and Year). With a subset of html format open-access PubMed Central articles, we report an overall 97.95% F1-score. The citation parser can be accessed at: http://www.cs.uwm.edu/~qing/projects/cithit/index.html. PMID:21419403

The lived experience of serenity: using Parse's research method.

PubMed

Kruse, B G

1999-04-01

Parse's research method was used to investigate the meaning of serenity for survivors of a life-threatening illness or traumatic event. Ten survivors of cancer told their stories of the meaning of serenity as they had lived it in their lives. Descriptions were aided by photographs chosen by each participant to represent the meaning of serenity for them. The structure of serenity was generated through the extraction-synthesis process. Four main concepts--steering-yielding with the flow, savoring remembered visions of engaging surroundings, abiding with aloneness-togetherness, and attesting to a loving presence--emerged and led to a theoretical structure of serenity from the human becoming perspective. Findings confirm serenity as a multidimensional process.

Sleep Disrupts High-Level Speech Parsing Despite Significant Basic Auditory Processing.

PubMed

Makov, Shiri; Sharon, Omer; Ding, Nai; Ben-Shachar, Michal; Nir, Yuval; Zion Golumbic, Elana

2017-08-09

The extent to which the sleeping brain processes sensory information remains unclear. This is particularly true for continuous and complex stimuli such as speech, in which information is organized into hierarchically embedded structures. Recently, novel metrics for assessing the neural representation of continuous speech have been developed using noninvasive brain recordings that have thus far only been tested during wakefulness. Here we investigated, for the first time, the sleeping brain's capacity to process continuous speech at different hierarchical levels using a newly developed Concurrent Hierarchical Tracking (CHT) approach that allows monitoring the neural representation and processing-depth of continuous speech online. Speech sequences were compiled with syllables, words, phrases, and sentences occurring at fixed time intervals such that different linguistic levels correspond to distinct frequencies. This enabled us to distinguish their neural signatures in brain activity. We compared the neural tracking of intelligible versus unintelligible (scrambled and foreign) speech across states of wakefulness and sleep using high-density EEG in humans. We found that neural tracking of stimulus acoustics was comparable across wakefulness and sleep and similar across all conditions regardless of speech intelligibility. In contrast, neural tracking of higher-order linguistic constructs (words, phrases, and sentences) was only observed for intelligible speech during wakefulness and could not be detected at all during nonrapid eye movement or rapid eye movement sleep. These results suggest that, whereas low-level auditory processing is relatively preserved during sleep, higher-level hierarchical linguistic parsing is severely disrupted, thereby revealing the capacity and limits of language processing during sleep. SIGNIFICANCE STATEMENT Despite the persistence of some sensory processing during sleep, it is unclear whether high-level cognitive processes such as speech

Parsing clinical text: how good are the state-of-the-art parsers?

PubMed

Jiang, Min; Huang, Yang; Fan, Jung-wei; Tang, Buzhou; Denny, Josh; Xu, Hua

2015-01-01

Parsing, which generates a syntactic structure of a sentence (a parse tree), is a critical component of natural language processing (NLP) research in any domain including medicine. Although parsers developed in the general English domain, such as the Stanford parser, have been applied to clinical text, there are no formal evaluations and comparisons of their performance in the medical domain. In this study, we investigated the performance of three state-of-the-art parsers: the Stanford parser, the Bikel parser, and the Charniak parser, using following two datasets: (1) A Treebank containing 1,100 sentences that were randomly selected from progress notes used in the 2010 i2b2 NLP challenge and manually annotated according to a Penn Treebank based guideline; and (2) the MiPACQ Treebank, which is developed based on pathology notes and clinical notes, containing 13,091 sentences. We conducted three experiments on both datasets. First, we measured the performance of the three state-of-the-art parsers on the clinical Treebanks with their default settings. Then we re-trained the parsers using the clinical Treebanks and evaluated their performance using the 10-fold cross validation method. Finally we re-trained the parsers by combining the clinical Treebanks with the Penn Treebank. Our results showed that the original parsers achieved lower performance in clinical text (Bracketing F-measure in the range of 66.6%-70.3%) compared to general English text. After retraining on the clinical Treebank, all parsers achieved better performance, with the best performance from the Stanford parser that reached the highest Bracketing F-measure of 73.68% on progress notes and 83.72% on the MiPACQ corpus using 10-fold cross validation. When the combined clinical Treebanks and Penn Treebank was used, of the three parsers, the Charniak parser achieved the highest Bracketing F-measure of 73.53% on progress notes and the Stanford parser reached the highest F-measure of 84.15% on the Mi

Parsing clinical text: how good are the state-of-the-art parsers?

PubMed Central

2015-01-01

Background Parsing, which generates a syntactic structure of a sentence (a parse tree), is a critical component of natural language processing (NLP) research in any domain including medicine. Although parsers developed in the general English domain, such as the Stanford parser, have been applied to clinical text, there are no formal evaluations and comparisons of their performance in the medical domain. Methods In this study, we investigated the performance of three state-of-the-art parsers: the Stanford parser, the Bikel parser, and the Charniak parser, using following two datasets: (1) A Treebank containing 1,100 sentences that were randomly selected from progress notes used in the 2010 i2b2 NLP challenge and manually annotated according to a Penn Treebank based guideline; and (2) the MiPACQ Treebank, which is developed based on pathology notes and clinical notes, containing 13,091 sentences. We conducted three experiments on both datasets. First, we measured the performance of the three state-of-the-art parsers on the clinical Treebanks with their default settings. Then we re-trained the parsers using the clinical Treebanks and evaluated their performance using the 10-fold cross validation method. Finally we re-trained the parsers by combining the clinical Treebanks with the Penn Treebank. Results Our results showed that the original parsers achieved lower performance in clinical text (Bracketing F-measure in the range of 66.6%-70.3%) compared to general English text. After retraining on the clinical Treebank, all parsers achieved better performance, with the best performance from the Stanford parser that reached the highest Bracketing F-measure of 73.68% on progress notes and 83.72% on the MiPACQ corpus using 10-fold cross validation. When the combined clinical Treebanks and Penn Treebank was used, of the three parsers, the Charniak parser achieved the highest Bracketing F-measure of 73.53% on progress notes and the Stanford parser reached the highest F

Learning for Semantic Parsing and Natural Language Generation Using Statistical Machine Translation Techniques

DTIC Science & Technology

2007-08-01

In this domain, queries typically show a deeply nested structure, which makes the semantic parsing task rather challenging , e.g.: What states border...only 80% of the GEOQUERY queries are semantically tractable, which shows that GEOQUERY is indeed a more challenging domain than ATIS. Note that none...a particularly challenging task, because of the inherent ambiguity of natural languages on both sides. It has inspired a large body of research. In

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.

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

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

Parsing with logical variables (logic-based programming systems)

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

Finin, T.W.; Stone Palmer, M.

1983-01-01

Logic based programming systems have enjoyed an increasing popularity in applied AI work in the last few years. One of the contributions to computational linguistics made by the logic programming paradigm has been the definite clause grammar. In comparing DCGS with previous parsing mechanisms such as ATNS, certain clear advantages are seen. The authors feel that the most important of these advantages are due to the use of logical variables with unification as the fundamental operation on them. To illustrate the power of the logical variable, they have implemented an experimental atn system which treats atn registers as logical variablesmore » and provides a unification operation over them. They aim to simultaneously encourage the use of the powerful mechanisms available in DCGS and demonstrate that some of these techniques can be captured without reference to a resolution theorem prover. 14 references.« less

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.

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

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

Parsing learning in networks using brain-machine interfaces.

PubMed

Orsborn, Amy L; Pesaran, Bijan

2017-10-01

Brain-machine interfaces (BMIs) define new ways to interact with our environment and hold great promise for clinical therapies. Motor BMIs, for instance, re-route neural activity to control movements of a new effector and could restore movement to people with paralysis. Increasing experience shows that interfacing with the brain inevitably changes the brain. BMIs engage and depend on a wide array of innate learning mechanisms to produce meaningful behavior. BMIs precisely define the information streams into and out of the brain, but engage wide-spread learning. We take a network perspective and review existing observations of learning in motor BMIs to show that BMIs engage multiple learning mechanisms distributed across neural networks. Recent studies demonstrate the advantages of BMI for parsing this learning and its underlying neural mechanisms. BMIs therefore provide a powerful tool for studying the neural mechanisms of learning that highlights the critical role of learning in engineered neural therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Weighting Statistical Inputs for Data Used to Support Effective Decision Making During Severe Emergency Weather and Environmental Events

NASA Technical Reports Server (NTRS)

Gardner, Adrian

2010-01-01

National Aeronautical and Space Administration (NASA) weather and atmospheric environmental organizations are insatiable consumers of geophysical, hydrometeorological and solar weather statistics. The expanding array of internet-worked sensors producing targeted physical measurements has generated an almost factorial explosion of near real-time inputs to topical statistical datasets. Normalizing and value-based parsing of such statistical datasets in support of time-constrained weather and environmental alerts and warnings is essential, even with dedicated high-performance computational capabilities. What are the optimal indicators for advanced decision making? How do we recognize the line between sufficient statistical sampling and excessive, mission destructive sampling ? How do we assure that the normalization and parsing process, when interpolated through numerical models, yields accurate and actionable alerts and warnings? This presentation will address the integrated means and methods to achieve desired outputs for NASA and consumers of its data.

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.

Marginal Space Deep Learning: Efficient Architecture for Volumetric Image Parsing.

PubMed

Ghesu, Florin C; Krubasik, Edward; Georgescu, Bogdan; Singh, Vivek; Yefeng Zheng; Hornegger, Joachim; Comaniciu, Dorin

2016-05-01

Robust and fast solutions for anatomical object detection and segmentation support the entire clinical workflow from diagnosis, patient stratification, therapy planning, intervention and follow-up. Current state-of-the-art techniques for parsing volumetric medical image data are typically based on machine learning methods that exploit large annotated image databases. Two main challenges need to be addressed, these are the efficiency in scanning high-dimensional parametric spaces and the need for representative image features which require significant efforts of manual engineering. We propose a pipeline for object detection and segmentation in the context of volumetric image parsing, solving a two-step learning problem: anatomical pose estimation and boundary delineation. For this task we introduce Marginal Space Deep Learning (MSDL), a novel framework exploiting both the strengths of efficient object parametrization in hierarchical marginal spaces and the automated feature design of Deep Learning (DL) network architectures. In the 3D context, the application of deep learning systems is limited by the very high complexity of the parametrization. More specifically 9 parameters are necessary to describe a restricted affine transformation in 3D, resulting in a prohibitive amount of billions of scanning hypotheses. The mechanism of marginal space learning provides excellent run-time performance by learning classifiers in clustered, high-probability regions in spaces of gradually increasing dimensionality. To further increase computational efficiency and robustness, in our system we learn sparse adaptive data sampling patterns that automatically capture the structure of the input. Given the object localization, we propose a DL-based active shape model to estimate the non-rigid object boundary. Experimental results are presented on the aortic valve in ultrasound using an extensive dataset of 2891 volumes from 869 patients, showing significant improvements of up to 45

The value of parsing as feature generation for gene mention recognition

PubMed Central

Smith, Larry H; Wilbur, W John

2009-01-01

We measured the extent to which information surrounding a base noun phrase reflects the presence of a gene name, and evaluated seven different parsers in their ability to provide information for that purpose. Using the GENETAG corpus as a gold standard, we performed machine learning to recognize from its context when a base noun phrase contained a gene name. Starting with the best lexical features, we assessed the gain of adding dependency or dependency-like relations from a full sentence parse. Features derived from parsers improved performance in this partial gene mention recognition task by a small but statistically significant amount. There were virtually no differences between parsers in these experiments. PMID:19345281

Acoustic landmarks drive delta-theta oscillations to enable speech comprehension by facilitating perceptual parsing

PubMed Central

Doelling, Keith; Arnal, Luc; Ghitza, Oded; Poeppel, David

2013-01-01

A growing body of research suggests that intrinsic neuronal slow (< 10 Hz) oscillations in auditory cortex appear to track incoming speech and other spectro-temporally complex auditory signals. Within this framework, several recent studies have identified critical-band temporal envelopes as the specific acoustic feature being reflected by the phase of these oscillations. However, how this alignment between speech acoustics and neural oscillations might underpin intelligibility is unclear. Here we test the hypothesis that the ‘sharpness’ of temporal fluctuations in the critical band envelope acts as a temporal cue to speech syllabic rate, driving delta-theta rhythms to track the stimulus and facilitate intelligibility. We interpret our findings as evidence that sharp events in the stimulus cause cortical rhythms to re-align and parse the stimulus into syllable-sized chunks for further decoding. Using magnetoencephalographic recordings, we show that by removing temporal fluctuations that occur at the syllabic rate, envelope-tracking activity is reduced. By artificially reinstating these temporal fluctuations, envelope-tracking activity is regained. These changes in tracking correlate with intelligibility of the stimulus. Together, the results suggest that the sharpness of fluctuations in the stimulus, as reflected in the cochlear output, drive oscillatory activity to track and entrain to the stimulus, at its syllabic rate. This process likely facilitates parsing of the stimulus into meaningful chunks appropriate for subsequent decoding, enhancing perception and intelligibility. PMID:23791839

Toward a theory of distributed word expert natural language parsing

NASA Technical Reports Server (NTRS)

Rieger, C.; Small, S.

1981-01-01

An approach to natural language meaning-based parsing in which the unit of linguistic knowledge is the word rather than the rewrite rule is described. In the word expert parser, knowledge about language is distributed across a population of procedural experts, each representing a word of the language, and each an expert at diagnosing that word's intended usage in context. The parser is structured around a coroutine control environment in which the generator-like word experts ask questions and exchange information in coming to collective agreement on sentence meaning. The word expert theory is advanced as a better cognitive model of human language expertise than the traditional rule-based approach. The technical discussion is organized around examples taken from the prototype LISP system which implements parts of the theory.

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.

The lived experience of doing the right thing: a parse method study.

PubMed

Smith, Sandra Maxwell

2012-01-01

The purposes of this research were to discover the structure of the experience of doing the right thing and to contribute to nursing knowledge. The Parse research method was used in this study to answer the research question: What is the structure of the lived experience of doing the right thing? Participants were 10 individuals living in the community. The central finding of this study was the following structure: The lived experience of doing the right thing is steadfast uprightness amid adversity, as honorableness with significant affiliations emerges with contentment. New knowledge extended the theory of humanbecoming and enhanced understanding of the experience of doing the right thing.

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

Mining protein phosphorylation information from biomedical literature using NLP parsing and Support Vector Machines.

PubMed

Raja, Kalpana; Natarajan, Jeyakumar

2018-07-01

Extraction of protein phosphorylation information from biomedical literature has gained much attention because of the importance in numerous biological processes. In this study, we propose a text mining methodology which consists of two phases, NLP parsing and SVM classification to extract phosphorylation information from literature. First, using NLP parsing we divide the data into three base-forms depending on the biomedical entities related to phosphorylation and further classify into ten sub-forms based on their distribution with phosphorylation keyword. Next, we extract the phosphorylation entity singles/pairs/triplets and apply SVM to classify the extracted singles/pairs/triplets using a set of features applicable to each sub-form. The performance of our methodology was evaluated on three corpora namely PLC, iProLink and hPP corpus. We obtained promising results of >85% F-score on ten sub-forms of training datasets on cross validation test. Our system achieved overall F-score of 93.0% on iProLink and 96.3% on hPP corpus test datasets. Furthermore, our proposed system achieved best performance on cross corpus evaluation and outperformed the existing system with recall of 90.1%. The performance analysis of our unique system on three corpora reveals that it extracts protein phosphorylation information efficiently in both non-organism specific general datasets such as PLC and iProLink, and human specific dataset such as hPP corpus. Copyright © 2018 Elsevier B.V. All rights reserved.

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.

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

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,…

Parsing in a Dynamical System: An Attractor-Based Account of the Interaction of Lexical and Structural Constraints in Sentence Processing.

ERIC Educational Resources Information Center

Tabor, Whitney; And Others

1997-01-01

Proposes a dynamical systems approach to parsing in which syntactic hypotheses are associated with attractors in a metric space. The experiments discussed documented various contingent frequency effects that cut across traditional linguistic grains, each of which was predicted by the dynamical systems model. (47 references) (Author/CK)

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.

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.

Video content parsing based on combined audio and visual information

NASA Astrophysics Data System (ADS)

Zhang, Tong; Kuo, C.-C. Jay

1999-08-01

While previous research on audiovisual data segmentation and indexing primarily focuses on the pictorial part, significant clues contained in the accompanying audio flow are often ignored. A fully functional system for video content parsing can be achieved more successfully through a proper combination of audio and visual information. By investigating the data structure of different video types, we present tools for both audio and visual content analysis and a scheme for video segmentation and annotation in this research. In the proposed system, video data are segmented into audio scenes and visual shots by detecting abrupt changes in audio and visual features, respectively. Then, the audio scene is categorized and indexed as one of the basic audio types while a visual shot is presented by keyframes and associate image features. An index table is then generated automatically for each video clip based on the integration of outputs from audio and visual analysis. It is shown that the proposed system provides satisfying video indexing results.

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.

GFFview: A Web Server for Parsing and Visualizing Annotation Information of Eukaryotic Genome.

PubMed

Deng, Feilong; Chen, Shi-Yi; Wu, Zhou-Lin; Hu, Yongsong; Jia, Xianbo; Lai, Song-Jia

2017-10-01

Owing to wide application of RNA sequencing (RNA-seq) technology, more and more eukaryotic genomes have been extensively annotated, such as the gene structure, alternative splicing, and noncoding loci. Annotation information of genome is prevalently stored as plain text in General Feature Format (GFF), which could be hundreds or thousands Mb in size. Therefore, it is a challenge for manipulating GFF file for biologists who have no bioinformatic skill. In this study, we provide a web server (GFFview) for parsing the annotation information of eukaryotic genome and then generating statistical description of six indices for visualization. GFFview is very useful for investigating quality and difference of the de novo assembled transcriptome in RNA-seq studies.

Comparing the Concept of Caring in Islamic Perspective with Watson and Parse's Nursing Theories

PubMed Central

Sadat-Hoseini, Akram-Sadat; Khosropanah, Abdoul-Hosein

2017-01-01

Background: In the nursing profession, it is apparent that the definition of caring differs between various perspectives. This article compares the difference of caring in Islamic with the Parse and Watson theories. Materials and Methods: In this study, we use concept analyses of Walker–Avants and compare research methods. Material used is all Islamic documents. Results: According to Islamic documents, there are four major types of caring, namely, (1) God taking care of humans, (2) Humans taking care of themselves, (3) Other humans taking care of humans, and (4) The universe taking care of humans and vice versa. God caring for humans affects the three other types of caring. All three definitions of caring have humanistic and holistic view. According to Watson's and Parse's definition, the development of the caring theory is based on the person's experiences that result from human interactions with, and experiences of, their environment. In Islamic definition, although the caring process is affected by environmental experiences and interactions, human not developed only base the effect of environment; rather, it is developed on the basis of human nature and divine commands. God taking care of humans is specific to Islamic perspective and is not found in other definitions. Islamic perspective maintains that God is the creator of humanity and is in charge of guiding humans. A superior form of human can always be discovered. Conclusions: Thus, nursing implementation in Muslims must be done based on Islamic commands, and Islamic commands are superior to human experiences. However, Islamic commands interpreted with human wisdom and thought can be striving toward excellence. PMID:28584543

Parsing Heterogeneity in the Brain Connectivity of Depressed and Healthy Adults During Positive Mood.

PubMed

Price, Rebecca B; Lane, Stephanie; Gates, Kathleen; Kraynak, Thomas E; Horner, Michelle S; Thase, Michael E; Siegle, Greg J

2017-02-15

There is well-known heterogeneity in affective mechanisms in depression that may extend to positive affect. We used data-driven parsing of neural connectivity to reveal subgroups present across depressed and healthy individuals during positive processing, informing targets for mechanistic intervention. Ninety-two individuals (68 depressed patients, 24 never-depressed control subjects) completed a sustained positive mood induction during functional magnetic resonance imaging. Directed functional connectivity paths within a depression-relevant network were characterized using Group Iterative Multiple Model Estimation (GIMME), a method shown to accurately recover the direction and presence of connectivity paths in individual participants. During model selection, individuals were clustered using community detection on neural connectivity estimates. Subgroups were externally tested across multiple levels of analysis. Two connectivity-based subgroups emerged: subgroup A, characterized by weaker connectivity overall, and subgroup B, exhibiting hyperconnectivity (relative to subgroup A), particularly among ventral affective regions. Subgroup predicted diagnostic status (subgroup B contained 81% of patients; 50% of control subjects; χ 2 = 8.6, p = .003) and default mode network connectivity during a separate resting-state task. Among patients, subgroup B members had higher self-reported symptoms, lower sustained positive mood during the induction, and higher negative bias on a reaction-time task. Symptom-based depression subgroups did not predict these external variables. Neural connectivity-based categorization travels with diagnostic category and is clinically predictive, but not clinically deterministic. Both patients and control subjects showed heterogeneous, and overlapping, profiles. The larger and more severely affected patient subgroup was characterized by ventrally driven hyperconnectivity during positive processing. Data-driven parsing suggests heterogeneous

Earth Sciences data user community feedbacks to PARSE.Insight

NASA Astrophysics Data System (ADS)

Giaretta, David; Guidetti, Veronica

2010-05-01

The presentation in point reports on the topic of long term availability of environmental data as perceived by the Earth Science data user community. In the context of the European strategy for preserving Earth Observation (EO) data and as partner of the EU FP7 PARSE.Insight project (http://www.parse-insight.eu/), the European Space Agency (ESA) issued a public consultation on-line targeting its EO data user base. The timely and active participation confirmed the high interest in the addressed topic. Primary target of such an action is to provide ESA teams dedicated to environmental data access, archiving and re-processing with the first insight from the Earth Science community on the preservation of space data in the long-term. As a significant example, ESA's Climate Change Initiative requires activities like long-term preservation, recalibration and re-processing of data records. The time-span of EO data archives extends from a few years to decades and their value as scientific time-series increases considerably regarding the topic of global change. Future research in the field of Earth Sciences is of invaluable importance: to carry it on researchers worldwide must be enabled to find and access data of interest quickly. At present several thousands of scientists, principal investigators and operators, access EO missions' metadata, data and derived information daily. Main objectives may be to study the global climate change, to check the status of the instrument and the quality of EO data. There is a huge worldwide scientific community calling for the need to keep EO data accessible without time constrains, easily and quickly. The scientific community's standpoint is given over the stewardship of environmental data and the appropriateness of current EO data access systems as enabling digital preservation and offering HPC capabilities. This insight in the Earth Sciences community provides a comprehensive illustration of the users' responses over topics like use

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.

Drug-related webpages classification based on multi-modal local decision fusion

NASA Astrophysics Data System (ADS)

Hu, Ruiguang; Su, Xiaojing; Liu, Yanxin

2018-03-01

In this paper, multi-modal local decision fusion is used for drug-related webpages classification. First, meaningful text are extracted through HTML parsing, and effective images are chosen by the FOCARSS algorithm. Second, six SVM classifiers are trained for six kinds of drug-taking instruments, which are represented by PHOG. One SVM classifier is trained for the cannabis, which is represented by the mid-feature of BOW model. For each instance in a webpage, seven SVMs give seven labels for its image, and other seven labels are given by searching the names of drug-taking instruments and cannabis in its related text. Concatenating seven labels of image and seven labels of text, the representation of those instances in webpages are generated. Last, Multi-Instance Learning is used to classify those drugrelated webpages. Experimental results demonstrate that the classification accuracy of multi-instance learning with multi-modal local decision fusion is much higher than those of single-modal classification.

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.

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.

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.

Using the Longman Mini-concordancer on Tagged and Parsed Corpora, with Special Reference to Their Use as an Aid to Grammar Learning.

ERIC Educational Resources Information Center

Qiao, Hong Liang; Sussex, Roland

1996-01-01

Presents methods for using the Longman Mini-Concordancer on tagged and parsed corpora rather than plain text corpora. The article discusses several aspects with models to be applied in the classroom as an aid to grammar learning. This paper suggests exercises suitable for teaching English to both native and nonnative speakers. (13 references)…

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.

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

The Self in Decision Making and Decision Implementation.

ERIC Educational Resources Information Center

Beach, Lee Roy; Mitchell, Terence R.

Since the early 1950's the principal prescriptive model in the psychological study of decision making has been maximization of Subjective Expected Utility (SEU). This SEU maximization has come to be regarded as a description of how people go about making decisions. However, while observed decision processes sometimes resemble the SEU model,…

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

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.

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.

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.

Multidimensional incremental parsing for universal source coding.

PubMed

Bae, Soo Hyun; Juang, Biing-Hwang

2008-10-01

A multidimensional incremental parsing algorithm (MDIP) for multidimensional discrete sources, as a generalization of the Lempel-Ziv coding algorithm, is investigated. It consists of three essential component schemes, maximum decimation matching, hierarchical structure of multidimensional source coding, and dictionary augmentation. As a counterpart of the longest match search in the Lempel-Ziv algorithm, two classes of maximum decimation matching are studied. Also, an underlying behavior of the dictionary augmentation scheme for estimating the source statistics is examined. For an m-dimensional source, m augmentative patches are appended into the dictionary at each coding epoch, thus requiring the transmission of a substantial amount of information to the decoder. The property of the hierarchical structure of the source coding algorithm resolves this issue by successively incorporating lower dimensional coding procedures in the scheme. In regard to universal lossy source coders, we propose two distortion functions, the local average distortion and the local minimax distortion with a set of threshold levels for each source symbol. For performance evaluation, we implemented three image compression algorithms based upon the MDIP; one is lossless and the others are lossy. The lossless image compression algorithm does not perform better than the Lempel-Ziv-Welch coding, but experimentally shows efficiency in capturing the source structure. The two lossy image compression algorithms are implemented using the two distortion functions, respectively. The algorithm based on the local average distortion is efficient at minimizing the signal distortion, but the images by the one with the local minimax distortion have a good perceptual fidelity among other compression algorithms. Our insights inspire future research on feature extraction of multidimensional discrete sources.

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.

Parsing fear: A reassessment of the evidence for fear deficits in psychopathy.

PubMed

Hoppenbrouwers, Sylco S; Bulten, Berend H; Brazil, Inti A

2016-06-01

Psychopathy is a personality disorder characterized by interpersonal manipulation and callousness, and reckless and impulsive antisocial behavior. It is often seen as a disorder in which profound emotional disturbances lead to antisocial behavior. A lack of fear in particular has been proposed as an etiologically salient factor. In this review, we employ a conceptual model in which fear is parsed into separate subcomponents. Important historical conceptualizations of psychopathy, the neuroscientific and empirical evidence for fear deficits in psychopathy are compared against this model. The empirical evidence is also subjected to a meta-analysis. We conclude that most studies have used the term "fear" generically, amassing different methods and levels of measurement under the umbrella term "fear." Unlike earlier claims that psychopathy is related to general fearlessness, we show there is evidence that psychopathic individuals have deficits in threat detection and responsivity, but that the evidence for reduced subjective experience of fear in psychopathy is far less compelling. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

Thermo-msf-parser: an open source Java library to parse and visualize Thermo Proteome Discoverer msf files.

PubMed

Colaert, Niklaas; Barsnes, Harald; Vaudel, Marc; Helsens, Kenny; Timmerman, Evy; Sickmann, Albert; Gevaert, Kris; Martens, Lennart

2011-08-05

The Thermo Proteome Discoverer program integrates both peptide identification and quantification into a single workflow for peptide-centric proteomics. Furthermore, its close integration with Thermo mass spectrometers has made it increasingly popular in the field. Here, we present a Java library to parse the msf files that constitute the output of Proteome Discoverer. The parser is also implemented as a graphical user interface allowing convenient access to the information found in the msf files, and in Rover, a program to analyze and validate quantitative proteomics information. All code, binaries, and documentation is freely available at http://thermo-msf-parser.googlecode.com.

Rapid transcriptome characterization and parsing of sequences in a non-model host-pathogen interaction; pea-Sclerotinia sclerotiorum

PubMed Central

2012-01-01

Background White mold, caused by Sclerotinia sclerotiorum, is one of the most important diseases of pea (Pisum sativum L.), however, little is known about the genetics and biochemistry of this interaction. Identification of genes underlying resistance in the host or pathogenicity and virulence factors in the pathogen will increase our knowledge of the pea-S. sclerotiorum interaction and facilitate the introgression of new resistance genes into commercial pea varieties. Although the S. sclerotiorum genome sequence is available, no pea genome is available, due in part to its large genome size (~3500 Mb) and extensive repeated motifs. Here we present an EST data set specific to the interaction between S. sclerotiorum and pea, and a method to distinguish pathogen and host sequences without a species-specific reference genome. Results 10,158 contigs were obtained by de novo assembly of 128,720 high-quality reads generated by 454 pyrosequencing of the pea-S. sclerotiorum interactome. A method based on the tBLASTx program was modified to distinguish pea and S. sclerotiorum ESTs. To test this strategy, a mixture of known ESTs (18,490 pea and 17,198 S. sclerotiorum ESTs) from public databases were pooled and parsed; the tBLASTx method successfully separated 90.1% of the artificial EST mix with 99.9% accuracy. The tBLASTx method successfully parsed 89.4% of the 454-derived EST contigs, as validated by PCR, into pea (6,299 contigs) and S. sclerotiorum (2,780 contigs) categories. Two thousand eight hundred and forty pea ESTs and 996 S. sclerotiorum ESTs were predicted to be expressed specifically during the pea-S. sclerotiorum interaction as determined by homology search against 81,449 pea ESTs (from flowers, leaves, cotyledons, epi- and hypocotyl, and etiolated and light treated etiolated seedlings) and 57,751 S. sclerotiorum ESTs (from mycelia at neutral pH, developing apothecia and developing sclerotia). Among those ESTs specifically expressed, 277 (9.8%) pea ESTs

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.

An Intelligent Polar Cyberinfrastrucuture to Support Spatiotemporal Decision Making

NASA Astrophysics Data System (ADS)

Song, M.; Li, W.; Zhou, X.

2014-12-01

In the era of big data, polar sciences have already faced an urgent demand of utilizing intelligent approaches to support precise and effective spatiotemporal decision-making. Service-oriented cyberinfrastructure has advantages of seamlessly integrating distributed computing resources, and aggregating a variety of geospatial data derived from Earth observation network. This paper focuses on building a smart service-oriented cyberinfrastructure to support intelligent question answering related to polar datasets. The innovation of this polar cyberinfrastructure includes: (1) a problem-solving environment that parses geospatial question in natural language, builds geoprocessing rules, composites atomic processing services and executes the entire workflow; (2) a self-adaptive spatiotemporal filter that is capable of refining query constraints through semantic analysis; (3) a dynamic visualization strategy to support results animation and statistics in multiple spatial reference systems; and (4) a user-friendly online portal to support collaborative decision-making. By means of this polar cyberinfrastructure, we intend to facilitate integration of distributed and heterogeneous Arctic datasets and comprehensive analysis of multiple environmental elements (e.g. snow, ice, permafrost) to provide a better understanding of the environmental variation in circumpolar regions.

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.

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.

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.

Deliberation before determination: the definition and evaluation of good decision making.

PubMed

Elwyn, Glyn; Miron-Shatz, Talya

2010-06-01

In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post-hoc estimations and post-decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches. We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated. We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision's end results. We propose decision making comprises a pre-decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre-decisional deliberation process, the act of determination and post-decisional outcomes. Evaluating the deliberation process, we propose, should comprise of a subjective sufficiency of knowledge, as well as emotional processing and

Deep PDF parsing to extract features for detecting embedded malware.

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

Munson, Miles Arthur; Cross, Jesse S.

2011-09-01

The number of PDF files with embedded malicious code has risen significantly in the past few years. This is due to the portability of the file format, the ways Adobe Reader recovers from corrupt PDF files, the addition of many multimedia and scripting extensions to the file format, and many format properties the malware author may use to disguise the presence of malware. Current research focuses on executable, MS Office, and HTML formats. In this paper, several features and properties of PDF Files are identified. Features are extracted using an instrumented open source PDF viewer. The feature descriptions of benignmore » and malicious PDFs can be used to construct a machine learning model for detecting possible malware in future PDF files. The detection rate of PDF malware by current antivirus software is very low. A PDF file is easy to edit and manipulate because it is a text format, providing a low barrier to malware authors. Analyzing PDF files for malware is nonetheless difficult because of (a) the complexity of the formatting language, (b) the parsing idiosyncrasies in Adobe Reader, and (c) undocumented correction techniques employed in Adobe Reader. In May 2011, Esparza demonstrated that PDF malware could be hidden from 42 of 43 antivirus packages by combining multiple obfuscation techniques [4]. One reason current antivirus software fails is the ease of varying byte sequences in PDF malware, thereby rendering conventional signature-based virus detection useless. The compression and encryption functions produce sequences of bytes that are each functions of multiple input bytes. As a result, padding the malware payload with some whitespace before compression/encryption can change many of the bytes in the final payload. In this study we analyzed a corpus of 2591 benign and 87 malicious PDF files. While this corpus is admittedly small, it allowed us to test a system for collecting indicators of embedded PDF malware. We will call these indicators features

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…

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…

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…

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…

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…

Abortion Decision and Ambivalence: Insights via an Abortion Decision Balance Sheet

ERIC Educational Resources Information Center

Allanson, Susie

2007-01-01

Decision ambivalence is a key concept in abortion literature, but has been poorly operationalised. This study explored the concept of decision ambivalence via an Abortion Decision Balance Sheet (ADBS) articulating reasons both for and against terminating an unintended pregnancy. Ninety-six women undergoing an early abortion for psychosocial…

Parse, simulation, and prediction of NOx emission across the Midwestern United States

NASA Astrophysics Data System (ADS)

Fang, H.; Michalski, G. M.; Spak, S.

2017-12-01

Accurately constraining N emissions in space and time has been a challenge for atmospheric scientists. It has been suggested that 15N isotopes may be a way of tracking N emission sources across various spatial and temporal scales. However, the complexity of multiple N sources that can quickly change in intensity has made this a difficult problem. We have used a SMOKE emission model to parse NOx emission across the Midwestern United States for a one-year simulation. An isotope mass balance methods was used to assign 15N values to road, non-road, point, and area sources. The SMOKE emissions and isotope mass balance were then combined to predict the 15N of NOx emissions (Figure 1). This ^15N of NOx emissions model was then incorporated into CMAQ to assess the role of transport and chemistry would impact the 15N value of NOx due to mixing and removal processes. The predicted 15N value of NOx was compared to those in recent measurements of NOx and atmospheric nitrate.

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

Maladaptive Decision Making in Adults with a History of Adolescent Alcohol use, in a Preclinical Model, Is Attributable to the Compromised Assignment of Incentive Value during Stimulus-Reward Learning.

PubMed

Kruse, Lauren C; Schindler, Abigail G; Williams, Rapheal G; Weber, Sophia J; Clark, Jeremy J

2017-01-01

According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood. Previously we have used a preclinical model of voluntary alcohol intake in rats to show that use in adolescence promotes risky decision making in adulthood that is mirrored by selective perturbations in dopamine network dynamics. Further, we have demonstrated that incentive learning processes in adulthood are also altered by adolescent alcohol use, again mirrored by changes in cue-evoked dopamine signaling. Indeed, we have proposed that these two processes, risk-based decision making and incentive learning, are fundamentally linked through dysfunction of midbrain circuitry where inputs to the dopamine system are disrupted by adolescent alcohol use. Here, we test the behavioral predictions of this model in rats and present the findings in the context of the prevailing literature with reference to the long-term consequences of early-life substance use on the vulnerability to develop substance use disorders. We utilize an impulsive choice task to assess the selectivity of alcohol's effect on decision-making profiles and conditioned reinforcement to parse out the effect of incentive value attribution, one mechanism of incentive learning. Finally, we use the differential reinforcement of low rates of responding (DRL) task to examine the degree to which

Maladaptive Decision Making in Adults with a History of Adolescent Alcohol use, in a Preclinical Model, Is Attributable to the Compromised Assignment of Incentive Value during Stimulus-Reward Learning

PubMed Central

Kruse, Lauren C.; Schindler, Abigail G.; Williams, Rapheal G.; Weber, Sophia J.; Clark, Jeremy J.

2017-01-01

According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood. Previously we have used a preclinical model of voluntary alcohol intake in rats to show that use in adolescence promotes risky decision making in adulthood that is mirrored by selective perturbations in dopamine network dynamics. Further, we have demonstrated that incentive learning processes in adulthood are also altered by adolescent alcohol use, again mirrored by changes in cue-evoked dopamine signaling. Indeed, we have proposed that these two processes, risk-based decision making and incentive learning, are fundamentally linked through dysfunction of midbrain circuitry where inputs to the dopamine system are disrupted by adolescent alcohol use. Here, we test the behavioral predictions of this model in rats and present the findings in the context of the prevailing literature with reference to the long-term consequences of early-life substance use on the vulnerability to develop substance use disorders. We utilize an impulsive choice task to assess the selectivity of alcohol’s effect on decision-making profiles and conditioned reinforcement to parse out the effect of incentive value attribution, one mechanism of incentive learning. Finally, we use the differential reinforcement of low rates of responding (DRL) task to examine the degree to which

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.

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.

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

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.

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'…

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.

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.

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.

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

"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…

A Python package for parsing, validating, mapping and formatting sequence variants using HGVS nomenclature.

PubMed

Hart, Reece K; Rico, Rudolph; Hare, Emily; Garcia, John; Westbrook, Jody; Fusaro, Vincent A

2015-01-15

Biological sequence variants are commonly represented in scientific literature, clinical reports and databases of variation using the mutation nomenclature guidelines endorsed by the Human Genome Variation Society (HGVS). Despite the widespread use of the standard, no freely available and comprehensive programming libraries are available. Here we report an open-source and easy-to-use Python library that facilitates the parsing, manipulation, formatting and validation of variants according to the HGVS specification. The current implementation focuses on the subset of the HGVS recommendations that precisely describe sequence-level variation relevant to the application of high-throughput sequencing to clinical diagnostics. The package is released under the Apache 2.0 open-source license. Source code, documentation and issue tracking are available at http://bitbucket.org/hgvs/hgvs/. Python packages are available at PyPI (https://pypi.python.org/pypi/hgvs). Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press.

Parsing recursive sentences with a connectionist model including a neural stack and synaptic gating.

PubMed

Fedor, Anna; Ittzés, Péter; Szathmáry, Eörs

2011-02-21

It is supposed that humans are genetically predisposed to be able to recognize sequences of context-free grammars with centre-embedded recursion while other primates are restricted to the recognition of finite state grammars with tail-recursion. Our aim was to construct a minimalist neural network that is able to parse artificial sentences of both grammars in an efficient way without using the biologically unrealistic backpropagation algorithm. The core of this network is a neural stack-like memory where the push and pop operations are regulated by synaptic gating on the connections between the layers of the stack. The network correctly categorizes novel sentences of both grammars after training. We suggest that the introduction of the neural stack memory will turn out to be substantial for any biological 'hierarchical processor' and the minimalist design of the model suggests a quest for similar, realistic neural architectures. Copyright © 2010 Elsevier Ltd. All rights reserved.

A Python package for parsing, validating, mapping and formatting sequence variants using HGVS nomenclature

PubMed Central

Hart, Reece K.; Rico, Rudolph; Hare, Emily; Garcia, John; Westbrook, Jody; Fusaro, Vincent A.

2015-01-01

Summary: Biological sequence variants are commonly represented in scientific literature, clinical reports and databases of variation using the mutation nomenclature guidelines endorsed by the Human Genome Variation Society (HGVS). Despite the widespread use of the standard, no freely available and comprehensive programming libraries are available. Here we report an open-source and easy-to-use Python library that facilitates the parsing, manipulation, formatting and validation of variants according to the HGVS specification. The current implementation focuses on the subset of the HGVS recommendations that precisely describe sequence-level variation relevant to the application of high-throughput sequencing to clinical diagnostics. Availability and implementation: The package is released under the Apache 2.0 open-source license. Source code, documentation and issue tracking are available at http://bitbucket.org/hgvs/hgvs/. Python packages are available at PyPI (https://pypi.python.org/pypi/hgvs). Contact: reecehart@gmail.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25273102

Decisions, Decisions: The Countless Times Instructional Practice and Reality Meet

ERIC Educational Resources Information Center

Miranda, Martina L.

2014-01-01

This article examines critical issues related to teacher decision-making in early childhood music classrooms. Through the story of one teacher's experience, we take a closer look at specific criteria to guide decision-making, and strategies to deepen awareness of young children's needs in the music classroom and guide instructional…

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.

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…

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.

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

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

USGS Publications Warehouse

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.

Online Object Tracking, Learning and Parsing with And-Or Graphs.

PubMed

Wu, Tianfu; Lu, Yang; Zhu, Song-Chun

2017-12-01

This paper presents a method, called AOGTracker, for simultaneously tracking, learning and parsing (TLP) of unknown objects in video sequences with a hierarchical and compositional And-Or graph (AOG) representation. The TLP method is formulated in the Bayesian framework with a spatial and a temporal dynamic programming (DP) algorithms inferring object bounding boxes on-the-fly. During online learning, the AOG is discriminatively learned using latent SVM [1] to account for appearance (e.g., lighting and partial occlusion) and structural (e.g., different poses and viewpoints) variations of a tracked object, as well as distractors (e.g., similar objects) in background. Three key issues in online inference and learning are addressed: (i) maintaining purity of positive and negative examples collected online, (ii) controling model complexity in latent structure learning, and (iii) identifying critical moments to re-learn the structure of AOG based on its intrackability. The intrackability measures uncertainty of an AOG based on its score maps in a frame. In experiments, our AOGTracker is tested on two popular tracking benchmarks with the same parameter setting: the TB-100/50/CVPR2013 benchmarks  , [3] , and the VOT benchmarks [4] -VOT 2013, 2014, 2015 and TIR2015 (thermal imagery tracking). In the former, our AOGTracker outperforms state-of-the-art tracking algorithms including two trackers based on deep convolutional network   [5] , [6] . In the latter, our AOGTracker outperforms all other trackers in VOT2013 and is comparable to the state-of-the-art methods in VOT2014, 2015 and TIR2015.

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

"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…

Parsing affective dynamics to identify risk for mood and anxiety disorders.

PubMed

Heller, Aaron S; Fox, Andrew S; Davidson, Richard J

2018-06-04

Emotional dysregulation is thought to underlie risk for both anxiety and depressive disorders. However, despite high rates of comorbidity, anxiety and depression are phenotypically different. Apart from nosological differences (e.g., worry for anxiety, low mood for depression), it remains unclear how the emotional dysregulation inherent in individual differences in trait anxiety and depression severity present on a day-to-day basis. One approach that may facilitate addressing these questions is to utilize Ecological Momentary Assessment (EMA) using mobile phones to parse the temporal dynamics of affective experiences into specific parameters. An emerging literature in affective science suggests that risk for anxiety and depressive disorders may be associated with variation in the mean and instability/variability of emotion. Here we examine the extent to which distinct temporal dynamic parameters uniquely predict risk for anxiety versus depression. Over 10 days, 105 individuals rated their current positive and negative affective state several times each day. Using two distinct approaches to statistically assess mean and instability of positive and negative affect, we found that individual differences in trait anxiety was generally associated with increased instability of positive and negative affect whereas mean levels of positive and negative affect were generally associated with individual differences in depression. These data provide evidence that the emotional dysregulation underlying risk for mood versus anxiety disorders unfolds in distinct ways and highlights the utility in examining affective dynamics to understand psychopathology. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Perceived visual speed constrained by image segmentation

NASA Technical Reports Server (NTRS)

Verghese, P.; Stone, L. S.

1996-01-01

Little is known about how or where the visual system parses the visual scene into objects or surfaces. However, it is generally assumed that the segmentation and grouping of pieces of the image into discrete entities is due to 'later' processing stages, after the 'early' processing of the visual image by local mechanisms selective for attributes such as colour, orientation, depth, and motion. Speed perception is also thought to be mediated by early mechanisms tuned for speed. Here we show that manipulating the way in which an image is parsed changes the way in which local speed information is processed. Manipulations that cause multiple stimuli to appear as parts of a single patch degrade speed discrimination, whereas manipulations that perceptually divide a single large stimulus into parts improve discrimination. These results indicate that processes as early as speed perception may be constrained by the parsing of the visual image into discrete entities.

'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

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.

Critiquing Systems for Decision Support

DTIC Science & Technology

2006-02-01

errors and deficiencies. An example of a comparative critic is the ATTENDING system ( anaesthesiology ), which first parses the user’s solution into a...design tools at the times when those tools are useful. 9. Experiential critics provide reminders of past experiences with similar designs or design...technique for hypertension rather than the broader field of anaesthesiology ; and (2) critiquing systems are most appropriate for tasks that require

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.

Modeling the Arden Syntax for medical decisions in XML.

PubMed

Kim, Sukil; Haug, Peter J; Rocha, Roberto A; Choi, Inyoung

2008-10-01

A new model expressing Arden Syntax with the eXtensible Markup Language (XML) was developed to increase its portability. Every example was manually parsed and reviewed until the schema and the style sheet were considered to be optimized. When the first schema was finished, several MLMs in Arden Syntax Markup Language (ArdenML) were validated against the schema. They were then transformed to HTML formats with the style sheet, during which they were compared to the original text version of their own MLM. When faults were found in the transformed MLM, the schema and/or style sheet was fixed. This cycle continued until all the examples were encoded into XML documents. The original MLMs were encoded in XML according to the proposed XML schema and reverse-parsed MLMs in ArdenML were checked using a public domain Arden Syntax checker. Two hundred seventy seven examples of MLMs were successfully transformed into XML documents using the model, and the reverse-parse yielded the original text version of MLMs. Two hundred sixty five of the 277 MLMs showed the same error patterns before and after transformation, and all 11 errors related to statement structure were resolved in XML version. The model uses two syntax checking mechanisms, first an XML validation process, and second, a syntax check using an XSL style sheet. Now that we have a schema for ArdenML, we can also begin the development of style sheets for transformation ArdenML into other languages.

Detecting modification of biomedical events using a deep parsing approach

PubMed Central

2012-01-01

Background This work describes a system for identifying event mentions in bio-molecular research abstracts that are either speculative (e.g. analysis of IkappaBalpha phosphorylation, where it is not specified whether phosphorylation did or did not occur) or negated (e.g. inhibition of IkappaBalpha phosphorylation, where phosphorylation did not occur). The data comes from a standard dataset created for the BioNLP 2009 Shared Task. The system uses a machine-learning approach, where the features used for classification are a combination of shallow features derived from the words of the sentences and more complex features based on the semantic outputs produced by a deep parser. Method To detect event modification, we use a Maximum Entropy learner with features extracted from the data relative to the trigger words of the events. The shallow features are bag-of-words features based on a small sliding context window of 3-4 tokens on either side of the trigger word. The deep parser features are derived from parses produced by the English Resource Grammar and the RASP parser. The outputs of these parsers are converted into the Minimal Recursion Semantics formalism, and from this, we extract features motivated by linguistics and the data itself. All of these features are combined to create training or test data for the machine learning algorithm. Results Over the test data, our methods produce approximately a 4% absolute increase in F-score for detection of event modification compared to a baseline based only on the shallow bag-of-words features. Conclusions Our results indicate that grammar-based techniques can enhance the accuracy of methods for detecting event modification. PMID:22595089

Detecting modification of biomedical events using a deep parsing approach.

PubMed

Mackinlay, Andrew; Martinez, David; Baldwin, Timothy

2012-04-30

This work describes a system for identifying event mentions in bio-molecular research abstracts that are either speculative (e.g. analysis of IkappaBalpha phosphorylation, where it is not specified whether phosphorylation did or did not occur) or negated (e.g. inhibition of IkappaBalpha phosphorylation, where phosphorylation did not occur). The data comes from a standard dataset created for the BioNLP 2009 Shared Task. The system uses a machine-learning approach, where the features used for classification are a combination of shallow features derived from the words of the sentences and more complex features based on the semantic outputs produced by a deep parser. To detect event modification, we use a Maximum Entropy learner with features extracted from the data relative to the trigger words of the events. The shallow features are bag-of-words features based on a small sliding context window of 3-4 tokens on either side of the trigger word. The deep parser features are derived from parses produced by the English Resource Grammar and the RASP parser. The outputs of these parsers are converted into the Minimal Recursion Semantics formalism, and from this, we extract features motivated by linguistics and the data itself. All of these features are combined to create training or test data for the machine learning algorithm. Over the test data, our methods produce approximately a 4% absolute increase in F-score for detection of event modification compared to a baseline based only on the shallow bag-of-words features. Our results indicate that grammar-based techniques can enhance the accuracy of methods for detecting event modification.

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.

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 CFR 12.303 - Pre-decision conferences.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Law Judge may, in his discretion, conduct one or more pre-decision conferences to be held in... amendments or supplements to the pleadings; (f) Encouraging an early settlement of disputes relating to... a pre-decision conference, the Administrative Law Judge may serve a pre-decision memorandum and...

17 CFR 12.303 - Pre-decision conferences.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Law Judge may, in his discretion, conduct one or more pre-decision conferences to be held in... amendments or supplements to the pleadings; (f) Encouraging an early settlement of disputes relating to... a pre-decision conference, the Administrative Law Judge may serve a pre-decision memorandum and...

17 CFR 12.303 - Pre-decision conferences.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Law Judge may, in his discretion, conduct one or more pre-decision conferences to be held in... amendments or supplements to the pleadings; (f) Encouraging an early settlement of disputes relating to... a pre-decision conference, the Administrative Law Judge may serve a pre-decision memorandum and...

17 CFR 12.303 - Pre-decision conferences.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Law Judge may, in his discretion, conduct one or more pre-decision conferences to be held in... amendments or supplements to the pleadings; (f) Encouraging an early settlement of disputes relating to... a pre-decision conference, the Administrative Law Judge may serve a pre-decision memorandum and...

17 CFR 12.303 - Pre-decision conferences.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Law Judge may, in his discretion, conduct one or more pre-decision conferences to be held in... amendments or supplements to the pleadings; (f) Encouraging an early settlement of disputes relating to... a pre-decision conference, the Administrative Law Judge may serve a pre-decision memorandum and...

Decision paths in complex tasks

NASA Technical Reports Server (NTRS)

Galanter, Eugene

1991-01-01

Complex real world action and its prediction and control has escaped analysis by the classical methods of psychological research. The reason is that psychologists have no procedures to parse complex tasks into their constituents. Where such a division can be made, based say on expert judgment, there is no natural scale to measure the positive or negative values of the components. Even if we could assign numbers to task parts, we lack rules i.e., a theory, to combine them into a total task representation. We compare here two plausible theories for the amalgamation of the value of task components. Both of these theories require a numerical representation of motivation, for motivation is the primary variable that guides choice and action in well-learned tasks. We address this problem of motivational quantification and performance prediction by developing psychophysical scales of the desireability or aversiveness of task components based on utility scaling methods (Galanter 1990). We modify methods used originally to scale sensory magnitudes (Stevens and Galanter 1957), and that have been applied recently to the measure of task 'workload' by Gopher and Braune (1984). Our modification uses utility comparison scaling techniques which avoid the unnecessary assumptions made by Gopher and Braune. Formula for the utility of complex tasks based on the theoretical models are used to predict decision and choice of alternate paths to the same goal.

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…

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

Understanding psychiatric disorder by capturing ecologically relevant features of learning and decision-making.

PubMed

Scholl, Jacqueline; Klein-Flügge, Miriam

2017-09-28

Recent research in cognitive neuroscience has begun to uncover the processes underlying increasingly complex voluntary behaviours, including learning and decision-making. Partly this success has been possible by progressing from simple experimental tasks to paradigms that incorporate more ecological features. More specifically, the premise is that to understand cognitions and brain functions relevant for real life, we need to introduce some of the ecological challenges that we have evolved to solve. This often entails an increase in task complexity, which can be managed by using computational models to help parse complex behaviours into specific component mechanisms. Here we propose that using computational models with tasks that capture ecologically relevant learning and decision-making processes may provide a critical advantage for capturing the mechanisms underlying symptoms of disorders in psychiatry. As a result, it may help develop mechanistic approaches towards diagnosis and treatment. We begin this review by mapping out the basic concepts and models of learning and decision-making. We then move on to consider specific challenges that emerge in realistic environments and describe how they can be captured by tasks. These include changes of context, uncertainty, reflexive/emotional biases, cost-benefit decision-making, and balancing exploration and exploitation. Where appropriate we highlight future or current links to psychiatry. We particularly draw examples from research on clinical depression, a disorder that greatly compromises motivated behaviours in real-life, but where simpler paradigms have yielded mixed results. Finally, we highlight several paradigms that could be used to help provide new insights into the mechanisms of psychiatric disorders. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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.

Design and Implementation of a C++ Software Package to scan for and parse Tsunami Messages issued by the Tsunami Warning Centers for Operational use at the Pacific Tsunami Warning Center

NASA Astrophysics Data System (ADS)

Sardina, V.

2012-12-01

The US Tsunami Warning Centers (TWCs) have traditionally generated their tsunami message products primarily as blocks of text then tagged with headers that identify them on each particular communications' (comms) circuit. Each warning center has a primary area of responsibility (AOR) within which it has an authoritative role regarding parameters such as earthquake location and magnitude. This means that when a major tsunamigenic event occurs the other warning centers need to quickly access the earthquake parameters issued by the authoritative warning center before issuing their message products intended for customers in their own AOR. Thus, within the operational context of the TWCs the scientists on duty have an operational need to access the information contained in the message products issued by other warning centers as quickly as possible. As a solution to this operational problem we designed and implemented a C++ software package that allows scanning for and parsing the entire suite of tsunami message products issued by the Pacific Tsunami Warning Center (PTWC), the West Coast and Alaska Tsunami Warning Center (WCATWC), and the Japan Meteorological Agency (JMA). The scanning and parsing classes composing the resulting C++ software package allow parsing both non-official message products(observatory messages) routinely issued by the TWCs, and all official tsunami message products such as tsunami advisories, watches, and warnings. This software package currently allows scientists on duty at the PTWC to automatically retrieve the parameters contained in tsunami messages issued by WCATWC, JMA, or PTWC itself. Extension of the capabilities of the classes composing the software package would make it possible to generate XML and CAP compliant versions of the TWCs' message products until new messaging software natively adds this capabilities. Customers who receive the TWCs' tsunami message products could also use the package to automatically retrieve information from

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

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

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

Webb, Erik Karl; Tidwell, Vincent Carroll

2009-10-01

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

Dissociating sensory from decision processes in human perceptual decision making.

PubMed

Mostert, Pim; Kok, Peter; de Lange, Floris P

2015-12-15

A key question within systems neuroscience is how the brain translates physical stimulation into a behavioral response: perceptual decision making. To answer this question, it is important to dissociate the neural activity underlying the encoding of sensory information from the activity underlying the subsequent temporal integration into a decision variable. Here, we adopted a decoding approach to empirically assess this dissociation in human magnetoencephalography recordings. We used a functional localizer to identify the neural signature that reflects sensory-specific processes, and subsequently traced this signature while subjects were engaged in a perceptual decision making task. Our results revealed a temporal dissociation in which sensory processing was limited to an early time window and consistent with occipital areas, whereas decision-related processing became increasingly pronounced over time, and involved parietal and frontal areas. We found that the sensory processing accurately reflected the physical stimulus, irrespective of the eventual decision. Moreover, the sensory representation was stable and maintained over time when it was required for a subsequent decision, but unstable and variable over time when it was task-irrelevant. In contrast, decision-related activity displayed long-lasting sustained components. Together, our approach dissects neuro-anatomically and functionally distinct contributions to perceptual decisions.

Dissociating sensory from decision processes in human perceptual decision making

PubMed Central

Mostert, Pim; Kok, Peter; de Lange, Floris P.

2015-01-01

A key question within systems neuroscience is how the brain translates physical stimulation into a behavioral response: perceptual decision making. To answer this question, it is important to dissociate the neural activity underlying the encoding of sensory information from the activity underlying the subsequent temporal integration into a decision variable. Here, we adopted a decoding approach to empirically assess this dissociation in human magnetoencephalography recordings. We used a functional localizer to identify the neural signature that reflects sensory-specific processes, and subsequently traced this signature while subjects were engaged in a perceptual decision making task. Our results revealed a temporal dissociation in which sensory processing was limited to an early time window and consistent with occipital areas, whereas decision-related processing became increasingly pronounced over time, and involved parietal and frontal areas. We found that the sensory processing accurately reflected the physical stimulus, irrespective of the eventual decision. Moreover, the sensory representation was stable and maintained over time when it was required for a subsequent decision, but unstable and variable over time when it was task-irrelevant. In contrast, decision-related activity displayed long-lasting sustained components. Together, our approach dissects neuro-anatomically and functionally distinct contributions to perceptual decisions. PMID:26666393

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.

School-Based Decision Making: Linking Decisions to Learning. Third-Year Report to the Prichard Committee.

ERIC Educational Resources Information Center

David, Jane L.

Under the Kentucky Education Reform Act (KERA), School-Based Decision Making (SBDM) is the provision that creates school councils and delegates to them the authority to make important educational decisions to improve student performance. This paper describes findings from the third year of a 5-year study of SBDM that focused on early examples of…

Parsing the Behavioral and Brain Mechanisms of Third-Party Punishment

PubMed Central

Bonnie, Richard J.; Hoffman, Morris B.; Shen, Francis X.; Simons, Kenneth W.

2016-01-01

The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood. Using fMRI, here we implement a novel experimental design to functionally dissociate the mechanisms underlying evaluation, integration, and decision that were conflated in previous studies of third-party punishment. Behaviorally, the punishment decision is primarily defined by a superadditive interaction between harm and mental state, with subjects weighing the interaction factor more than the single factors of harm and mental state. On a neural level, evaluation of harms engaged brain areas associated with affective and somatosensory processing, whereas mental state evaluation primarily recruited circuitry involved in mentalization. Harm and mental state evaluations are integrated in medial prefrontal and posterior cingulate structures, with the amygdala acting as a pivotal hub of the interaction between harm and mental state. This integrated information is used by the right dorsolateral prefrontal cortex at the time of the decision to assign an appropriate punishment through a distributed coding system. Together, these findings provide a blueprint of the brain mechanisms by which neutral third parties render punishment decisions. SIGNIFICANCE STATEMENT Punishment undergirds large-scale cooperation and helps dispense criminal justice. Yet it is currently unknown precisely how people assess the mental states of offenders, evaluate the harms they caused, and integrate those two components into a single punishment decision. Using a

Parsing the Behavioral and Brain Mechanisms of Third-Party Punishment.

PubMed

Ginther, Matthew R; Bonnie, Richard J; Hoffman, Morris B; Shen, Francis X; Simons, Kenneth W; Jones, Owen D; Marois, René

2016-09-07

The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood. Using fMRI, here we implement a novel experimental design to functionally dissociate the mechanisms underlying evaluation, integration, and decision that were conflated in previous studies of third-party punishment. Behaviorally, the punishment decision is primarily defined by a superadditive interaction between harm and mental state, with subjects weighing the interaction factor more than the single factors of harm and mental state. On a neural level, evaluation of harms engaged brain areas associated with affective and somatosensory processing, whereas mental state evaluation primarily recruited circuitry involved in mentalization. Harm and mental state evaluations are integrated in medial prefrontal and posterior cingulate structures, with the amygdala acting as a pivotal hub of the interaction between harm and mental state. This integrated information is used by the right dorsolateral prefrontal cortex at the time of the decision to assign an appropriate punishment through a distributed coding system. Together, these findings provide a blueprint of the brain mechanisms by which neutral third parties render punishment decisions. Punishment undergirds large-scale cooperation and helps dispense criminal justice. Yet it is currently unknown precisely how people assess the mental states of offenders, evaluate the harms they caused, and integrate those two components into a single punishment decision. Using a new design, we isolated

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.

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.

Variable Perceptions of Decision: An Operationalization of Four Models.

ERIC Educational Resources Information Center

Benjamin, Beverly P.; Kerchner, Charles T.

Decision-making and the models of decision-making that people carry in their minds were assessed. Participants in a public policy decision involving early childhood education were mapped onto four frequently used models of decision making: the rational, the bureaucratic, organizational process (Allison, 1971) and the garbage can or organized…

40 CFR 124.66 - Special procedures for decisions on thermal variances under section 316(a).

Code of Federal Regulations, 2010 CFR

2010-07-01

... the best available technology under section 316(b). Permit applicants who wish an early decision on... filed under § 122.21. The Regional Administrator will then decide whether or not to make an early decision. If it is granted, both the early decision on CWA section 316 (a) or (b) issues and the grant of...

40 CFR 124.66 - Special procedures for decisions on thermal variances under section 316(a).

Code of Federal Regulations, 2013 CFR

2013-07-01

... the best available technology under section 316(b). Permit applicants who wish an early decision on... filed under § 122.21. The Regional Administrator will then decide whether or not to make an early decision. If it is granted, both the early decision on CWA section 316 (a) or (b) issues and the grant of...

40 CFR 124.66 - Special procedures for decisions on thermal variances under section 316(a).

Code of Federal Regulations, 2012 CFR

2012-07-01

... the best available technology under section 316(b). Permit applicants who wish an early decision on... filed under § 122.21. The Regional Administrator will then decide whether or not to make an early decision. If it is granted, both the early decision on CWA section 316 (a) or (b) issues and the grant of...

40 CFR 124.66 - Special procedures for decisions on thermal variances under section 316(a).

Code of Federal Regulations, 2011 CFR

2011-07-01

... the best available technology under section 316(b). Permit applicants who wish an early decision on... filed under § 122.21. The Regional Administrator will then decide whether or not to make an early decision. If it is granted, both the early decision on CWA section 316 (a) or (b) issues and the grant of...

40 CFR 124.66 - Special procedures for decisions on thermal variances under section 316(a).

Code of Federal Regulations, 2014 CFR

2014-07-01

... the best available technology under section 316(b). Permit applicants who wish an early decision on... filed under § 122.21. The Regional Administrator will then decide whether or not to make an early decision. If it is granted, both the early decision on CWA section 316 (a) or (b) issues and the grant of...

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.

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

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.

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.

Review of early assessment models of innovative medical technologies.

PubMed

Fasterholdt, Iben; Krahn, Murray; Kidholm, Kristian; Yderstræde, Knud Bonnet; Pedersen, Kjeld Møller

2017-08-01

Hospitals increasingly make decisions regarding the early development of and investment in technologies, but a formal evaluation model for assisting hospitals early on in assessing the potential of innovative medical technologies is lacking. This article provides an overview of models for early assessment in different health organisations and discusses which models hold most promise for hospital decision makers. A scoping review of published studies between 1996 and 2015 was performed using nine databases. The following information was collected: decision context, decision problem, and a description of the early assessment model. 2362 articles were identified and 12 studies fulfilled the inclusion criteria. An additional 12 studies were identified and included in the review by searching reference lists. The majority of the 24 early assessment studies were variants of traditional cost-effectiveness analysis. Around one fourth of the studies presented an evaluation model with a broader focus than cost-effectiveness. Uncertainty was mostly handled by simple sensitivity or scenario analysis. This review shows that evaluation models using known methods assessing cost-effectiveness are most prevalent in early assessment, but seems ill-suited for early assessment in hospitals. Four models provided some usable elements for the development of a hospital-based model. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Punctuation and Implicit Prosody in Silent Reading: An ERP Study Investigating English Garden-Path Sentences.

PubMed

Drury, John E; Baum, Shari R; Valeriote, Hope; Steinhauer, Karsten

2016-01-01

This study presents the first two ERP reading studies of comma-induced effects of covert (implicit) prosody on syntactic parsing decisions in English. The first experiment used a balanced 2 × 2 design in which the presence/absence of commas determined plausibility (e.g., John, said Mary, was the nicest boy at the party vs. John said Mary was the nicest boy at the party ). The second reading experiment replicated a previous auditory study investigating the role of overt prosodic boundaries in closure ambiguities (Pauker et al., 2011). In both experiments, commas reliably elicited CPS components and generally played a dominant role in determining parsing decisions in the face of input ambiguity. The combined set of findings provides further evidence supporting the claim that mechanisms subserving speech processing play an active role during silent reading.

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

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.

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

Strategic larval decision-making in a bivoltine butterfly.

PubMed

Friberg, Magne; Dahlerus, Josefin; Wiklund, Christer

2012-07-01

In temperate areas, insect larvae must decide between entering winter diapause or developing directly and reproducing in the same season. Long daylength and high temperature promote direct development, which is generally associated with a higher growth rate. In this work, we investigated whether the larval pathway decision precedes the adjustment of growth rate (state-independent), or whether the pathway decision is conditional on the individual's growth rate (state-dependent), in the butterfly Pieris napi. This species typically makes the pathway decision in the penultimate instar. We measured growth rate throughout larval development under two daylengths: slightly shorter and slightly longer than the critical daylength. Results indicate that the pathway decision can be both state-independent and state-dependent; under the shorter daylength condition, most larvae entered diapause, and direct development was chosen exclusively by a small subset of larvae showing the highest growth rates already in the early instars; under the longer daylength condition, most larvae developed directly, and the diapause pathway was chosen exclusively by a small subset of slow-growing individuals. Among the remainder, the choice of pathway was independent of the early growth rate; larvae entering diapause under the short daylength grew as fast as or faster than the direct developers under the longer daylength in the early instars, whereas the direct developers grew faster than the diapausers only in the ultimate instar. Hence, the pathway decision was state-dependent in a subset with a very high or very low growth rate, whereas the decision was state-independent in the majority of the larvae, which made the growth rate adjustment downstream from the pathway decision.

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…

Training Decisions Technology Analysis

DTIC Science & Technology

1992-06-01

4.5.1 Relational Data Base Management 69 4.5.2 TASCS Data Content 69 4.5.3 Relationships with TDS 69 4.6 Other Air Force Modeling R&D 70 4.6.1 Time ...executive decision making were first developed by M. S. Scott Morton in the early 1970’s who, at that time , termed them " management decision systems" (Scott...Allocations to Training Settings o Managers ’ Preferences for Task Allocations to Training Settings o Times Required to Training Tasks in Various

Decision-making in frontotemporal dementia: clinical, theoretical and legal implications.

PubMed

Manes, Facundo; Torralva, Teresa; Ibáñez, Agustín; Roca, María; Bekinschtein, Tristán; Gleichgerrcht, Ezequiel

2011-01-01

The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'. 2011 S. Karger AG, Basel.

Communication and Decision Making in Cancer Care: Setting Research Priorities for Decision Support/Patients’ Decision Aids

PubMed Central

Barnato, Amber E.; Llewellyn-Thomas, Hilary A.; Peters, Ellen M.; Siminoff, Laura; Collins, E. Dale; Barry, Michael J.

2013-01-01

The following is a summary report from a special symposium, entitled “Translating Research into Practice: Setting a Research Agenda for Clinical Decision Tools in Cancer Prevention, Early Detection, and Treatment”, that was held on October 23, 2005 in San Francisco at the Annual Meeting of the Society for Medical Decision Making (SMDM). The symposium was designed to answer the question: “What are the top two research priorities in the field of patients’ cancer-related decision aids?” After introductory remarks by Dr. Barry, each of four panelists–Drs. Hilary Llewellyn-Thomas, Ellen Peters, Laura Siminoff, and Dale Collins–addressed the question and provided their rationale during prepared remarks. The moderator, Dr. Michael Barry, then facilitated a discussion between the panelists, with input from the audience, to further explore and add to the various proposed research questions. Finally, Dr. Amber Barnato conducted a simple vote count (see Table 1) to prioritize the panelists’ and the audience’s recommendations. PMID:17873249

Risk, Reward, and Decision-Making in a Rodent Model of Cognitive Aging

PubMed Central

Gilbert, Ryan J.; Mitchell, Marci R.; Simon, Nicholas W.; Bañuelos, Cristina; Setlow, Barry; Bizon, Jennifer L.

2011-01-01

Impaired decision-making in aging can directly impact factors (financial security, health care) that are critical to maintaining quality of life and independence at advanced ages. Naturalistic rodent models mimic human aging in other cognitive domains, and afford the opportunity to parse the effects of age on discrete aspects of decision-making in a manner relatively uncontaminated by experiential factors. Young adult (5–7 months) and aged (23–25 months) male F344 rats were trained on a probability discounting task in which they made discrete-trial choices between a small certain reward (one food pellet) and a large but uncertain reward (two food pellets with varying probabilities of delivery ranging from 100 to 0%). Young rats chose the large reward when it was associated with a high probability of delivery and shifted to the small but certain reward as probability of the large reward decreased. As a group, aged rats performed comparably to young, but there was significantly greater variance among aged rats. One subgroup of aged rats showed strong preference for the small certain reward. This preference was maintained under conditions in which large reward delivery was also certain, suggesting decreased sensitivity to reward magnitude. In contrast, another subgroup of aged rats showed strong preference for the large reward at low probabilities of delivery. Interestingly, this subgroup also showed elevated preference for probabilistic rewards when reward magnitudes were equalized. Previous findings using this same aged study population described strongly attenuated discounting of delayed rewards with age, together suggesting that a subgroup of aged rats may have deficits associated with accounting for reward costs (i.e., delay or probability). These deficits in cost-accounting were dissociable from the age-related differences in sensitivity to reward magnitude, suggesting that aging influences multiple, distinct mechanisms that can impact cost�

Risk, reward, and decision-making in a rodent model of cognitive aging.

PubMed

Gilbert, Ryan J; Mitchell, Marci R; Simon, Nicholas W; Bañuelos, Cristina; Setlow, Barry; Bizon, Jennifer L

2011-01-01

Impaired decision-making in aging can directly impact factors (financial security, health care) that are critical to maintaining quality of life and independence at advanced ages. Naturalistic rodent models mimic human aging in other cognitive domains, and afford the opportunity to parse the effects of age on discrete aspects of decision-making in a manner relatively uncontaminated by experiential factors. Young adult (5-7 months) and aged (23-25 months) male F344 rats were trained on a probability discounting task in which they made discrete-trial choices between a small certain reward (one food pellet) and a large but uncertain reward (two food pellets with varying probabilities of delivery ranging from 100 to 0%). Young rats chose the large reward when it was associated with a high probability of delivery and shifted to the small but certain reward as probability of the large reward decreased. As a group, aged rats performed comparably to young, but there was significantly greater variance among aged rats. One subgroup of aged rats showed strong preference for the small certain reward. This preference was maintained under conditions in which large reward delivery was also certain, suggesting decreased sensitivity to reward magnitude. In contrast, another subgroup of aged rats showed strong preference for the large reward at low probabilities of delivery. Interestingly, this subgroup also showed elevated preference for probabilistic rewards when reward magnitudes were equalized. Previous findings using this same aged study population described strongly attenuated discounting of delayed rewards with age, together suggesting that a subgroup of aged rats may have deficits associated with accounting for reward costs (i.e., delay or probability). These deficits in cost-accounting were dissociable from the age-related differences in sensitivity to reward magnitude, suggesting that aging influences multiple, distinct mechanisms that can impact cost-benefit decision-making.

[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.

Punctuation and Implicit Prosody in Silent Reading: An ERP Study Investigating English Garden-Path Sentences

PubMed Central

Drury, John E.; Baum, Shari R.; Valeriote, Hope; Steinhauer, Karsten

2016-01-01

This study presents the first two ERP reading studies of comma-induced effects of covert (implicit) prosody on syntactic parsing decisions in English. The first experiment used a balanced 2 × 2 design in which the presence/absence of commas determined plausibility (e.g., John, said Mary, was the nicest boy at the party vs. John said Mary was the nicest boy at the party). The second reading experiment replicated a previous auditory study investigating the role of overt prosodic boundaries in closure ambiguities (Pauker et al., 2011). In both experiments, commas reliably elicited CPS components and generally played a dominant role in determining parsing decisions in the face of input ambiguity. The combined set of findings provides further evidence supporting the claim that mechanisms subserving speech processing play an active role during silent reading. PMID:27695428

A collaborative framework for contributing DICOM RT PHI (Protected Health Information) to augment data mining in clinical decision support

NASA Astrophysics Data System (ADS)

Deshpande, Ruchi; Thuptimdang, Wanwara; DeMarco, John; Liu, Brent J.

2014-03-01

We have built a decision support system that provides recommendations for customizing radiation therapy treatment plans, based on patient models generated from a database of retrospective planning data. This database consists of relevant metadata and information derived from the following DICOM objects - CT images, RT Structure Set, RT Dose and RT Plan. The usefulness and accuracy of such patient models partly depends on the sample size of the learning data set. Our current goal is to increase this sample size by expanding our decision support system into a collaborative framework to include contributions from multiple collaborators. Potential collaborators are often reluctant to upload even anonymized patient files to repositories outside their local organizational network in order to avoid any conflicts with HIPAA Privacy and Security Rules. We have circumvented this problem by developing a tool that can parse DICOM files on the client's side and extract de-identified numeric and text data from DICOM RT headers for uploading to a centralized system. As a result, the DICOM files containing PHI remain local to the client side. This is a novel workflow that results in adding only relevant yet valuable data from DICOM files to the centralized decision support knowledge base in such a way that the DICOM files never leave the contributor's local workstation in a cloud-based environment. Such a workflow serves to encourage clinicians to contribute data for research endeavors by ensuring protection of electronic patient data.

Teachers in Early Childhood Policy

ERIC Educational Resources Information Center

Kilderry, Anna

2014-01-01

This paper examines teacher accountability and authority in early childhood policy. It reports on data from a study that investigated the influences affecting early childhood teacher decision-making at the preschool level in Victoria, Australia. Using a question raised by Ball "Where are the teachers in all this [policy]?" provided a…

Age-Related Changes in Decision Making: Comparing Informed and Noninformed Situations

ERIC Educational Resources Information Center

Van Duijvenvoorde, Anna C. K.; Jansen, Brenda R. J.; Bredman, Joren C.; Huizenga, Hilde M.

2012-01-01

Advantageous decision making progressively develops into early adulthood, most specifically in complex and motivationally salient decision situations in which direct feedback on gains and losses is provided (Figner & Weber, 2011). However, the factors that underlie this developmental improvement in decision making are still not well understood.…

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…

Emotion regulation during threat: Parsing the time course and consequences of safety signal processing

PubMed Central

HEFNER, KATHRYN R.; VERONA, EDELYN; CURTIN, JOHN. J.

2017-01-01

Improved understanding of fear inhibition processes can inform the etiology and treatment of anxiety disorders. Safety signals can reduce fear to threat, but precise mechanisms remain unclear. Safety signals may acquire attentional salience and affective properties (e.g., relief) independent of the threat; alternatively, safety signals may only hold affective value in the presence of simultaneous threat. To clarify such mechanisms, an experimental paradigm assessed independent processing of threat and safety cues. Participants viewed a series of red and green words from two semantic categories. Shocks were administered following red words (cue+). No shocks followed green words (cue−). Words from one category were defined as safety signals (SS); no shocks were administered on cue+ trials. Words from the other (control) category did not provide information regarding shock administration. Threat (cue+ vs. cue−) and safety (SS+ vs. SS−) were fully crossed. Startle response and ERPs were recorded. Startle response was increased during cue+ versus cue−. Safety signals reduced startle response during cue+, but had no effect on startle response during cue−. ERP analyses (PD130 and P3) suggested that participants parsed threat and safety signal information in parallel. Motivated attention was not associated with safety signals in the absence of threat. Overall, these results confirm that fear can be reduced by safety signals. Furthermore, safety signals do not appear to hold inherent hedonic salience independent of their effect during threat. Instead, safety signals appear to enable participants to engage in effective top-down emotion regulatory processes. PMID:27088643

The Early Communication Indicator for Infants and Toddlers: Early Head Start Growth Norms from Two States

ERIC Educational Resources Information Center

Greenwood, Charles R.; Walker, Dale; Buzhardt, Jay

2010-01-01

The Early Communication Indicator (ECI) is a measure relevant to intervention decision making and progress monitoring for infants and toddlers. With increasing recognition of the importance of quality early childhood education and intervention for all children, measurement plays an important role in documenting children's progress and outcomes of…

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…

Decision Regulation Impact Statement for Changes to the National Quality Framework

ERIC Educational Resources Information Center

Education Council, 2017

2017-01-01

The purpose of this Decision Regulation Impact Statement (Decision RIS) is to recommend preferred options for improving the National Quality Framework for Early Childhood Education and Care. The Decision RIS follows the public release of the Consultation RIS and incorporates stakeholders' views and comments received during the ten week stakeholder…

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.

Preschool Teachers' Constructions of Early Reading

ERIC Educational Resources Information Center

Walker, Karen E.

2015-01-01

Research concerning preschool teachers' constructions of early reading has potential to influence teachers' curricular decisions and classroom practice. Six preschool teachers in North Texas were interviewed in regard to what they think about early reading and how they develop these understandings or constructions. The systematic, inductive…

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.

Impacts of Hospitals' Innovativeness on Information System Outsourcing Decisions

PubMed Central

2014-01-01

Objectives The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Methods Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Results Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Conclusions Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management. PMID:24872912

Impacts of hospitals' innovativeness on information system outsourcing decisions.

PubMed

Park, Jae Sung

2014-04-01

The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.

Decision-making in the adolescent brain.

PubMed

Blakemore, Sarah-Jayne; Robbins, Trevor W

2012-09-01

Adolescence is characterized by making risky decisions. Early lesion and neuroimaging studies in adults pointed to the ventromedial prefrontal cortex and related structures as having a key role in decision-making. More recent studies have fractionated decision-making processes into its various components, including the representation of value, response selection (including inter-temporal choice and cognitive control), associative learning, and affective and social aspects. These different aspects of decision-making have been the focus of investigation in recent studies of the adolescent brain. Evidence points to a dissociation between the relatively slow, linear development of impulse control and response inhibition during adolescence versus the nonlinear development of the reward system, which is often hyper-responsive to rewards in adolescence. This suggests that decision-making in adolescence may be particularly modulated by emotion and social factors, for example, when adolescents are with peers or in other affective ('hot') contexts.

Influence of Peers on Young Adolescent Females' Romantic Decisions

ERIC Educational Resources Information Center

Wisnieski, Deborah; Sieving, Renee E.; Garwick, Ann W.

2013-01-01

Background: Initiation of sexual intercourse during early adolescence is a known risk factor for teen pregnancy and sexually transmitted infections. Purpose: To examine young women's stories describing peer in?uences on their romantic and sexual decisions and behavior during early adolescence. Methods: Semistructured ethnographic interviews were…

[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%.

The Metamorphosis of the Statistical Segmentation Output: Lexicalization during Artificial Language Learning

ERIC Educational Resources Information Center

Fernandes, Tania; Kolinsky, Regine; Ventura, Paulo

2009-01-01

This study combined artificial language learning (ALL) with conventional experimental techniques to test whether statistical speech segmentation outputs are integrated into adult listeners' mental lexicon. Lexicalization was assessed through inhibitory effects of novel neighbors (created by the parsing process) on auditory lexical decisions to…

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

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

Generating Visionary Policy for Early Childhood Education and Care: Politicians' and Early Childhood Sector Advocate/Activists' Perspectives

ERIC Educational Resources Information Center

Bown, Kathryn; Sumsion, Jennifer

2016-01-01

This article contributes to the global conversation about generating a "vision" in early childhood education and care policy by reporting on an investigation of influences on politicians' policy decisions in early childhood education and care in Australia. This article is inspired by the provocations of social and political theorists who…

Cognitive influences on self-care decision making in persons with heart failure.

PubMed

Dickson, Victoria V; Tkacs, Nancy; Riegel, Barbara

2007-09-01

Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial

PubMed Central

2014-01-01

Background Decision aids offer promise as a practical solution to improve patient decision making about coronary heart disease (CHD) prevention medications and help patients choose medications to which they are likely to adhere. However, little data is available on decision aids designed to promote adherence. Methods In this paper, we report on secondary analyses of a randomized trial of a CHD adherence intervention (second generation decision aid plus tailored messages) versus usual care in an effort to understand how the decision aid facilitates adherence. We focus on data collected from the primary study visit, when intervention participants presented 45 minutes early to a previously scheduled provider visit; viewed the decision aid, indicating their intent for CHD risk reduction after each decision aid component (individualized risk assessment and education, values clarification, and coaching); and filled out a post-decision aid survey assessing their knowledge, perceived risk, decisional conflict, and intent for CHD risk reduction. Control participants did not present early and received usual care from their provider. Following the provider visit, participants in both groups completed post-visit surveys assessing the number and quality of CHD discussions with their provider, their intent for CHD risk reduction, and their feelings about the decision aid. Results We enrolled 160 patients into our study (81 intervention, 79 control). Within the decision aid group, the decision aid significantly increased knowledge of effective CHD prevention strategies (+21 percentage points; adjusted p<.0001) and the accuracy of perceived CHD risk (+33 percentage points; adjusted p<.0001), and significantly decreased decisional conflict (-0.63; adjusted p<.0001). Comparing between study groups, the decision aid also significantly increased CHD prevention discussions with providers (+31 percentage points; adjusted p<.0001) and improved perceptions of some features of patient

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…

Clinical decision support of radiotherapy treatment planning: A data-driven machine learning strategy for patient-specific dosimetric decision making.

PubMed

Valdes, Gilmer; Simone, Charles B; Chen, Josephine; Lin, Alexander; Yom, Sue S; Pattison, Adam J; Carpenter, Colin M; Solberg, Timothy D

2017-12-01

Clinical decision support systems are a growing class of tools with the potential to impact healthcare. This study investigates the construction of a decision support system through which clinicians can efficiently identify which previously approved historical treatment plans are achievable for a new patient to aid in selection of therapy. Treatment data were collected for early-stage lung and postoperative oropharyngeal cancers treated using photon (lung and head and neck) and proton (head and neck) radiotherapy. Machine-learning classifiers were constructed using patient-specific feature-sets and a library of historical plans. Model accuracy was analyzed using learning curves, and historical treatment plan matching was investigated. Learning curves demonstrate that for these datasets, approximately 45, 60, and 30 patients are needed for a sufficiently accurate classification model for radiotherapy for early-stage lung, postoperative oropharyngeal photon, and postoperative oropharyngeal proton, respectively. The resulting classification model provides a database of previously approved treatment plans that are achievable for a new patient. An exemplary case, highlighting tradeoffs between the heart and chest wall dose while holding target dose constant in two historical plans is provided. We report on the first artificial-intelligence based clinical decision support system that connects patients to past discrete treatment plans in radiation oncology and demonstrate for the first time how this tool can enable clinicians to use past decisions to help inform current assessments. Clinicians can be informed of dose tradeoffs between critical structures early in the treatment process, enabling more time spent on finding the optimal course of treatment for individual patients. Copyright © 2017. Published by Elsevier B.V.

The window of opportunity: decision theory and the timing of prognostic tests for newborn infants.

PubMed

Wilkinson, Dominic

2009-11-01

In many forms of severe acute brain injury there is an early phase when prognosis is uncertain, followed later by physiological recovery and the possibility of more certain predictions of future impairment. There may be a window of opportunity for withdrawal of life support early, but if decisions are delayed there is the risk that the patient will survive with severe impairment. In this paper I focus on the example of neonatal encephalopathy and the question of the timing of prognostic tests and decisions to continue or to withdraw life-sustaining treatment. Should testing be performed early or later; and how should parents decide what to do given the conflicting values at stake? I apply decision theory to the problem, using sensitivity analysis to assess how different features of the tests or different values would affect a decision to perform early or late prognostic testing. I draw some general conclusions from this model for decisions about the timing of testing in neonatal encephalopathy. Finally I consider possible solutions to the problem posed by the window of opportunity. Decision theory highlights the costs of uncertainty. This may prompt further research into improving prognostic tests. But it may also prompt us to reconsider our current attitudes towards the palliative care of newborn infants predicted to be severely impaired.

Do neonatologists limit parental decision-making authority? A Canadian perspective.

PubMed

Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

2010-12-01

According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

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.

45 CFR 1210.3-9 - Decision by Director of VISTA.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Decision by Director of VISTA. 1210.3-9 Section 1210.3-9 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early...

45 CFR 1210.3-9 - Decision by Director of VISTA.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Decision by Director of VISTA. 1210.3-9 Section 1210.3-9 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early...

45 CFR 1210.3-9 - Decision by Director of VISTA.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Decision by Director of VISTA. 1210.3-9 Section 1210.3-9 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early...

45 CFR 1210.3-9 - Decision by Director of VISTA.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Decision by Director of VISTA. 1210.3-9 Section 1210.3-9 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early...

45 CFR 1210.3-9 - Decision by Director of VISTA.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Decision by Director of VISTA. 1210.3-9 Section 1210.3-9 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early...

Older Women and Their Career Decisions and Compromise.

ERIC Educational Resources Information Center

Gerlicher, Cathie

Career theory is not a new topic, but one with an interesting past. The theories have been developed through working with men in the early days of the study of careers, modified to add women, and then modified even more for men and women in transition. Making a career decision is not a single event that takes place only in one's early adulthood,…

Early Childhood Development in Abbotsford, British Columbia. Understanding the Early Years

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Early Childhood Development in Niagara Falls, Ontario. Understanding the Early Years

ERIC Educational Resources Information Center

Wilms, Douglas J.

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Financing Early Care and Education: Funding and Policy Choices in a Changing Fiscal Environment.

ERIC Educational Resources Information Center

Clothier, Steffanie; Clemens, Beth; Poppe, Julie

Because of an increasingly challenging fiscal climate, state lawmakers are faced with making tough financial decisions regarding their early childhood systems. This document describes and examines various funding sources used when making decisions about possible early childhood initiatives combined with policy choices that may be considered in…

The Case against Intelligence Testing in Early Intervention.

ERIC Educational Resources Information Center

Neisworth, John T.; Bagnato, Stephen J.

1992-01-01

Major presumptions that underlie the use of early intelligence tests are presented and disputed, centering on the construct of early intelligence, reliability, prediction, standardized administration, professional acceptability, utility for decision making, and congruence with Public Law 99-457. Professional solidarity is urged in opposing the…

Brain signals do not demonstrate unconscious decision making: an interpretation based on graded conscious awareness.

PubMed

Miller, Jeff; Schwarz, Wolf

2014-02-01

Neuroscientific studies have shown that brain activity correlated with a decision to move can be observed before a person reports being consciously aware of having made that decision (e.g., Libet, Gleason, Wright, & Pearl, 1983; Soon, Brass, Heinze, & Haynes, 2008). Given that a later event (i.e., conscious awareness) cannot cause an earlier one (i.e., decision-related brain activity), such results have been interpreted as evidence that decisions are made unconsciously (e.g., Libet, 1985). We argue that this interpretation depends upon an all-or-none view of consciousness, and we offer an alternative interpretation of the early decision-related brain activity based on models in which conscious awareness of the decision to move develops gradually up to the level of a reporting criterion. Under this interpretation, the early brain activity reflects sub-criterion levels of awareness rather than complete absence of awareness and thus does not suggest that decisions are made unconsciously. Copyright © 2013 Elsevier Inc. All rights reserved.

Phase III of Early Restoration | NOAA Gulf Spill Restoration

Science.gov Websites

information about this phase of Early Restoration, including fact sheets on each project. The final Phase III 44 projects are documented in a final Record of Decision. Information about Phase III of Early Archive Home Phase III of Early Restoration Phase III of Early Restoration Beach habitat would be restored

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.

Decisions without blinders.

PubMed

Bazerman, Max H; Chugh, Dolly

2006-01-01

By the time Merck withdrew its pain relief drug Vioxx from the market in 2004, more than 100 million prescriptions had been filled in the United States alone. Yet researchers now estimate that Vioxx may have been associated with as many as 25,000 heart attacks and strokes. Evidence of the drug's risks was available as early as 2000, so why did so many doctors keep prescribing it? The answer, say the authors, involves the phenomenon of bounded awareness--when cognitive blinders prevent a person from seeing, seeking, using, or sharing highly relevant, easily accessible, and readily perceivable information during the decision-making process. Doctors prescribing Vioxx, for instance, more often than not received positive feedback from patients. So, despite having access to information about the risks, physicians may have been blinded to the actual extent of the risks. Bounded awareness can occur at three points in the decision-making process. First, executives may fail to see or seek out the important information needed to make a sound decision. Second, they may fail to use the information that they do see because they aren't aware of its relevance. Third, executives may fail to share information with others, thereby bounding the organization's awareness. Drawing on examples such as the Challenger disaster and Citibank's failures in Japan, this article examines what prevents executives from seeing what's right in front of them and offers advice on how to increase awareness. Of course, not every decision requires executives to consciously broaden their focus. Collecting too much information for every decision would waste time and other valuable resources. The key is being mindful. If executives think an error could generate almost irrecoverable damage, then they should insist on getting all the information they need to make a wise decision.

Visualization support for risk-informed decision making when planning and managing software developments

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Kiper, James D.; Menzies, Tim

2005-01-01

Key decisions are made in the early stages of planning and management of software developments. The information basis for these decisions is often a mix of analogy with past developments, and the best judgments of domain experts. Visualization of this information can support to such decision making by clarifying the status of the information and yielding insights into the ramifications of that information vis-a-vis decision alternatives.

Phrase Length Matters: The Interplay between Implicit Prosody and Syntax in Korean "Garden Path" Sentences

ERIC Educational Resources Information Center

Hwang, Hyekyung; Steinhauer, Karsten

2011-01-01

In spoken language comprehension, syntactic parsing decisions interact with prosodic phrasing, which is directly affected by phrase length. Here we used ERPs to examine whether a similar effect holds for the on-line processing of written sentences during silent reading, as suggested by theories of "implicit prosody." Ambiguous Korean sentence…

Longitudinal associations between mothers' perceptions of nonresidential fathers' investment of resources and influence in decision-making.

PubMed

Fagan, Jay; Palkovitz, Rob

2018-02-01

Nonresidential fathers are challenged to remain involved with their children across time in both direct and indirect ways, including influencing decision-making around important issues such as school attendance and medical care. An analytic sample of 1,350 families with residential mothers and nonresidential fathers was selected from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) to examine the longitudinal relationships between mothers' reports of nonresidential fathers' influence in decision-making and their provision of resources to their children. Findings indicate that fathers' voluntary contribution of tangible resources (informal child support, caregiving time) when children are 2 years old positively predict fathers' influence in decision-making regarding the care of their 4-year-old children. Fathers' early formal child support is not related to later decision-making. Fathers' communication with mother about the child at 24 months is related to later decision-making among daughters but not sons. Fathers' early decision-making is longitudinally related to later informal child support, caregiving time, and coparenting communication. The findings support the utility of a resource theory of fathering for understanding and predicting observed patterns of father involvement. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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.

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.

Autoimmunity: a decision theory model.

PubMed Central

Morris, J A

1987-01-01

Concepts from statistical decision theory were used to analyse the detection problem faced by the body's immune system in mounting immune responses to bacteria of the normal body flora. Given that these bacteria are potentially harmful, that there can be extensive cross reaction between bacterial antigens and host tissues, and that the decisions are made in uncertainty, there is a finite chance of error in immune response leading to autoimmune disease. A model of ageing in the immune system is proposed that is based on random decay in components of the decision process, leading to a steep age dependent increase in the probability of error. The age incidence of those autoimmune diseases which peak in early and middle life can be explained as the resultant of two processes: an exponentially falling curve of incidence of first contact with common bacteria, and a rapidly rising error function. Epidemiological data on the variation of incidence with social class, sibship order, climate and culture can be used to predict the likely site of carriage and mode of spread of the causative bacteria. Furthermore, those autoimmune diseases precipitated by common viral respiratory tract infections might represent reactions to nasopharyngeal bacterial overgrowth, and this theory can be tested using monoclonal antibodies to search the bacterial isolates for cross reacting antigens. If this model is correct then prevention of autoimmune disease by early exposure to low doses of bacteria might be possible. PMID:3818985

Pragmatic precision oncology: the secondary uses of clinical tumor molecular profiling

PubMed Central

Thota, Ramya; Staggs, David B; Johnson, Douglas B; Warner, Jeremy L

2016-01-01

Background Precision oncology increasingly utilizes molecular profiling of tumors to determine treatment decisions with targeted therapeutics. The molecular profiling data is valuable in the treatment of individual patients as well as for multiple secondary uses. Objective To automatically parse, categorize, and aggregate clinical molecular profile data generated during cancer care as well as use this data to address multiple secondary use cases. Methods A system to parse, categorize and aggregate molecular profile data was created. A naÿve Bayesian classifier categorized results according to clinical groups. The accuracy of these systems were validated against a published expertly-curated subset of molecular profiling data. Results Following one year of operation, 819 samples have been accurately parsed and categorized to generate a data repository of 10,620 genetic variants. The database has been used for operational, clinical trial, and discovery science research. Conclusions A real-time database of molecular profiling data is a pragmatic solution to several knowledge management problems in the practice and science of precision oncology. PMID:27026612

Parsing multiple processes of high temperature impacts on corn/soybean yield using a newly developed CLM-APSIM modeling framework

NASA Astrophysics Data System (ADS)

Peng, B.; Guan, K.; Chen, M.

2016-12-01

Future agricultural production faces a grand challenge of higher temperature under climate change. There are multiple physiological or metabolic processes of how high temperature affects crop yield. Specifically, we consider the following major processes: (1) direct temperature effects on photosynthesis and respiration; (2) speed-up growth rate and the shortening of growing season; (3) heat stress during reproductive stage (flowering and grain-filling); (4) high-temperature induced increase of atmospheric water demands. In this work, we use a newly developed modeling framework (CLM-APSIM) to simulate the corn and soybean growth and explicitly parse the above four processes. By combining the strength of CLM in modeling surface biophysical (e.g., hydrology and energy balance) and biogeochemical (e.g., photosynthesis and carbon-nitrogen interactions), as well as that of APSIM in modeling crop phenology and reproductive stress, the newly developed CLM-APSIM modeling framework enables us to diagnose the impacts of high temperature stress through different processes at various crop phenology stages. Ground measurements from the advanced SoyFACE facility at University of Illinois is used here to calibrate, validate, and improve the CLM-APSIM modeling framework at the site level. We finally use the CLM-APSIM modeling framework to project crop yield for the whole US Corn Belt under different climate scenarios.

10 CFR 2.603 - Acceptance and docketing of application for early review of site suitability issues in a...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance and docketing of application for early review... Procedures Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application... Issuance of Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2...

Teacher Participation in Curriculum and Pedagogical Decisions: Insights into Curriculum Leadership

ERIC Educational Resources Information Center

Ho, Dora Choi Wa

2010-01-01

In recent years, teacher participation in school decision making has become an important topic for discussion in the field of early childhood education in Hong Kong. The purpose of this article is to discuss the theoretical significance, difficulties and issues of greater teacher participation in curriculum and pedagogical decision making in local…

Studying the Effects of Early Experiences on Women's Career Achievement.

ERIC Educational Resources Information Center

Lykes, M. Brinton; Stewart, Abigail J.

Virtually all psychological theories assume that early life experiences have an impact on later life choices. However, increasing doubts have been expressed about the universality and permanence of the relationship between women's work and family lives. To explore how early family experiences and early adult decisions affect women's later career…

Early Childhood Development in Hampton/Sussex, New Brunswick. Understanding the Early Years

ERIC Educational Resources Information Center

Willms, J. Douglas

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice...

Learning to Teach in the Early Years Classroom

ERIC Educational Resources Information Center

Blaise, Mindy; Nuttal, Joce

2011-01-01

"Learning to Teach in the Early Years Classroom" helps teacher education students understand the complexities of teaching in early years' classrooms. It integrates research and theory with practice through vignettes, based on authentic classroom case studies, in order to show students how educators make decisions and achieve expected outcomes.…

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 CFR 2.621 - Acceptance and docketing of application for early review of site suitability issues in a combined...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance and docketing of application for early review... Procedures Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application... Issuance of Limited Work Authorizations Early Partial Decisions on Site Suitability-Combined License Under...

The clinical utility index as a practical multiattribute approach to drug development decisions.

PubMed

Poland, B; Hodge, F L; Khan, A; Clemen, R T; Wagner, J A; Dykstra, K; Krishna, R

2009-07-01

We identify some innovative approaches to predicting overall patient benefit from investigational drugs to support development decisions. We then illustrate calculation of a probabilistic clinical utility index (CUI), an implementation of multiattribute utility that focuses on clinical attributes. We recommend use of the CUI for the support of early drug development decisions because of its practicality, reasonable accuracy, and transparency to decision makers, at stages in which financial factors that may dominate later-phase decisions are less critical.

Impaired decision-making and brain shrinkage in alcoholism.

PubMed

Le Berre, A-P; Rauchs, G; La Joie, R; Mézenge, F; Boudehent, C; Vabret, F; Segobin, S; Viader, F; Allain, P; Eustache, F; Pitel, A-L; Beaunieux, H

2014-03-01

Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (P<0.001, uncorrected). Decision-making deficits in alcoholism may result from impairment of both emotional and cognitive networks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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.

A Methodology for Making Early Comparative Architecture Performance Evaluations

ERIC Educational Resources Information Center

Doyle, Gerald S.

2010-01-01

Complex and expensive systems' development suffers from a lack of method for making good system-architecture-selection decisions early in the development process. Failure to make a good system-architecture-selection decision increases the risk that a development effort will not meet cost, performance and schedule goals. This research provides a…

Plasticity of Decision-Making Abilities Among Maltreated Adolescents: Evidence From a Random Controlled Trial

PubMed Central

Weller, Joshua A.; Leve, Leslie D.; Kim, Hyoun K.; Bhimji, Jabeene; Fisher, Philip A.

2014-01-01

Childhood maltreatment has lasting negative effects throughout the lifespan. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls’ ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and non-maltreated age and SES-matched girls living with their biological parent(s) (n = 80), completed a decision-making task (at age 15–17) that assessed risk-taking and sensitivity to expected value, an index of advantageous decision-making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to non-maltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects. PMID:25997770

TAILORx finds no chemotherapy benefit for most early breast cancers

Cancer.gov

Findings from the TAILORx clinical trial show chemotherapy does not benefit most women with early breast cancer. The new data, released at the 2018 ASCO annual meeting, will help inform treatment decisions for many women with early-stage breast cancer.

Zero-block mode decision algorithm for H.264/AVC.

PubMed

Lee, Yu-Ming; Lin, Yinyi

2009-03-01

In the previous paper , we proposed a zero-block intermode decision algorithm for H.264 video coding based upon the number of zero-blocks of 4 x 4 DCT coefficients between the current macroblock and the co-located macroblock. The proposed algorithm can achieve significant improvement in computation, but the computation performance is limited for high bit-rate coding. To improve computation efficiency, in this paper, we suggest an enhanced zero-block decision algorithm, which uses an early zero-block detection method to compute the number of zero-blocks instead of direct DCT and quantization (DCT/Q) calculation and incorporates two adequate decision methods into semi-stationary and nonstationary regions of a video sequence. In addition, the zero-block decision algorithm is also applied to the intramode prediction in the P frame. The enhanced zero-block decision algorithm brings out a reduction of average 27% of total encoding time compared to the zero-block decision algorithm.

Early Childhood Development in the Montreal Study Area (Quebec). Understanding the Early Years

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Interpersonal Influences and Attitudes about Adjuvant Therapy Treatment Decisions among Early Stage Breast Cancer Patients: An Examination of Differences by Age and Race/Ethnicity in the BQUAL Study

PubMed Central

Shelton, Rachel C.; Hillyer, Grace Clarke; Hershman, Dawn L.; Leoce, Nicole; Kushi, Lawrence H.; Lamerato, Lois; Nathanson, S. David; Ambrosone, Christine B.; Bovbjerg, Dana H.; Mandelblatt, Jeanne S.; Neugut, Alfred I.

2013-01-01

Patients are increasingly involved in cancer treatment decisions and yet little research has explored factors that may affect patient attitudes and beliefs about their therapeutic choices. This paper examines psychosocial factors (e.g., attitudes, social support), provider-related factors (e.g., communication, trust), and treatment considerations in a prospective study of a sample of early stage breast cancer patients eligible for chemotherapy and/or hormonal therapy (BQUAL cohort). The data comes from a multi-site cohort study of white, black, Hispanic, and Asian non-metastatic breast cancer patients recruited in New York City, Northern California, and Detroit Michigan. Baseline surveys were conducted over the telephone between 2006 and 2010 among a total of 1145 women. Most participants were white (68%), had more than a high school education (76%), and were diagnosed with stage I disease (51%). The majority of women reported discussing chemotherapy and hormonal therapy with their doctor (90% and 83% respectively); these discussions primarily took place with medical oncologists. Nearly a quarter of women reported that the treatment decision was difficult and the majority were accompanied to the doctor (76%) and involved a friend or family member in the decision (54%). Positive considerations (e.g., beliefs about treatment reducing risk of recurrence) were important in making treatment decisions. Participants preferred a shared decision-making style, but results suggested that there is room for improvement in terms of actual patient involvement in the decision and provider communication, particularly among black patients. Patients 65 years and older reported fewer provider discussions of chemotherapy, poorer patient-provider communication, higher rates of being assisted by family members in making the decision, and more negative attitudes and beliefs towards treatment. PMID:23263696

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part...

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part...

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Notice of hearing on application for early review of site... Applicable to Early Partial Decisions on Site Suitability Issues in Connection With an Application for a... Limited Work Authorizations Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part...

Shaping parents: impact of contrasting professional counseling on parents' decision making for children with disorders of sex development.

PubMed

Streuli, Jürg C; Vayena, Effy; Cavicchia-Balmer, Yvonne; Huber, Johannes

2013-08-01

The management of disorders or differences of sex development (DSD) remains complex, especially with respect to parents' decision for or against early genitoplasty. Most parents still tend to disfavor postponing surgery until the child is old enough to provide consent. To identify the determinants of parental decisions for or against early sex assignment surgery in DSD children, and in particular to assess the influence of contrasting behavior of health-care professionals and the information they dispense. Preliminary data analysis from a focus group identified two broad approaches to counseling information. Two six-minute counseling videos were produced on this basis: one medicalized, by an endocrinologist, the other demedicalized, by a psychologist. Third-year medical students (N = 89) were randomized to watch either video as prospective parents and report its impact on their decision in a self-administered questionnaire. Statistical analysis of questionnaire responses regarding decisions for or against surgery, including self-assessed impact of potential determinants. Thirty-eight of eighty-nine "parents" (43%) chose early surgery for "their" child, including 27/41 "parents" (66%) shown the medicalized video vs. 11/48 (23%) shown the demedicalized video (P < 0.001). Desired aims for "their" child also differed significantly depending on the counseling approach viewed. Yet "parents" perceived their personal attitudes on a four-point Likert scale as the main influence on their decision although their "attitude" was significantly shaped by the video. Parental decisions concerning early sex assignment surgery for DSD children depend on the health professional counseling received, to a degree of which neither parents nor professionals appear fully aware. In the absence of conclusive data for or against early surgery, there is a danger of medicalized or demedicalized parentalism resulting in irreversible and inadequately grounded decisions, regardless of the

Improving early cycle economic evaluation of diagnostic technologies.

PubMed

Steuten, Lotte M G; Ramsey, Scott D

2014-08-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

PubMed

Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

2014-12-12

Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p < 0.01). Combining decision science and health informatics approaches facilitated rapid development of a web-based patient decision support research platform that was feasible for use in research studies in

[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.

Famines in Africa: is early warning early enough?

PubMed Central

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984–1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response. PMID:22745628

Famines in Africa: is early warning early enough?

PubMed

Kim, Jeeyon Janet; Guha-Sapir, Debarati

2012-01-01

Following the second Sahelian famine in 1984-1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response.

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part 52 § 2.623 Notice of...

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part 52 § 2.623 Notice of...

TEMPO Early Adopters in Air-Quality Forecasting, Planning and Assessment, Pollution Emissions, Health, Agriculture, and Environmental Impacts: Applications and Decision Support

NASA Astrophysics Data System (ADS)

Newchurch, M.; Zavodsky, B.; Chance, K.; Haynes, J.; Lefer, B. L.; Naeger, A.

2016-12-01

The AQ research community has a long legacy of using space-based observations (e.g., Solar Backscatter Ultraviolet Instrument [SBUV], Global Ozone Monitoring Experiment [GOME], Ozone Monitoring Instrument [OMI], and the Ozone Mapping & Profiler Suite [OMPS]) to study atmospheric chemistry. These measurements have been used to observe day-to-day and year-to-year changes in atmospheric constituents. However, they have not been able to capture the diurnal variability of pollution with enough temporal or spatial fidelity and a low enough latency for regular use by operational decision makers. As a result, the operational AQ community has traditionally relied on ground-based (e.g., collection stations, LIDAR) and airborne observing systems to study tropospheric chemistry. In order to maximize its utility for applications and decision support, there is a need to educate the community about the game-changing potential for the geostationary TEMPO mission well ahead of its expected launch date early in the third decade of this millinium. This NASA mission will engage user communities and enable science across the NASA Applied Science Focus Areas of Health and Air Quality, Disasters, Water Resources, and Ecological Forecasting, In addition, topics discussed will provide opportunities for collaborations extending TEMPO applications to future program areas in Agriculture, Weather and Climate (including Numerical Weather Prediction), Energy, and Oceans.

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.

Using the 21-gene assay to guide adjuvant chemotherapy decision-making in early-stage breast cancer: a cost-effectiveness evaluation in the German setting.

PubMed

Blohmer, J U; Rezai, M; Kümmel, S; Kühn, T; Warm, M; Friedrichs, K; Benkow, A; Valentine, W J; Eiermann, W

2013-01-01

The 21-gene assay (Oncotype DX Breast Cancer Test (Genomic Health Inc., Redwood City, CA)) is a well validated test that predicts the likelihood of adjuvant chemotherapy benefit and the 10-year risk of distant recurrence in patients with ER+, HER2- early-stage breast cancer. The aim of this analysis was to evaluate the cost-effectiveness of using the assay to inform adjuvant chemotherapy decisions in Germany. A Markov model was developed to make long-term projections of distant recurrence, survival, quality-adjusted life expectancy, and direct costs for patients with ER+, HER2-, node-negative, or up to 3 node-positive early-stage breast cancer. Scenarios using conventional diagnostic procedures or the 21-gene assay to inform treatment recommendations for adjuvant chemotherapy were modeled based on a prospective, multi-center trial in 366 patients. Transition probabilities and risk adjustment were based on published landmark trials. Costs (2011 Euros (€)) were estimated from a sick fund perspective based on resource use in patients receiving chemotherapy. Future costs and clinical benefits were discounted at 3% annually. The 21-gene assay was projected to increase mean life expectancy by 0.06 years and quality-adjusted life expectancy by 0.06 quality-adjusted life years (QALYs) compared with current clinical practice over a 30-year time horizon. Clinical benefits were driven by optimized allocation of adjuvant chemotherapy. Costs from a healthcare payer perspective were lower with the 21-gene assay by ∼€561 vs standard of care. Probabilistic sensitivity analysis indicated that there was an 87% probability that the 21-gene assay would be dominant (cost and life saving) to standard of care. Country-specific data on the risk of distant recurrence and quality-of-life were not available. Guiding decision-making on adjuvant chemotherapy using the 21-gene assay was projected to improve survival, quality-adjusted life expectancy, and be cost saving vs the current

A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the U.K.

PubMed

Holt, S; Bertelli, G; Humphreys, I; Valentine, W; Durrani, S; Pudney, D; Rolles, M; Moe, M; Khawaja, S; Sharaiha, Y; Brinkworth, E; Whelan, S; Jones, S; Bennett, H; Phillips, C J

2013-06-11

Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the U.K. Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting.

Development of a patient decision aid for choice of surgical treatment for breast cancer

PubMed Central

Sawka, Carol A.; Goel, Vivek; Mahut, Catherine A.; Taylor, Glen A.; Thiel, Elaine C.; O'Connor, Annette M.; Ackerman, Ida; Burt, Janet H.; Gort, Elaine H.

2002-01-01

Purpose A patient decision aid for the surgical treatment of early stage breast cancer was developed and evaluated. The rationale for its development was the knowledge that breast conserving therapy (lumpectomy followed by breast radiation) and mastectomy produce equivalent outcomes, and the current general agreement that the decision for the type of surgery should rest with the patient. Methods A decision aid was developed and evaluated in sequential pilot studies of 18 and 10 women with newly diagnosed breast cancer who were facing a decision for breast conserving therapy or mastectomy. Both qualitative (general reaction, self‐reported anxiety, clarity, satisfaction) and quantitative (knowledge and decisional conflict) measures were assessed. Results The decision aid consists of an audiotape and workbook and takes 36 min to complete. Based on qualitative comments and satisfaction ratings, 17 of 18 women reported a positive reaction to the decision aid, and all 18 reported that it helped clarify information given by the surgeon. Women did not report an increase in anxiety and 17 of 18 women were either satisfied or very satisfied with the decision aid. Conclusion This pilot study supports the hypothesis that this decision aid may be a helpful adjunct in the decision for surgical management of early stage breast cancer. We are currently conducting a randomized trial of the decision aid versus a simple educational pamphlet to evaluate its efficacy as measured by knowledge, decisional conflict, anxiety and post‐decisional regret. PMID:11281859

Discrimination in lexical decision

PubMed Central

Feldman, Laurie Beth; Ramscar, Michael; Hendrix, Peter; Baayen, R. Harald

2017-01-01

In this study we present a novel set of discrimination-based indicators of language processing derived from Naive Discriminative Learning (ndl) theory. We compare the effectiveness of these new measures with classical lexical-distributional measures—in particular, frequency counts and form similarity measures—to predict lexical decision latencies when a complete morphological segmentation of masked primes is or is not possible. Data derive from a re-analysis of a large subset of decision latencies from the English Lexicon Project, as well as from the results of two new masked priming studies. Results demonstrate the superiority of discrimination-based predictors over lexical-distributional predictors alone, across both the simple and primed lexical decision tasks. Comparable priming after masked corner and cornea type primes, across two experiments, fails to support early obligatory segmentation into morphemes as predicted by the morpho-orthographic account of reading. Results fit well with ndl theory, which, in conformity with Word and Paradigm theory, rejects the morpheme as a relevant unit of analysis. Furthermore, results indicate that readers with greater spelling proficiency and larger vocabularies make better use of orthographic priors and handle lexical competition more efficiently. PMID:28235015

Discrimination in lexical decision.

PubMed

Milin, Petar; Feldman, Laurie Beth; Ramscar, Michael; Hendrix, Peter; Baayen, R Harald

2017-01-01

In this study we present a novel set of discrimination-based indicators of language processing derived from Naive Discriminative Learning (ndl) theory. We compare the effectiveness of these new measures with classical lexical-distributional measures-in particular, frequency counts and form similarity measures-to predict lexical decision latencies when a complete morphological segmentation of masked primes is or is not possible. Data derive from a re-analysis of a large subset of decision latencies from the English Lexicon Project, as well as from the results of two new masked priming studies. Results demonstrate the superiority of discrimination-based predictors over lexical-distributional predictors alone, across both the simple and primed lexical decision tasks. Comparable priming after masked corner and cornea type primes, across two experiments, fails to support early obligatory segmentation into morphemes as predicted by the morpho-orthographic account of reading. Results fit well with ndl theory, which, in conformity with Word and Paradigm theory, rejects the morpheme as a relevant unit of analysis. Furthermore, results indicate that readers with greater spelling proficiency and larger vocabularies make better use of orthographic priors and handle lexical competition more efficiently.

Parsing Social Network Survey Data from Hidden Populations Using Stochastic Context-Free Grammars

PubMed Central

Poon, Art F. Y.; Brouwer, Kimberly C.; Strathdee, Steffanie A.; Firestone-Cruz, Michelle; Lozada, Remedios M.; Kosakovsky Pond, Sergei L.; Heckathorn, Douglas D.; Frost, Simon D. W.

2009-01-01

Background Human populations are structured by social networks, in which individuals tend to form relationships based on shared attributes. Certain attributes that are ambiguous, stigmatized or illegal can create a ÔhiddenÕ population, so-called because its members are difficult to identify. Many hidden populations are also at an elevated risk of exposure to infectious diseases. Consequently, public health agencies are presently adopting modern survey techniques that traverse social networks in hidden populations by soliciting individuals to recruit their peers, e.g., respondent-driven sampling (RDS). The concomitant accumulation of network-based epidemiological data, however, is rapidly outpacing the development of computational methods for analysis. Moreover, current analytical models rely on unrealistic assumptions, e.g., that the traversal of social networks can be modeled by a Markov chain rather than a branching process. Methodology/Principal Findings Here, we develop a new methodology based on stochastic context-free grammars (SCFGs), which are well-suited to modeling tree-like structure of the RDS recruitment process. We apply this methodology to an RDS case study of injection drug users (IDUs) in Tijuana, México, a hidden population at high risk of blood-borne and sexually-transmitted infections (i.e., HIV, hepatitis C virus, syphilis). Survey data were encoded as text strings that were parsed using our custom implementation of the inside-outside algorithm in a publicly-available software package (HyPhy), which uses either expectation maximization or direct optimization methods and permits constraints on model parameters for hypothesis testing. We identified significant latent variability in the recruitment process that violates assumptions of Markov chain-based methods for RDS analysis: firstly, IDUs tended to emulate the recruitment behavior of their own recruiter; and secondly, the recruitment of like peers (homophily) was dependent on the number of

Decision-Making Skills for Middle School Students.

ERIC Educational Resources Information Center

Bergmann, Sherrel; Rudman, Gerald J.

Early adolescence is a time when students require adult assistance to become accurate and effective decision makers and problem solvers. Because of the fragmented nature of society, the family structure, and the schooling process, schools need to establish a nonthreatening environment in which students can discuss the issues related to growing up.…

A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the UK

PubMed Central

Holt, S; Bertelli, G; Humphreys, I; Valentine, W; Durrani, S; Pudney, D; Rolles, M; Moe, M; Khawaja, S; Sharaiha, Y; Brinkworth, E; Whelan, S; Jones, S; Bennett, H; Phillips, C J

2013-01-01

Background: Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the UK. Methods: Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. Results: Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. Conclusion: Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting. PMID:23695023

Gd-EOB-DTPA-enhanced MRI is better than MDCT in decision making of curative treatment for hepatocellular carcinoma.

PubMed

Yoo, Sun Hong; Choi, Jong Young; Jang, Jeong Won; Bae, Si Hyun; Yoon, Seung Kew; Kim, Dong Goo; Yoo, Young Kyoung; Rha, Sung Eun; Lee, Young Joon; Jung, Eun Sun

2013-09-01

We assessed the change in the therapeutic decision among curative treatments after adding Gd-EOB-DTPA-enhanced MRI to triple-phase MDCT for patients with early-stage HCC. This study retrospectively investigated two groups: 33 pathologically confirmed HCC patients after liver transplantation in group 1; 34 HCC patients without pathology in group 2. In group 1, we simulated the therapeutic decision-making process by pretransplant MDCT and Gd-EOB-DTPA-enhanced MRI. In group 2, including the 34 early-stage HCC patients consecutively enrolled, we investigated the change of therapeutic decision after adding Gd-EOB-DTPA-enhanced MRI to MDCT. In the simulation from group 1, after adding Gd-EOB-DTPA-enhanced MRI, 33.3% (11/33 patients) of treatment decisions were changed from the decision based on MDCT alone. Among 22 patients considered eligible for resection and 33 patients for radiofrequency ablation, the therapeutic decision was changed for 10 patients in the surgical group and 4 patients for the RFA group (45.5 and 12.1%). In group 2, the rate of change in the therapeutic decision after adding Gd-EOB-DTPA-enhanced MRI to MDCT was 41.2% (14/34 patients). In group 1 with explants pathology, the median diameter of HCCs not detected by MDCT but detected by Gd-EOB-DTPA-enhanced MRI was 1.15 cm (0.3-3.0 cm). The median diameter of HCCs seen only in the explanted liver was 1.0 cm (0.3-1.7 cm), and 60.7% of them were well-differentiated HCCs. This study suggests that performing Gd-EOB-DTPA-enhanced MRI before deciding on curative treatment for early-stage HCC may improve the accuracy of treatment decision for early-stage HCC.

Ventral striatal dopamine reflects behavioral and neural signatures of model-based control during sequential decision making.

PubMed

Deserno, Lorenz; Huys, Quentin J M; Boehme, Rebecca; Buchert, Ralph; Heinze, Hans-Jochen; Grace, Anthony A; Dolan, Raymond J; Heinz, Andreas; Schlagenhauf, Florian

2015-02-03

Dual system theories suggest that behavioral control is parsed between a deliberative "model-based" and a more reflexive "model-free" system. A balance of control exerted by these systems is thought to be related to dopamine neurotransmission. However, in the absence of direct measures of human dopamine, it remains unknown whether this reflects a quantitative relation with dopamine either in the striatum or other brain areas. Using a sequential decision task performed during functional magnetic resonance imaging, combined with striatal measures of dopamine using [(18)F]DOPA positron emission tomography, we show that higher presynaptic ventral striatal dopamine levels were associated with a behavioral bias toward more model-based control. Higher presynaptic dopamine in ventral striatum was associated with greater coding of model-based signatures in lateral prefrontal cortex and diminished coding of model-free prediction errors in ventral striatum. Thus, interindividual variability in ventral striatal presynaptic dopamine reflects a balance in the behavioral expression and the neural signatures of model-free and model-based control. Our data provide a novel perspective on how alterations in presynaptic dopamine levels might be accompanied by a disruption of behavioral control as observed in aging or neuropsychiatric diseases such as schizophrenia and addiction.

Pragmatic precision oncology: the secondary uses of clinical tumor molecular profiling.

PubMed

Rioth, Matthew J; Thota, Ramya; Staggs, David B; Johnson, Douglas B; Warner, Jeremy L

2016-07-01

Precision oncology increasingly utilizes molecular profiling of tumors to determine treatment decisions with targeted therapeutics. The molecular profiling data is valuable in the treatment of individual patients as well as for multiple secondary uses. To automatically parse, categorize, and aggregate clinical molecular profile data generated during cancer care as well as use this data to address multiple secondary use cases. A system to parse, categorize and aggregate molecular profile data was created. A naÿve Bayesian classifier categorized results according to clinical groups. The accuracy of these systems were validated against a published expertly-curated subset of molecular profiling data. Following one year of operation, 819 samples have been accurately parsed and categorized to generate a data repository of 10,620 genetic variants. The database has been used for operational, clinical trial, and discovery science research. A real-time database of molecular profiling data is a pragmatic solution to several knowledge management problems in the practice and science of precision oncology. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An approach to measuring the quality of breast cancer decisions.

PubMed

Sepucha, Karen; Ozanne, Elissa; Silvia, Kerry; Partridge, Ann; Mulley, Albert G

2007-02-01

To explore an approach to measuring the quality of decisions made in the treatment of early stage breast cancer, focusing on patients' decision-specific knowledge and the concordance between patients' stated preferences for treatment outcomes and treatment received. Candidate knowledge and value items were identified after an extensive review of the published literature as well as reports on 27 focus groups and 46 individual interviews with breast cancer survivors. Items were subjected to cognitive interviews with six additional patients. A preliminary decision quality measure consisting of five knowledge items and four value items was pilot tested with 35 breast cancer survivors who also completed the control preferences scale and the decisional conflict scale (DCS). Preference for control and knowledge did not vary by treatment. The mean of the participants' knowledge scores was 54%. There was no correlation between the knowledge scores and the informed subscale of the DCS (Pearson r = .152, n = 32, p = 0.408). Patients who preferred to keep their breast were over five times as likely to have breast-conserving surgery than those who did not (OR 5.33, 95% CI (1.2, 24.5), p = 0.06). Patients who wanted to avoid radiation were six times as likely to choose mastectomy than those who did not (OR 6.4, 95% CI (1.34, 30.61), p = 0.04). Measuring decision quality by assessing patients' decision-specific knowledge and concordance between their values and treatment received, is feasible and important. Further work is necessary to overcome the methodological challenges identified in this pilot work. Guidelines for early stage breast cancer emphasize the importance of including patients' preferences in decisions about treatment. The ability of doctors and patients to make decisions that reflect the considered preferences of well-informed patients can and should be measured.

A triangular climate-based decision model to forecast crop anomalies in Kenya

NASA Astrophysics Data System (ADS)

Guimarães Nobre, G.; Davenport, F.; Veldkamp, T.; Jongman, B.; Funk, C. C.; Husak, G. J.; Ward, P.; Aerts, J.

2017-12-01

By the end of 2017, the world is expected to experience unprecedented demands for food assistance where, across 45 countries, some 81 million people will face a food security crisis. Prolonged droughts in Eastern Africa are playing a major role in these crises. To mitigate famine risk and save lives, government bodies and international donor organisations are increasingly building up efforts to resolve conflicts and secure humanitarian relief. Disaster-relief and financing organizations traditionally focus on emergency response, providing aid after an extreme drought event, instead of taking actions in advance based on early warning. One of the reasons for this approach is that the seasonal risk information provided by early warning systems is often considered highly uncertain. Overcoming the reluctance to act based on early warnings greatly relies on understanding the risk of acting in vain, and assessing the cost-effectiveness of early actions. This research develops a triangular climate-based decision model for multiple seasonal time-scales to forecast strong anomalies in crop yield shortages in Kenya using Casual Discovery Algorithms and Fast and Frugal Decision Trees. This Triangular decision model (1) estimates the causality and strength of the relationship between crop yields and hydro climatological predictors (extracted from the Famine Early Warning Systems Network's data archive) during the crop growing season; (2) provides probabilistic forecasts of crop yield shortages in multiple time scales before the harvesting season; and (3) evaluates the cost-effectiveness of different financial mechanisms to respond to early warning indicators of crop yield shortages obtained from the model. Furthermore, we reflect on how such a model complements and advances the current state-of-art FEWS Net system, and examine its potential application to improve the management of agricultural risks in Kenya.

Resource Guide: Selected Early Childhood/Early Intervention Training Materials. 9th Edition. Systems Change in Personnel Preparation.

ERIC Educational Resources Information Center

Catlett, Camille, Ed.; Winton, Pamela J., Ed.

This resource guide identifies and describes early childhood education teaching, training, and staff development materials that meet three basic criteria: good, readily available, and inexpensive. It is designed to provide educators, trainers, supervisors, and other personnel preparation decision makers with resources for designing quality…

Early Childhood Development in the Dixie Bloor Community of Mississauga, Ontario. Understanding the Early Years.

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Investigating Reported Data Practices in Early Childhood: An Exploratory Study

ERIC Educational Resources Information Center

Brawley, Susan; Stormont, Melissa A.

2014-01-01

The importance of collecting and using data for educational decision making is clear. However, little information has been gathered about the systematic collection and use of data in early childhood. The purpose of this study was to explore teacher perceptions of data collection practices in early childhood. Participants included 137 early…

Early-career experts essential for planetary sustainability

USGS Publications Warehouse

Lim, Michelle; Lynch, Abigail J.; Fernández-Llamazares, Alvaro; Balint, Lenke; Basher, Zeenatul; Chan, Ivis; Jaureguiberry, Pedro; Mohamed, A.A.A.; Mwampamba, Tuyeni H.; Palomo, Ignacio; Pliscoff, Patricio; Salimov, R.A.; Samakov, Aibek; Selomane, Odirilwe; Shrestha, Uttam B.; Sidorovich, Anna A.

2017-01-01

Early-career experts can play a fundamental role in achieving planetary sustainability by bridging generational divides and developing novel solutions to complex problems. We argue that intergenerational partnerships and interdisciplinary collaboration among early-career experts will enable emerging sustainability leaders to contribute fully to a sustainable future. We review 16 international, interdisciplinary, and sustainability-focused early-career capacity building programs. We conclude that such programs are vital to developing sustainability leaders of the future and that decision-making for sustainability is likely to be best served by strong institutional cultures that promote intergenerational learning and involvement.

A spiral model of musical decision-making.

PubMed

Bangert, Daniel; Schubert, Emery; Fabian, Dorottya

2014-01-01

This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans' (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor's (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally.

A spiral model of musical decision-making

PubMed Central

Bangert, Daniel; Schubert, Emery; Fabian, Dorottya

2014-01-01

This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans’ (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor’s (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally. PMID:24795673

Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN): evolution of a content management system for point-of-care clinical decision support.

PubMed

Barwise, Amelia; Garcia-Arguello, Lisbeth; Dong, Yue; Hulyalkar, Manasi; Vukoja, Marija; Schultz, Marcus J; Adhikari, Neill K J; Bonneton, Benjamin; Kilickaya, Oguz; Kashyap, Rahul; Gajic, Ognjen; Schmickl, Christopher N

2016-10-03

The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. One of CERTAIN's key features is clinical decision support providing point-of-care information about common acute illness syndromes, procedures, and medications in an index card format. This paper describes 1) the process of developing and validating the content for point-of-care decision support, and 2) the content management system that facilitates frequent peer-review and allows rapid updates of content across different platforms (CERTAIN software, mobile apps, pdf-booklet) and different languages. Content was created based on survey results of acute care providers and validated using an open peer-review process. Over a 3 year period, CERTAIN content expanded to include 67 syndrome cards, 30 procedure cards, and 117 medication cards. 127 (59 %) cards have been peer-reviewed so far. Initially MS Word® and Dropbox® were used to create, store, and share content for peer-review. Recently Google Docs® was used to make the peer-review process more efficient. However, neither of these approaches met our security requirements nor has the capacity to instantly update the different CERTAIN platforms. Although we were able to successfully develop and validate a large inventory of clinical decision support cards in a short period of time, commercially available software solutions for content management are suboptimal. Novel custom solutions are necessary for efficient global point of care content system management.

Clinical decision-making of rural novice nurses.

PubMed

Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in

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

Does Early Childhood Teacher Education Affect Students' Cognitive Orientations? The Effect of Different Education Tracks in Teacher Education on Prospective Early Childhood Teachers' Cognitive Orientations in Germany

ERIC Educational Resources Information Center

Mischo, Christoph; Wahl, Stefan; Strohmer, Janina; Wolf, Carina

2014-01-01

Early childhood teachers may differ regarding the knowledge base they use when making professional decisions. In this study two orientations are distinguished: the orientation towards scientific knowledge vs. the orientation towards intuition and subjective experience. As different tracks in early childhood teacher education qualify for…

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

Database of tsunami scenario simulations for Western Iberia: a tool for the TRIDEC Project Decision Support System for tsunami early warning

NASA Astrophysics Data System (ADS)

Armigliato, Alberto; Pagnoni, Gianluca; Zaniboni, Filippo; Tinti, Stefano

2013-04-01

TRIDEC is a EU-FP7 Project whose main goal is, in general terms, to develop suitable strategies for the management of crises possibly arising in the Earth management field. The general paradigms adopted by TRIDEC to develop those strategies include intelligent information management, the capability of managing dynamically increasing volumes and dimensionality of information in complex events, and collaborative decision making in systems that are typically very loosely coupled. The two areas where TRIDEC applies and tests its strategies are tsunami early warning and industrial subsurface development. In the field of tsunami early warning, TRIDEC aims at developing a Decision Support System (DSS) that integrates 1) a set of seismic, geodetic and marine sensors devoted to the detection and characterisation of possible tsunamigenic sources and to monitoring the time and space evolution of the generated tsunami, 2) large-volume databases of pre-computed numerical tsunami scenarios, 3) a proper overall system architecture. Two test areas are dealt with in TRIDEC: the western Iberian margin and the eastern Mediterranean. In this study, we focus on the western Iberian margin with special emphasis on the Portuguese coasts. The strategy adopted in TRIDEC plans to populate two different databases, called "Virtual Scenario Database" (VSDB) and "Matching Scenario Database" (MSDB), both of which deal only with earthquake-generated tsunamis. In the VSDB we simulate numerically few large-magnitude events generated by the major known tectonic structures in the study area. Heterogeneous slip distributions on the earthquake faults are introduced to simulate events as "realistically" as possible. The members of the VSDB represent the unknowns that the TRIDEC platform must be able to recognise and match during the early crisis management phase. On the other hand, the MSDB contains a very large number (order of thousands) of tsunami simulations performed starting from many different

Creative Construction of Mathematics and Science Concepts in Early Childhood.

ERIC Educational Resources Information Center

Gallenstein, Nancy L.

Noting that effective teaching models that emphasize critical thinking in mathematics and science are used less often in early childhood classrooms than in those for older students, this book provides early childhood educators with an explanation of teaching models that promote 3- to 8-year-olds critical thinking, problem solving, decision making,…

Early Childhood Services in AEAs: A Blueprint for the Future.

ERIC Educational Resources Information Center

Iowa State Department of Education, 2004

2004-01-01

The purpose of this document is to facilitate discussion among decision makers at the Iowa Department of Education (DE), Area Education Agencies (AEAs) and local communities (including school districts) to establish early childhood priorities, and define the AEA role in the statewide efforts to build a strong early care, health, and education…

Practitioners' Views on Involving Young Children in Decision Making: Challenges for the Children's Rights Agenda

ERIC Educational Resources Information Center

Hudson, Kim

2012-01-01

This article presents the key findings and discussion from a research project and subsequent report: "Involving young children in decision making: An exploration of practitioners' views". This research explored early childhood practitioners'--childcare workers, kindergarten, pre-primary and grade 1-2 teachers--views on decision making…

When Friends' and Society's Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College.

PubMed

Bollich, Kathryn L; Hill, Patrick L; Harms, Peter D; Jackson, Joshua J

2016-01-01

Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change.

Modeling uncertainty in requirements engineering decision support

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Maynard-Zhang, Pedrito; Kiper, James D.

2005-01-01

One inherent characteristic of requrements engineering is a lack of certainty during this early phase of a project. Nevertheless, decisions about requirements must be made in spite of this uncertainty. Here we describe the context in which we are exploring this, and some initial work to support elicitation of uncertain requirements, and to deal with the combination of such information from multiple stakeholders.

Age-related differences in early novelty processing: Using PCA to parse the overlapping anterior P2 and N2 components

PubMed Central

Daffner, Kirk R.; Alperin, Brittany R.; Mott, Katherine K.; Tusch, Erich; Holcomb, Phillip J.

2015-01-01

Previous work demonstrated age-associated increases in the anterior P2 and age-related decreases in the anterior N2 in response to novel stimuli. Principal component analysis (PCA) was used to determine if the inverse relationship between these components was due to their temporal and spatial overlap. PCA revealed an early anterior P2, sensitive to task relevance, and a late anterior P2, responsive to novelty, both exhibiting age-related amplitude increases. A PCA factor representing the anterior N2, sensitive to novelty, exhibited age-related amplitude decreases. The late P2 and N2 to novels inversely correlated. Larger late P2 amplitude to novels was associated with better behavioral performance. Age-related differences in the anterior P2 and N2 to novel stimuli likely represent age-associated changes in independent cognitive operations. Enhanced anterior P2 activity (indexing augmentation in motivational salience) may be a compensatory mechanism for diminished anterior N2 activity (indexing reduced ability of older adults to process ambiguous representations). PMID:25596483

Do adolescents support early marriage in Bangladesh? Evidence from study.

PubMed

Rahman, M M; Kabir, M

2005-01-01

Adolescence is a critical period for female adolescents as they have to make decisions regarding their marriage, education and work which would influence and determine their future course of life. Although, early marriage has negative consequences, still a proportion of female adolescents favour early marriage because of prevailing cultural norms. This paper attempts to investigate the factors influencing the adolescents' attitude towards early marriage among the married and unmarried female adolescents. This is a quantitative and qualitative study. A multistage cluster sampling technique was used to select the sample. For quantitative results, data on 3362 female adolescents from rural and urban areas irrespective of their marital status were analyzed. To supplement the results found in quantitative analysis, a series of focus group discussions were conducted among the adolescents. Analysis revealed that one fourth (25.9%) of the adolescents were in favour of early marriage. A number of societal factors influenced them towards early marriage, despite the fact that adolescents are aware of the consequences of maternal and child health. Multivariate logistic regression analysis showed that current marital status, years of schooling, work status and parental marital decision are important predictors of early marriage (p < 0.05). The study concluded that female education would be an important determinant of adolescent marriage. Therefore, opportunities and scope of education beyond secondary would helps to bring change in the attitude towards early marriage.

An Exploratory Qualitative Study of Ethical Beliefs among Early Childhood Teachers

ERIC Educational Resources Information Center

French-Lee, Stacey; Dooley, Caitlin McMunn

2015-01-01

The purpose of this study is to learn how early childhood educators make ethical decisions. The study also explores how these educators might learn to base their ethical decisions on a professionally accepted ethical code through a participatory professional development process. The professional code of ethics used in this study is the National…

The Space Shuttle Decision: NASA's Search for a Reusable Space Vehicle

NASA Technical Reports Server (NTRS)

Heppenheimer, T. A.

1999-01-01

This significant new study of the decision to build the Space Shuttle explains the Shuttle's origins and early development. In addition to internal NASA discussions, this work details the debates in the late 1960s and early 1970s among policymakers in Congress, the Air Force, and the Office of Management and Budget over the roles and technical designs of the Shuttle. Examining the interplay of these organizations with sometimes conflicting goals, the author not only explains how the world's premier space launch vehicle came into being, but also how politics can interact with science, technology, national security, and economics in national government. The weighty policy decision to build the Shuttle represents the first component of the broader story: future NASA volumes will cover the Shuttle's development and operational histories.

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

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

Cultural Challenges to Engaging Patients in Shared Decision Making

PubMed Central

Hawley, Sarah T.; Morris, Arden M.

2016-01-01

Objective Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. Discussion The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. Conclusion While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. PMID:27461943

Cultural challenges to engaging patients in shared decision making.

PubMed

Hawley, Sarah T; Morris, Arden M

2017-01-01

Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. Published by Elsevier Ireland Ltd.

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,…

Entertainment education for breast cancer surgery decisions: a randomized trial among patients with low health literacy.

PubMed

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

2011-07-01

To evaluate an entertainment-based patient decision aid for early stage breast cancer surgery in low health literacy patients. Newly diagnosed female patients with early stage breast cancer from two public hospitals were randomized to receive an entertainment-based decision aid for breast cancer treatment along with usual care (intervention arm) or to receive usual care only (control arm). Pre-decision (baseline), pre-surgery, and 1-year follow-up assessments were conducted. Patients assigned to the intervention arm of the study were more likely than the controls to choose mastectomy rather than breast-conserving surgery; however, they appeared better informed and clearer about their surgical options than women assigned to the control group. No differences in satisfaction with the surgical decision or the decision-making process were observed between the patients who viewed the intervention and those assigned to the control group. Entertainment education may be a desirable strategy for informing lower health literate women about breast cancer surgery options. Incorporating patient decision aids, particularly computer-based decision aids, into standard clinical practice remains a challenge; however, patients may be directed to view programs at home or at public locations (e.g., libraries, community centers). Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial.

PubMed

Osaka, Wakako; Nakayama, Kazuhiro

2017-03-01

We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer. Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups. At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P=0.021, Cohen's d =0.26) and Group 2 vs control (P=0.008, Cohen's d=0.40). The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer. The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Driving in Early-Stage Alzheimer's Disease: An Integrative Review of the Literature.

PubMed

Davis, Rebecca L; Ohman, Jennifer M

2017-03-01

One of the most difficult decisions for individuals with Alzheimer's disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and well-being, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to increase driving safety, and methods to assist cessation and coping for individuals with early-stage AD. The evidence shows that changes in driving ability start early and progress throughout the trajectory of AD. Some individuals with mild cognitive impairment or early-stage AD may be safe to drive for a period of time. Support groups aimed at helping with the transition have been shown to be helpful for individuals who stop driving. Research and practice must support interventions to help individuals maintain safety while driving, as well as cope with driving cessation. [Res Gerontol Nurs. 2017; 10(2):86-100.]. Copyright 2016, SLACK Incorporated.

How they see it: young women's views on early marriage in a post-conflict setting.

PubMed

Knox, Sonya Em

2017-10-01

Current understandings of early marriage in conflict and post-conflict settings are incomplete and under-researched, and do not sufficiently take into consideration the views and experiences of adolescent girls. While much of the literature, development reports and mainstream media emphasise the poverty, health risks and lack of agency of young women married early, they seldom provide these teenagers an open platform from which to speak. In 2007, a Palestinian refugee camp in North Lebanon was destroyed and its residents forced to flee. Returning families experienced extreme hardships and a military cordon. Through ethnographic research undertaken in the camp a year later with adolescent girls in or en route to an early marriage, their mothers and NGO community workers, I explored decision-making processes leading to an early marriage and adolescent brides' assessments of married life. The decision to enter an early marriage, neither unilateral nor imposed, was instead described as an assessment of numerous factors, including economic hardships, insecurity and loneliness, many arising as a result of the conflict. Findings of this study challenge common understandings of early marriage - both the decision and its consequences - and call for greater nuance in designing interventions. These findings are particularly pertinent amid sensationalised media reports of early marriage in Syrian refugee communities; presenting girls in early marriages as victims garners international attention, but is not necessarily an accurate reflection of these girls' own understandings of their situation.

Family involvement for breast cancer decision making among Chinese-American women.

PubMed

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of early efficacy endpoints for proof-of-concept trials.

PubMed

Chen, Cong; Sun, Linda; Li, Chih-Lin

2013-03-11

A Phase II proof-of-concept (POC) trial usually uses an early efficacy endpoint other than a clinical endpoint as the primary endpoint. Because of the advancement in bioscience and technology, which has yielded a number of new surrogate biomarkers, drug developers often have more candidate endpoints to choose from than they can handle. As a result, selection of endpoint and its effect size as well as choice of type I/II error rates are often at the center of heated debates in design of POC trials. While optimization of the trade-off between benefit and cost is the implicit objective in such a decision-making process, it is seldom explicitly accounted for in practice. In this research note, motivated by real examples from the oncology field, we provide practical measures for evaluation of early efficacy endpoints (E4) for POC trials. We further provide optimal design strategies for POC trials that include optimal Go-No Go decision criteria for initiation of Phase III and optimal resource allocation strategies for conducting multiple POC trials in a portfolio under fixed resources. Although oncology is used for illustration purpose, the same idea developed in this research note also applies to similar situations in other therapeutic areas or in early-stage drug development in that a Go-No Go decision has to rely on limited data from an early efficacy endpoint and cost-effectiveness is the main concern.

The decision to adopt evidence-based and other innovative mental health practices: risky business?

PubMed

Panzano, Phyllis C; Roth, Dee

2006-08-01

A risk-based decision-making framework was used to examine the decision to adopt innovative mental health practices, including both evidence-based and other research-guided practices. Seventy-eight projects involving decisions to adopt one of four innovative mental health practices were the focus of this study. Key informants with direct knowledge about the adoption decision provided data for hypothesis testing. As predicted, the propensity to adopt an innovative practice-as measured by decision stage-was negatively related to the perceived risk of adopting the practice, positively related to expected capacity to manage risk, and positively related to an organization's past propensity to take risks. Further, perceived risk, anticipated resource availability, and exposure to field-based evidence explained a substantial part of what differentiated adopters from nonadopters. Finally, several features of innovations known to influence innovation adoption decisions were found to be related in expected ways to perceived risk, capacity to manage risk, and risk propensity. This research supports the view that the decision to adopt an innovative mental health practice is a decision made in consideration of risk. Contrary to popular views that early adopters of innovations are willing to take enormous risks, these data offer the novel idea that early adopters act because they see the risks associated with adopting as lower than their nonadopter counterparts, partly because the risks are seen as more manageable. Implications of results are discussed for organizations considering adoption of innovative health care practices and for state or local mental health authorities hoping for a higher level of adoption in their areas.

Implementing Observation Protocols: Lessons for K-12 Education from the Field of Early Childhood

ERIC Educational Resources Information Center

Pianta, Robert C.

2012-01-01

This report draws from decades of experience using observation in early childhood education, which has implications for administrative decisions, evaluation practices, and policymaking in K-12. Early childhood education has long embraced the value of observing classrooms and teacher-child interactions. In early childhood education the features of…

Engaging Pupils in Decision-Making about Biodiversity Conservation Issues

ERIC Educational Resources Information Center

Grace, Marcus; Byrne, Jenny

2010-01-01

Our pupils' generation will eventually have the daunting responsibility of making decisions about local and global biodiversity. School provides an early opportunity for them to enter into formal discussion about the science and values associated with biodiversity conservation; but the crowded curriculum offers little time for such activities.…

Suitability of Open-Ocean Instrumentation for Use in Near-Field Tsunami Early Warning Along Seismically Active Subduction Zones

NASA Astrophysics Data System (ADS)

Williamson, Amy L.; Newman, Andrew V.

2018-05-01

Over the past decade, the number of open-ocean gauges capable of parsing information about a passing tsunami has steadily increased, particularly through national cable networks and international buoyed efforts such as the Deep-ocean Assessment and Reporting of Tsunami (DART). This information is analyzed to disseminate tsunami warnings to affected regions. However, most current warnings that incorporate tsunami are directed at mid- and far-field localities. In this study, we analyze the region surrounding four seismically active subduction zones, Cascadia, Japan, Chile, and Java, for their potential to facilitate local tsunami early warning using such systems. We assess which locations currently have instrumentation in the right locations for direct tsunami observations with enough time to provide useful warning to the nearest affected coastline—and which are poorly suited for such systems. Our primary findings are that while some regions are ill-suited for this type of early warning, such as the coastlines of Chile, other localities, like Java, Indonesia, could incorporate direct tsunami observations into their hazard forecasts with enough lead time to be effective for coastal community emergency response. We take into account the effect of tsunami propagation with regard to shallow bathymetry on the fore-arc as well as the effect of earthquake source placement. While it is impossible to account for every type of off-shore tsunamigenic event in these locales, this study aims to characterize a typical large tsunamigenic event occurring in the shallow part of the megathrust as a guide in what is feasible with early tsunami warning.

Risky decision-making in children with and without ADHD: A prospective study.

PubMed

Humphreys, Kathryn L; Tottenham, Nim; Lee, Steve S

2018-02-01

Learning from past decisions can enhance successful decision-making. It is unclear whether difficulties in learning from experience may contribute to risky decision-making, which may be altered among individuals with attention-deficit/hyperactivity disorder (ADHD). This study follows 192 children with and without ADHD aged 5 to 10 years for approximately 2.5 years and examines their risky decision-making using the Balloon Emotional Learning Task (BELT), a computerized assessment of sequential risky decision-making in which participants pump up a series of virtual balloons for points. The BELT contains three task conditions: one with a variable explosion point, one with a stable and early explosion point, and one with a stable and late explosion point. These conditions may be learned via experience on the task. Contrary to expectations, ADHD status was not found to be related to greater risk-taking on the BELT, and among younger children ADHD status is in fact associated with reduced risk-taking. In addition, the typically-developing children without ADHD showed significant learning-related gains on both stable task conditions. However, the children with ADHD demonstrated learning on the condition with a stable and early explosion point, but not on the condition with the stable and late explosion point, in which more pumps are required before learning when the balloon will explode. Learning during decision-making may be more difficult for children with ADHD. Because adapting to changing environmental demands requires the use of feedback to guide future behavior, negative outcomes associated with childhood ADHD may partially reflect difficulties in learning from experience.

Establishing Final Cleanup Decisions for the Hanford Site River Corridor

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

Lerch, J.A.; Sands, J.P.

2007-07-01

A major challenge in the River Corridor Closure Contract is establishing final cleanup decisions for the source operable units in the Hanford Site river corridor. Cleanup actions in the river corridor began in 1994 and have been performed in accordance with a 'bias for action' approach adopted by the Tri-Parties - the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology. This approach enabled early application of cleanup dollars on actual remediation of contaminated waste sites. Consequently, the regulatory framework authorizing cleanup actions at source operable units in the river corridor consists largely of interimmore » action records of decision, which were supported by qualitative risk assessments. Obtaining final cleanup decisions for the source operable units is necessary to determine whether past cleanup actions in the river corridor are protective of human health and the environment and to identify any course corrections that may be needed to ensure that ongoing and future cleanup actions are protective. Because the cleanup actions are ongoing, it is desirable to establish the final cleanup decisions as early as possible to minimize the impacts of any identified course corrections to the present cleanup approach. Development of a strategy to obtain final cleanup decisions for the source operable units in a manner that is responsive to desires for an integrated approach with the groundwater and Columbia River components while maintaining the ability to evaluate each component on its own merit represents a significant challenge. There are many different options for grouping final cleanup decisions, and each involved party or stakeholder brings slightly different interests that shape the approach. Regardless of the selected approach, there are several specific challenges and issues to be addressed before making final cleanup decisions. A multi-agency and contractor working group has been established to

Postnatal Psychosocial Assessment and Clinical Decision-Making, a Descriptive Study.

PubMed

Sims, Deborah; Fowler, Cathrine

2018-05-18

The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making. A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirms that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. Knowledge of the information domains and the decision-making strategies

Maternal psychological distress and child decision-making.

PubMed

Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Effectiveness and cost-effectiveness of sentinel lymph node biopsy compared with axillary node dissection in patients with early-stage breast cancer: a decision model analysis.

PubMed

Verry, H; Lord, S J; Martin, A; Gill, G; Lee, C K; Howard, K; Wetzig, N; Simes, J

2012-03-13

Sentinel lymph node biopsy (SLNB) is less invasive than axillary lymph node dissection (ALND) for staging early breast cancer, and has a lower risk of arm lymphoedema and similar rates of locoregional recurrence up to 8 years. This study estimates the longer-term effectiveness and cost-effectiveness of SLNB. A Markov decision model was developed to estimate the incremental quality-adjusted life years (QALYs) and costs of an SLNB-based staging and management strategy compared with ALND over 20 years' follow-up. The probability and quality-of-life weighting (utility) of outcomes were estimated from published data and population statistics. Costs were estimated from the perspective of the Australian health care system. The model was used to identify key factors affecting treatment decisions. The SLNB was more effective and less costly than the ALND over 20 years, with 8 QALYs gained and $883,000 saved per 1000 patients. The SLNB was less effective when: SLNB false negative (FN) rate >13%; 5-year incidence of axillary recurrence after an SLNB FN>19%; risk of an SLNB-positive result >48%; lymphoedema prevalence after ALND <14%; or lymphoedema utility decrement <0.012. The long-term advantage of SLNB over ALND was modest and sensitive to variations in key assumptions, indicating a need for reliable information on lymphoedema incidence and disutility following SLNB. In addition to awaiting longer-term trial data, risk models to better identify patients at high risk of axillary metastasis will be valuable to inform decision-making.

Individual Variations in Maternal Care Early in Life Correlate with Later Life Decision-Making and c-Fos Expression in Prefrontal Subregions of Rats

PubMed Central

van Hasselt, Felisa N.; de Visser, Leonie; Tieskens, Jacintha M.; Cornelisse, Sandra; Baars, Annemarie M.; Lavrijsen, Marla; Krugers, Harm J.; van den Bos, Ruud; Joëls, Marian

2012-01-01

Early life adversity affects hypothalamus-pituitary-adrenal axis activity, alters cognitive functioning and in humans is thought to increase the vulnerability to psychopathology–e.g. depression, anxiety and schizophrenia- later in life. Here we investigated whether subtle natural variations among individual rat pups in the amount of maternal care received, i.e. differences in the amount of licking and grooming (LG), correlate with anxiety and prefrontal cortex-dependent behavior in young adulthood. Therefore, we examined the correlation between LG received during the first postnatal week and later behavior in the elevated plus maze and in decision-making processes using a rodent version of the Iowa Gambling Task (rIGT). In our cohort of male and female animals a high degree of LG correlated with less anxiety in the elevated plus maze and more advantageous choices during the last 10 trials of the rIGT. In tissue collected 2 hrs after completion of the task, the correlation between LG and c-fos expression (a marker of neuronal activity) was established in structures important for IGT performance. Negative correlations existed between rIGT performance and c-fos expression in the lateral orbitofrontal cortex, prelimbic cortex, infralimbic cortex and insular cortex. The insular cortex correlations between c-fos expression and decision-making performance depended on LG background; this was also true for the lateral orbitofrontal cortex in female rats. Dendritic complexity of insular or infralimbic pyramidal neurons did not or weakly correlate with LG background. We conclude that natural variations in maternal care received by pups may significantly contribute to later-life decision-making and activity of underlying brain structures. PMID:22693577

Mental disorder and legal responsibility: the relevance of stages of decision making.

PubMed

Kalis, Annemarie; Meynen, Gerben

2014-01-01

The paper discusses the relevance of decision-making models for evaluating the impact of mental disorder on legal responsibility. A three-stage model is presented that analyzes decision making in terms of behavioral control. We argue that understanding dysfunctions in each of the three stages of decision making could provide important insights in the relation between mental disorder and legal responsibility. In particular, it is argued that generating options for action constitutes an important but largely ignored stage of the decision-making process, and that dysfunctions in this early stage might undermine the whole process of making decisions (and thus behavioral control) more strongly than dysfunctions in later stages. Lastly, we show how the presented framework could be relevant to the actual psychiatric assessment of a defendant's decision making within the context of an insanity defense. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementing Obstetric Early Warning Systems.

PubMed

Friedman, Alexander M; Campbell, Mary L; Kline, Carolyn R; Wiesner, Suzanne; D'Alton, Mary E; Shields, Laurence E

2018-04-01

Severe maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings. This manuscript reports on key points from this session. While implementation experiences varied based on factors specific to individual sites, common themes relevant to all hospitals presenting were identified. Successful implementation of early warnings systems requires administrative and leadership support, dedication of resources, improved coordination between nurses, providers, and ancillary staff, optimization of information technology, effective education, evaluation of and change in hospital culture and practices, and support in provider decision-making. Evolving data on outcomes on early warning systems suggest that maternal risk may be reduced. To effectively reduce maternal, risk early warning systems that capture deterioration from a broad range of conditions may be required in addition to bundles tailored to specific conditions such as hemorrhage, thromboembolism, and hypertension.

Civil Rights Law and the Brown Decision.

ERIC Educational Resources Information Center

Greenberg, Jack

The Brown decision of 1954 was the product of a planned program of litigation begun in the late 1920s and the early 1930s by a group of Black lawyers. Their work would not have succeeded if the ethos of the United States had not been changing simultaneously. The growth of a climate more conducive to civil rights is reflected in the presidential…

When Friends’ and Society’s Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College

PubMed Central

Bollich, Kathryn L.; Hill, Patrick L.; Harms, Peter D.; Jackson, Joshua J.

2016-01-01

Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change. PMID:26751944

Genital surgery for disorders of sex development: implementing a shared decision-making approach.

PubMed

Karkazis, Katrina; Tamar-Mattis, Anne; Kon, Alexander A

2010-08-01

Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear "best-choice" treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: (1) Set the stage and develop an appropriate team; (2) Establish preferences for information and roles in decision-making; (3) Perceive and address emotions; (4) Define concerns and values; (5) Identify options and present evidence; and (6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.

Early and late retirement exits.

PubMed

Brougham, Ruby R; Walsh, David A

2009-01-01

The current study proposes that personal need fulfillment (relatedness, generativity, identity, growth, and finances) predicts early and late retirement intentions. The personal needs of 160 full-time older employees were measured by personal goals, job satisfactions, job characteristics, and intrinsic motivation. Results suggest that the personal needs fulfilled by job employment remain important in retirement. The expectation for personal need fulfillment for identity, growth, and relatedness shifts from work to retirement for those who intend to retire early. The results are discussed in terms of the need for greater study of the relationship between expectations of personal need fulfillment, worker self-concept, and retirement decisions.

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

Decision Making and Binge Drinking: A Longitudinal Study

PubMed Central

Goudriaan, Anna E.; Grekin, Emily R.; Sher, Kenneth J.

2009-01-01

Background: Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity. Methods: Latent class growth analysis was used to classify college students into 4 groups (each group n = 50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included. Results: The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men. Conclusions: Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general. PMID:17403069

IBM's Health Analytics and Clinical Decision Support.

PubMed

Kohn, M S; Sun, J; Knoop, S; Shabo, A; Carmeli, B; Sow, D; Syed-Mahmood, T; Rapp, W

2014-08-15

This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation.

Coral Reef Early Warning System (CREWS) RPC Experiment

NASA Technical Reports Server (NTRS)

Estep, Leland; Spruce, Joseph P.; Hall, Callie

2007-01-01

This viewgraph document reviews the background, objectives, methodology, validation, and present status of the Coral Reef Early Warning System (CREWS) Rapid Prototyping Capability (RPC) experiment. The potential NASA contribution to CREWS Decision Support Tool (DST) centers on remotely sensed imagery products.

Early-stage valuation of medical devices: the role of developmental uncertainty.

PubMed

Girling, Alan; Young, Terry; Brown, Celia; Lilford, Richard

2010-08-01

At the concept stage, many uncertainties surround the commercial viability of a new medical device. These include the ultimate functionality of the device, the cost of producing it and whether, and at what price, it can be sold to a health-care provider (HCP). Simple assessments of value can be made by estimating such unknowns, but the levels of uncertainty may mean that their operational value for investment decisions is unclear. However, many decisions taken at the concept stage are reversible and will be reconsidered later before the product is brought to market. This flexibility can be exploited to enhance early-stage valuations. To develop a framework for valuing a new medical device at the concept stage that balances benefit to the HCP against commercial costs. This is done within a simplified stage-gated model of the development cycle for new products. The approach is intended to complement existing proposals for the evaluation of the commercial headroom available to new medical products. A model based on two decision gates can lead to lower bounds (underestimates) for product value that can serve to support a decision to develop the product. Quantifiable uncertainty that can be resolved before the device is brought to market will generally enhance early-stage valuations of the device, and this remains true even when some components of uncertainty cannot be fully described. Clinical trials and other evidence-gathering activities undertaken as part of the development process can contribute to early-stage estimates of value.

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

The neural basis of belief updating and rational decision making

PubMed Central

Achtziger, Anja; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes’ rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision. PMID:22956673

The neural basis of belief updating and rational decision making.

PubMed

Achtziger, Anja; Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes' rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision.

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

PubMed

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

2015-01-01

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

Unreliable gut feelings can lead to correct decisions: the somatic marker hypothesis in non-linear decision chains.

PubMed

Bedia, Manuel G; Di Paolo, Ezequiel

2012-01-01

Dual-process approaches of decision-making examine the interaction between affective/intuitive and deliberative processes underlying value judgment. From this perspective, decisions are supported by a combination of relatively explicit capabilities for abstract reasoning and relatively implicit evolved domain-general as well as learned domain-specific affective responses. One such approach, the somatic markers hypothesis (SMH), expresses these implicit processes as a system of evolved primary emotions supplemented by associations between affect and experience that accrue over lifetime, or somatic markers. In this view, somatic markers are useful only if their local capability to predict the value of an action is above a baseline equal to the predictive capability of the combined rational and primary emotional subsystems. We argue that decision-making has often been conceived of as a linear process: the effect of decision sequences is additive, local utility is cumulative, and there is no strong environmental feedback. This widespread assumption can have consequences for answering questions regarding the relative weight between the systems and their interaction within a cognitive architecture. We introduce a mathematical formalization of the SMH and study it in situations of dynamic, non-linear decision chains using a discrete-time stochastic model. We find, contrary to expectations, that decision-making events can interact non-additively with the environment in apparently paradoxical ways. We find that in non-lethal situations, primary emotions are represented globally over and above their local weight, showing a tendency for overcautiousness in situated decision chains. We also show that because they tend to counteract this trend, poorly attuned somatic markers that by themselves do not locally enhance decision-making, can still produce an overall positive effect. This result has developmental and evolutionary implications since, by promoting exploratory behavior

Unreliable Gut Feelings Can Lead to Correct Decisions: The Somatic Marker Hypothesis in Non-Linear Decision Chains

PubMed Central

Bedia, Manuel G.; Di Paolo, Ezequiel

2012-01-01

Dual-process approaches of decision-making examine the interaction between affective/intuitive and deliberative processes underlying value judgment. From this perspective, decisions are supported by a combination of relatively explicit capabilities for abstract reasoning and relatively implicit evolved domain-general as well as learned domain-specific affective responses. One such approach, the somatic markers hypothesis (SMH), expresses these implicit processes as a system of evolved primary emotions supplemented by associations between affect and experience that accrue over lifetime, or somatic markers. In this view, somatic markers are useful only if their local capability to predict the value of an action is above a baseline equal to the predictive capability of the combined rational and primary emotional subsystems. We argue that decision-making has often been conceived of as a linear process: the effect of decision sequences is additive, local utility is cumulative, and there is no strong environmental feedback. This widespread assumption can have consequences for answering questions regarding the relative weight between the systems and their interaction within a cognitive architecture. We introduce a mathematical formalization of the SMH and study it in situations of dynamic, non-linear decision chains using a discrete-time stochastic model. We find, contrary to expectations, that decision-making events can interact non-additively with the environment in apparently paradoxical ways. We find that in non-lethal situations, primary emotions are represented globally over and above their local weight, showing a tendency for overcautiousness in situated decision chains. We also show that because they tend to counteract this trend, poorly attuned somatic markers that by themselves do not locally enhance decision-making, can still produce an overall positive effect. This result has developmental and evolutionary implications since, by promoting exploratory behavior

Early Childhood Curriculum: Planning, Assessment, and Implementation

ERIC Educational Resources Information Center

McLachlan, Claire; Fleer, Marilyn; Edwards, Susan

2010-01-01

"Early Childhood Curriculum" addresses current approaches to curriculum for infants, toddlers and young children, ages birth to eight. It provides a comprehensive introduction to the curriculum issues that student teachers and emerging practitioners will face and equips them with the decision-making tools that will ultimately enhance and promote…

Colorado Public Utility Commission's Xcel Wind Decision

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

Lehr, R. L.; Nielsen, J.; Andrews, S.

2001-09-20

In early 2001 the Colorado Public Utility Commission ordered Xcel Energy to undertake good faith negotiations for a wind plant as part of the utility's integrated resource plan. This paper summarizes the key points of the PUC decision, which addressed the wind plant's projected impact on generation cost and ancillary services. The PUC concluded that the wind plant would cost less than new gas-fired generation under reasonable gas cost projections.

"There were more decisions and more options than just yes or no": Evaluating a decision aid for advanced cancer patients and their family caregivers.

PubMed

Bakitas, Marie; Dionne-Odom, J Nicholas; Jackson, Lisa; Frost, Jennifer; Bishop, Margaret F; Li, Zhongze

2017-02-01

Few decision aids are available for patients with a serious illness who face many treatment and end-of-life decisions. We evaluated the Looking Ahead: Choices for Medical Care When You're Seriously Ill® patient decision aid (PtDA), one component of an early palliative care clinical trial. Our participants included individuals with advanced cancer and their caregivers who had participated in the ENABLE (Educate, Nurture, Advise, Before Life Ends) early palliative care telehealth randomized controlled trial (RCT) conducted in a National Cancer Institute-designated cancer center, a U.S. Department of Veterans Affairs medical center, and affiliated outreach clinics in rural New England. ENABLE included six weekly patient and three weekly family caregiver structured sessions. Participants watched the Looking Ahead PtDA prior to session 3, which covered content on decision making and advance care planning. Nurse coaches employed semistructured interviews to obtain feedback from consecutive patient and caregiver participants approximately one week after viewing the Looking Ahead PtDA program (booklet and DVD). Between April 1, 2011, and October 31, 2012, 57 patients (mean age = 64), 42% of whom had lung and 23% gastrointestinal cancer, and 20 caregivers (mean age = 59), 80% of whom were spouses, completed the PtDA evaluation. Participants reported a high degree of satisfaction with the PtDA format, as well as with its length and clarity. They found the format of using patient interviews "validating." The key themes were: (1) "the earlier the better" to view the PtDA; (2) feeling empowered, aware of different options, and an urgency to participate in advance care planning. The Looking Ahead PtDA was well received and helped patients with a serious illness realize the importance of prospective decision making in guiding their treatment pathways. We found that this PtDA can help seriously ill patients prior to the end of life to understand and discuss future healthcare

Timing the provision of a pregnancy decision-aid: temporal patterns of preference for mode of birth during pregnancy.

PubMed

Shorten, Allison; Shorten, Brett

2014-10-01

To help identify the optimal timing for provision of pregnancy decision-aids, this paper examines temporal patterns in women's preference for mode of birth after previous cesarean, prior to a decision-aid intervention. Pregnant women (n=212) with one prior cesarean responded to surveys regarding their preference for elective repeat cesarean delivery (ERCD) or trial of labor (TOL) at 12-18 weeks and again at 28 weeks gestation. Patterns of adherence or change in preference were examined. Women's preferences for birth were not set in early pregnancy. There was evidence of increasing uncertainty about preferred mode of birth during the first two trimesters of pregnancy (McNemar value=4.41, p=0.04), decrease in preference for TOL (McNemar value=3.79, p=0.05) and stability in preference for ERCD (McNemar value=0.31, p=0.58). Adherence to early pregnancy choice was associated with previous birth experience, maternal country of birth, emotional state and hospital site. Women's growing uncertainty about mode of birth prior to 28 weeks indicates potential readiness for a decision-aid earlier in pregnancy. Pregnancy decision-aids affecting mode of birth could be provided early in pregnancy to increase women's opportunity to improve knowledge, clarify personal values and reduce decision uncertainty. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

The management of patients with early Parkinson's disease.

PubMed

Rascol, O; Payoux, P; Ferreira, J; Brefel-Courbon, C

2002-10-01

A major problem in the management of early Parkinson's disease is to choose the first medication to prescribe. This decision should rely on the level of available clinical evidence, largely based, at least for efficacy, on the results of randomised clinical trials. Safety and costs are also crucial to consider. Other factors like for example pathophysiological concepts, individual experience, marketing pressure, socio-economical environment, patients needs and expectations have, however, also their own influence. Levodopa is efficacious and cheap, but induces long-term motor complications. The early use of dopamine agonists is more and more frequently promoted, because large prospective L-dopa-controlled trials demonstrated that this strategy reduces the risk of such long-term complications. Integrating individual clinical expertise to the best available external clinical evidence (evidence-based medicine) is the best strategy in making decisions about the care of individual patients. Copyright 2002 Elsevier Science Ltd.

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.

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

"It Could Have Been so Much Better": The Aesthetic and Social Work of Theatre

ERIC Educational Resources Information Center

Gallagher, Kathleen; Freeman, Barry; Wessells, Anne

2010-01-01

In this paper, the authors consider early results from their ethnographic research in urban drama classrooms by parsing the aesthetic and social imperatives at play in the classroom. Moved by the observation that teachers and students alike seem to be pursuing elusive aesthetic and social ideals, the authors draw on Judith Butler's notion of…

Superfund record of decision (EPA Region 6): Longhorn Army Ammunition Plant, IHAAP 12 and 16 Landfills, Karnack, TX, September 27, 1995

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

NONE

1996-03-01

This decision document presents the selected Early Interim Remedial Action for the LHAAP 12 and 16 landfills, Longhorn Army Ammunition Plant (LHAAP), Karnack, Texas. The Record of Decision for the sites addresses an Early Interim Remedial Action. The selected remedy consists of a multilayer landfill cap section which includes the following components: Foundation soil layer, Sodium Bentonite Geocomposite Liner, Geosynthetic Membrane Liner, Final soil cover, and Perimeter berms and drainage swales.

Emotionally positive stimuli facilitate lexical decisions-an ERP study.

PubMed

Kissler, Johanna; Koessler, Susanne

2011-03-01

The influence of briefly presented positive and negative emotional pictures on lexical decisions on positive, negative and neutral words or pseudowords was investigated. Behavioural reactions were the fastest following all positive stimuli and most accurate for positive words. Stimulus-locked ERPs revealed enhanced early posterior and late parietal attention effects following positive pictures. A small neural affective priming effect was reflected by P3 modulation, indicating more attention allocation to affectively incongruent prime-target pairs. N400 was insensitive to emotion. Response-locked ERPs revealed an early fronto-central negativity from 480ms before reactions to positive words. It was generated in both fronto-central and extra-striate visual areas, demonstrating a contribution of perceptual and, notably, motor preparation processes. Thus, no behavioural and little neural evidence for congruency-driven affective priming with emotional pictures was found, but positive stimuli generally facilitated lexical decisions, not only enhancing perception, but also acting rapidly on response preparation and by-passing full semantic analysis. Copyright © 2010 Elsevier B.V. All rights reserved.

Factors Influencing the Food Purchases of Early Care and Education Providers.

PubMed

Otten, Jennifer J; Hirsch, Tad; Lim, Catherine

2017-05-01

With the majority of US children enrolled in some form of early care and education, the settings for early care and education represent a valuable opportunity to positively impact young children's diets and their interactions with food. Little evidence exists on how early care and education providers make food purchasing and service decisions for this population of young children. Our aim was to explore the factors that influence early care and education providers' food purchasing and service decisions. A qualitative design consisting of individual, in-person, and semi-structured interviews with providers and on-site observations was used. Sixteen early care and education providers-selected across a variety of characteristics that might affect food selection (eg, size of site, participation in reimbursement programs, presence of staff assigned to foodservice) using maximum variation purposive sampling-based in the Puget Sound region, Washington, were interviewed from June to September 2014. Provider perspectives on food purchasing and service decisions. Inductive analysis of transcribed interviews using TAMS Analyzer software (GPL version 2, 2012) to identify themes. Ten main influencers emerged from the data. These were grouped into four categories based on an ecological framework: macro-level environments (ie, regulations; suppliers and vendors, including stores); physical environment and settings (ie, organizational mission, budget, and structure; the facility itself); social environments (ie, professional networks; peers; the site-specific parent and child community); and individual factors at both a provider and child-level (ie, providers' skills, behaviors, motivations, attitudes, knowledge, and values; child food preferences; and, child allergies). A model was then developed to identify potential pathways of intervention and underscore the need for a comprehensive approach to improve early care and education nutrition. This study suggests that a more

A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

PubMed

Liu, C Carrie; Rudmik, Luke

2016-10-01

The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

Asymmetric life-history decision-making in butterfly larvae

PubMed Central

Aalberg Haugen, Inger M.; Dahlerus, Josefin; Gotthard, Karl; Wiklund, Christer

2010-01-01

In temperate environments, insects appearing in several generations in the growth season typically have to decide during the larval period whether to develop into adulthood, or to postpone adult emergence until next season by entering a species-specific diapause stage. This decision is typically guided by environmental cues experienced during development. An early decision makes it possible to adjust growth rate, which would allow the growing larva to respond to time stress involved in direct development, whereas a last-minute decision would instead allow the larva to use up-to-date information about which developmental pathway is the most favourable under the current circumstances. We study the timing of the larval pathway decision-making between entering pupal winter diapause and direct development in three distantly related butterflies (Pieris napi, Araschnia levana and Pararge aegeria). We pinpoint the timing of the larval diapause decision by transferring larvae from first to last instars from long daylength (inducing direct development) to short daylength conditions (inducing diapause), and vice versa. Results show that the pathway decision is typically made in the late instars in all three species, and that the ability to switch developmental pathway late in juvenile life is conditional; larvae more freely switched from diapause to direct development than in the opposite direction. We contend that this asymmetry is influenced by the additional physiological preparations needed to survive the long and cold winter period, and that the reluctance to make a late decision to enter diapause has the potential to be a general trait among temperate insects. PMID:20953962

Experiencing cancer treatment decision-making in managed care.

PubMed

Wenzel, Jennifer; Shaha, Maya

2008-09-01

This paper is a report of a study to explore women's perceptions of and experiences with breast cancer treatment decision-making in managed care organizations (MCOs). Managed care organizations are the predominant form of employer-sponsored healthcare insurance in the United States of America. These healthcare financing entities minimize cost by streamlining healthcare delivery and may impose choice restrictions. The extent of these restrictions has not previously been studied from an in-depth patient perspective. A qualitative descriptive approach was adopted using interviews with a purposive sample of 14 managed care enrollees diagnosed with breast cancer at all stages. The data were collected between 2003 and 2005. Data analysis involved a reflexive process of transcript reading, categorization, data reduction and interpretation. The findings are presented as a single theme: 'decisional conflict in managed care', with two distinct categories: decisions regarding (1) the MCOs and (2) treatment. MCO selection was perceived to be limited by employer constraints, cost issues or healthcare plan providers. For study participants, selecting a MCO was less difficult than issues surrounding treatment decision-making. Women reported that their most important treatment-related decisions surrounded diagnosis and involved selecting a treatment facility and provider. Once a satisfactory facility and provider were selected, these women preferred to defer treatment decisions to their healthcare providers. Decision interventions should be focused on assisting women with provider and treatment facility selection early in diagnosis. Our findings might also serve as a basis for policy/practice changes to address healthcare financing limitations and to expand cancer treatment-related choices while providing desired treatment decision-making support.

Everyday ethics and help-seeking in early rheumatoid arthritis

PubMed Central

Townsend, A.; Adam, P.; Cox, S.M.; Li, L.C.

2018-01-01

Background Sociological understandings of chronic illness have revealed tensions and complexities around help-seeking. Although ethics underpins healthcare, its application in the area of chronic illness is limited. Here we apply an ethical framework to interview accounts and identify ethical challenges in the early rheumatoid arthritis (RA) experience. Methods In-depth interviews were conducted with eight participants who had been diagnosed with RA in the 12 months prior to recruitment. Applying the concepts of autonomous decision-making and procedural justice highlighted ethical concerns which arose throughout the help-seeking process. Analysis was based on the constant-comparison approach. Results Individuals described decision-making, illness actions and the medical encounter. The process was complicated by inadequate knowledge about symptoms, common-sense understandings about the GP appointment, difficulties concerning access to specialists, and patient–practitioner interactions. Autonomous decision-making and procedural justice were compromised. The accounts revealed contradictions between the policy ideals of active self-management, patient-centred care and shared decision-making, and the everyday experiences of individuals. Conclusions For ethical healthcare there is a need for: public knowledge about early RA symptoms; more effective patient–practitioner communication; and increased support during the wait between primary and secondary care. Healthcare facilities and the government may consider different models to deliver services to people requiring rheumatology consults. PMID:20610465

Multi-Criteria Decision Making for a Spatial Decision Support System on the Analysis of Changing Risk

NASA Astrophysics Data System (ADS)

Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2014-05-01

this case study namely: construction of defense structures, relocation, implementation of an early warning system and spatial planning regulations. Some of the criteria are determined partly in other modules of the CHANGES SDSS, such as the costs for implementation, the risk reduction in monetary values, and societal risk. Other criteria, which could be environmental, economic, cultural, perception in nature, are defined by different stakeholders such as local authorities, expert organizations, private sector, and local public. In the next step, the stakeholders weight the importance of the criteria by pairwise comparison and visualize the decision matrix, which is a matrix based on criteria versus alternatives values. Finally alternatives are ranked by Analytic Hierarchy Process (AHP) method. We expect that this approach will help the decision makers to ease their works and reduce their costs, because the process is more transparent, more accurate and involves a group decision. In that way there will be more confidence in the overall decision making process. Keywords: MCDM, Analytic Hierarchy Process (AHP), SDSS, Natural Hazard Risk Management

Dynamic decision making for dam-break emergency management - Part 1: Theoretical framework

NASA Astrophysics Data System (ADS)

Peng, M.; Zhang, L. M.

2013-02-01

An evacuation decision for dam breaks is a very serious issue. A late decision may lead to loss of lives and properties, but a very early evacuation will incur unnecessary expenses. This paper presents a risk-based framework of dynamic decision making for dam-break emergency management (DYDEM). The dam-break emergency management in both time scale and space scale is introduced first to define the dynamic decision problem. The probability of dam failure is taken as a stochastic process and estimated using a time-series analysis method. The flood consequences are taken as functions of warning time and evaluated with a human risk analysis model (HURAM) based on Bayesian networks. A decision criterion is suggested to decide whether to evacuate the population at risk (PAR) or to delay the decision. The optimum time for evacuating the PAR is obtained by minimizing the expected total loss, which integrates the time-related probabilities and flood consequences. When a delayed decision is chosen, the decision making can be updated with available new information. A specific dam-break case study is presented in a companion paper to illustrate the application of this framework to complex dam-breaching problems.

An early warning and control system for urban, drinking water quality protection: China's experience.

PubMed

Hou, Dibo; Song, Xiaoxuan; Zhang, Guangxin; Zhang, Hongjian; Loaiciga, Hugo

2013-07-01

An event-driven, urban, drinking water quality early warning and control system (DEWS) is proposed to cope with China's urgent need for protecting its urban drinking water. The DEWS has a web service structure and provides users with water quality monitoring functions, water quality early warning functions, and water quality accident decision-making functions. The DEWS functionality is guided by the principles of control theory and risk assessment as applied to the feedback control of urban water supply systems. The DEWS has been deployed in several large Chinese cities and found to perform well insofar as water quality early warning and emergency decision-making is concerned. This paper describes a DEWS for urban water quality protection that has been developed in China.

The metamorphosis of the statistical segmentation output: lexicalization during artificial language learning.

PubMed

Fernandes, Tânia; Kolinsky, Régine; Ventura, Paulo

2009-09-01

This study combined artificial language learning (ALL) with conventional experimental techniques to test whether statistical speech segmentation outputs are integrated into adult listeners' mental lexicon. Lexicalization was assessed through inhibitory effects of novel neighbors (created by the parsing process) on auditory lexical decisions to real words. Both immediately after familiarization and post-one week, ALL outputs were lexicalized only when the cues available during familiarization (transitional probabilities and wordlikeness) suggested the same parsing (Experiments 1 and 3). No lexicalization effect occurred with incongruent cues (Experiments 2 and 4). Yet, ALL differed from chance, suggesting a dissociation between item knowledge and lexicalization. Similarly contrasted results were found when frequency of occurrence of the stimuli was equated during familiarization (Experiments 3 and 4). Our findings thus indicate that ALL outputs may be lexicalized as far as the segmentation cues are congruent, and that this process cannot be accounted for by raw frequency.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

PubMed

Velickovski, Filip; Ceccaroni, Luigi; Roca, Josep; Burgos, Felip; Galdiz, Juan B; Marina, Nuria; Lluch-Ariet, Magí

2014-11-28

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

Helping decision makers frame, analyze, and implement decisions

USGS Publications Warehouse

Runge, Michael C.; McDonald-Madden, Eve

2018-01-01

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

A Cost-Effectiveness Analysis of Early Literacy Interventions

ERIC Educational Resources Information Center

Simon, Jessica

2011-01-01

Success in early literacy activities is associated with improved educational outcomes, including reduced dropout risk, in-grade retention, and special education referrals. When considering programs that will work for a particular school and context; cost-effectiveness analysis may provide useful information for decision makers. The study…

Time to decide: Diurnal variations on the speed and quality of human decisions.

PubMed

Leone, María Juliana; Fernandez Slezak, Diego; Golombek, Diego; Sigman, Mariano

2017-01-01

Human behavior and physiology exhibit diurnal fluctuations. These rhythms are entrained by light and social cues, with vast individual differences in the phase of entrainment - referred as an individual's chronotype - ranging in a continuum between early larks and late owls. Understanding whether decision-making in real-life situations depends on the relation between time of the day and an individual's diurnal preferences has both practical and theoretical implications. However, answering this question has remained elusive because of the difficulty of measuring precisely the quality of a decision in real-life scenarios. Here we investigate diurnal variations in decision-making as a function of an individual's chronotype capitalizing on a vast repository of human decisions: online chess servers. In a chess game, every player has to make around 40 decisions using a finite time budget and both the time and quality of each decision can be accurately determined. We found reliable diurnal rhythms in activity and decision-making policy. During the morning, players adopt a prevention focus policy (slower and more accurate decisions) which is later modified to a promotion focus (faster but less accurate decisions), without daily changes in performance. Copyright © 2016 Elsevier B.V. All rights reserved.

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…

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.

IBM’s Health Analytics and Clinical Decision Support

PubMed Central

Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.

2014-01-01

Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

Impaired Decision-Making in Adolescent Suicide Attempters

PubMed Central

Bridge, Jeffrey A.; McBee-Strayer, Sandra M.; Cannon, Elizabeth A.; Sheftall, Arielle H.; Reynolds, Brady; Campo, John V.; Pajer, Kathleen A.; Barbe, Rémy P.; Brent, David A.

2012-01-01

Objective Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision-making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison subjects. Method Using the Iowa Gambling Task, the authors examined decision-making in 40 adolescent suicide attempters, ages 13–18, and 40 never-suicidal, demographically-matched psychiatric comparison subjects. Results Overall, suicide attempters performed significantly worse on the Iowa Gambling Task than comparison subjects. This difference in overall task performance between the groups persisted in an exact conditional logistic regression analysis that controlled for affective disorder, current psychotropic medication use, impulsivity, and hostility (adjusted odds ratio=0.96, 95% confidence interval=0.90–0.99, p<.05). A two-way repeated-measures analysis of variance revealed a significant group-by-block interaction, demonstrating that attempters failed to learn during the task, picking approximately the same proportion of disadvantageous cards in the first and final blocks of the task. In contrast, comparison subjects picked proportionately fewer cards from the disadvantageous decks as the task progressed. Within the attempter group, overall task performance did not correlate with any characteristic of the index attempt or with the personality dimensions of impulsivity, hostility, and emotional lability. Conclusions Similar to findings in adults, impaired decision-making is associated with suicidal behavior in adolescents. Longitudinal studies are needed to elucidate the temporal relationship between decision-making processes and suicidal behavior and help frame potential targets for early identification and preventive interventions to reduce youth suicide and suicidal behavior. PMID:22449645

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…

Human Decision Making Based on Variations in Internal Noise: An EEG Study

PubMed Central

Amitay, Sygal; Guiraud, Jeanne; Sohoglu, Ediz; Zobay, Oliver; Edmonds, Barrie A.; Zhang, Yu-Xuan; Moore, David R.

2013-01-01

Perceptual decision making is prone to errors, especially near threshold. Physiological, behavioural and modeling studies suggest this is due to the intrinsic or ‘internal’ noise in neural systems, which derives from a mixture of bottom-up and top-down sources. We show here that internal noise can form the basis of perceptual decision making when the external signal lacks the required information for the decision. We recorded electroencephalographic (EEG) activity in listeners attempting to discriminate between identical tones. Since the acoustic signal was constant, bottom-up and top-down influences were under experimental control. We found that early cortical responses to the identical stimuli varied in global field power and topography according to the perceptual decision made, and activity preceding stimulus presentation could predict both later activity and behavioural decision. Our results suggest that activity variations induced by internal noise of both sensory and cognitive origin are sufficient to drive discrimination judgments. PMID:23840904

Improving the Use of Data in Early Reading Intervention Programs in Northwest Florida

ERIC Educational Resources Information Center

Thompson, Carla J.

2012-01-01

Improving student performance for high-need student populations by improving the use of data in decision-making for early reading intervention programs in northwest Florida is the focus of this research to practice effort. The study is conceptually based on using a relational-feedback intervention (RFI) database model in early learning…

The decision neuroscience perspective on suicidal behavior: evidence and hypotheses

PubMed Central

Dombrovski, Alexandre Y.; Hallquist, Michael N.

2017-01-01

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

Pioneers: A Simulation of Decision-Making on a Wagon Train.

ERIC Educational Resources Information Center

Wesley, John

This simulation allows students to participate in situations and events similar to those experienced by pioneers who headed west in early wagon trains. Students face problems such as floods, droughts, blocked trails, snakes, Indians, and the lack of food. Students must make numerous individual and small-group decisions that provide them with a…

Carbon Cycle Science in Support of Decision-Making

NASA Astrophysics Data System (ADS)

Brown, M. E.; West, T. O.; McGlynn, E.; Gurwick, N. P.; Duren, R. M.; Ocko, I.; Paustian, K.

2016-12-01

There has been an extensive amount of basic and applied research conducted on biogeochemical cycles, land cover change, watershed to earth system modeling, climate change, and energy efficiency. Concurrently, there continues to be interest in how to best reduce net carbon emissions, including maintaining or augmenting global carbon stocks and decreasing fossil fuel emissions. Decisions surrounding reductions in net emissions should be grounded in, and informed by, existing scientific knowledge and analyses in order to be most effective. The translation of scientific research to decision-making is rarely direct, and often requires coordination of objectives or intermediate research steps. For example, complex model output may need to be simplified to provide mean estimates for given activities; biogeochemical models used for climate change prediction may need to be altered to estimate net carbon flux associated with particular activities; or scientific analyses may need to aggregate and analyze data in a different manner to address specific questions. In the aforementioned cases, expertise and capabilities of researchers and decision-makers are both needed, and early coordination and communication is most effective. Initial analysis of existing science and current decision-making needs indicate that (a) knowledge that is co-produced by scientists and decision-makers has a higher probability of being usable for decision making, (b) scientific work in the past decade to integrate activity data into models has resulted in more usable information for decision makers, (c) attribution and accounting of carbon cycle fluxes is key to using carbon cycle science for decision-making, and (d) stronger, long-term links among research on climate and management of carbon-related sectors (e.g., energy, land use, industry, and buildings) are needed to adequately address current issues.

The Liberation Procedure Decision-Making Experience for People With Multiple Sclerosis

PubMed Central

Murray, Cynthia L.; Ploughman, Michelle; Harris, Chelsea; Hogan, Stephen; Murdoch, Michelle; Stefanelli, Mark

2014-01-01

Despite the absence of scientific evidence demonstrating the efficacy of the “liberation procedure” in treating multiple sclerosis (MS), thousands of MS patients worldwide have undergone the procedure. The study objective was to explore the experience of liberation procedure decision making for individuals with MS. Fifteen adults in Newfoundland and Labrador, Canada, each participated in an in-depth interview. The data analysis revealed three groups of people: “waiters,” “early embracers,” and “late embracers.” Using van Manen’s hermeneutic phenomenological approach, we identified three themes each in the stories of the early and late embracers and four themes in the waiters’ stories. A characteristic of the late embracers and waiters was skepticism, whereas desperation set the embracers apart from the waiters. With a deeper understanding of the experience, nurses can be more attuned to the perspectives of MS patients while helping them make informed decisions about undergoing the liberation procedure. PMID:28462292

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

NASA Astrophysics Data System (ADS)

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

2014-05-01

Uncertainty is present in all fields of climate research, spanning from projections of future climate change, to assessing regional impacts and vulnerabilities, to adaptation policy and decision-making. In addition to uncertainties, managers and planners in many sectors are often confronted with large amounts of information from climate change research whose complex and interdisciplinary nature make it challenging to incorporate into the decision-making process. An overarching issue in tackling this problem is the lack of institutionalized dialogue between climate researchers, decision-makers and user groups. Forums that facilitate such dialogue would allow climate researchers to actively engage with end-users and researchers in different disciplines to better characterize uncertainties and ultimately understand which ones are critically considered and incorporated into decisions made. We propose that the introduction of students to these challenges at an early stage of their education and career is a first step towards improving future dialogue between climate researchers, decision-makers and user groups. To this end, we organized a workshop at the University of Zurich, Switzerland, entitled "Uncertainty in Decision Making in a Changing Climate". It brought together 50 participants, including Bachelor, Master and PhD students and academic staff, and nine selected speakers from academia, industry, government, and philanthropy. Speakers introduced participants to topics ranging from uncertainties in climate model scenarios to managing uncertainties in development and aid agencies. The workshop consisted of experts' presentations, a panel discussion and student group work on case studies. Pedagogical goals included i) providing participants with an overview of the current research on uncertainty and on how uncertainty is dealt with by decision-makers, ii) fostering exchange between practitioners, students, and scientists from different backgrounds, iii) exposing

What you don't know about making decisions.

PubMed

Garvin, D A; Roberto, M A

2001-09-01

Most executives think of decision making as a singular event that occurs at a particular point in time. In reality, though, decision making is a process fraught with power plays, politics, personal nuances, and institutional history. Leaders who recognize this make far better decisions than those who persevere in the fantasy that decisions are events they alone control. That said, some decision-making processes are far more effective than others. Most often, participants use an advocacy process, possibly the least productive way to get things done. They view decision making as a contest, arguing passionately for their preferred solutions, presenting information selectively, withholding relevant conflicting data so they can make a convincing case, and standing firm against opposition. Much more powerful is an inquiry process, in which people consider a variety of options and work together to discover the best solution. Moving from advocacy to inquiry requires careful attention to three critical factors: fostering constructive, rather than personal, conflict; making sure everyone knows that their viewpoints are given serious consideration even if they are not ultimately accepted; and knowing when to bring deliberations to a close. The authors discuss in detail strategies for moving from an advocacy to an inquiry process, as well as for fostering productive conflict, true consideration, and timely closure. And they offer a framework for assessing the effectiveness of your process while you're still in the middle of it. Decision making is a job that lies at the very heart of leadership and one that requires a genius for balance: the ability to embrace the divergence that may characterize early discussions and to forge the unity needed for effective implementation.

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.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

PubMed

Hendrick, C Emily; Marteleto, Leticia

2017-06-01

Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras

PubMed Central

Hendrick, C. Emily; Marteleto, Leticia

2017-01-01

Maternal decision-making autonomy has been linked to positive outcomes for children’s health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children’s outcomes into adolescence and whether it impacts other domains of children’s lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents’ environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12–16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011–12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents’ school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers’ high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents’ school enrollment above and beyond other maternal, household, and regional influences. PMID:29075048

Facilitating Adoption of News Tool to Develop Clinical Decision Making

ERIC Educational Resources Information Center

Brown, Robin T.

2017-01-01

This scholarly project was a non-experimental, pre/post-test design to (a) facilitate the voluntary adoption of the National Early Warning Score (NEWS), and (b) develop clinical decision making (CDM) in one cohort of junior level nursing students participating in a simulation lab. NEWS is an evidence-based predictive scoring tool developed by the…

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

PubMed Central

2014-01-01

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health

Decision theory with resource-bounded agents.

PubMed

Halpern, Joseph Y; Pass, Rafael; Seeman, Lior

2014-04-01

There have been two major lines of research aimed at capturing resource-bounded players in game theory. The first, initiated by Rubinstein (), charges an agent for doing costly computation; the second, initiated by Neyman (), does not charge for computation, but limits the computation that agents can do, typically by modeling agents as finite automata. We review recent work on applying both approaches in the context of decision theory. For the first approach, we take the objects of choice in a decision problem to be Turing machines, and charge players for the "complexity" of the Turing machine chosen (e.g., its running time). This approach can be used to explain well-known phenomena like first-impression-matters biases (i.e., people tend to put more weight on evidence they hear early on) and belief polarization (two people with different prior beliefs, hearing the same evidence, can end up with diametrically opposed conclusions) as the outcomes of quite rational decisions. For the second approach, we model people as finite automata, and provide a simple algorithm that, on a problem that captures a number of settings of interest, provably performs optimally as the number of states in the automaton increases. Copyright © 2014 Cognitive Science Society, Inc.

Cognitive Tests in Early Childhood: Psychometric and Cultural Considerations

ERIC Educational Resources Information Center

Williams, Marian E.; Sando, Lara; Soles, Tamara Glen

2014-01-01

Cognitive assessment of young children contributes to high-stakes decisions because results are often used to determine eligibility for early intervention and special education. Previous reviews of cognitive measures for young children highlighted concerns regarding adequacy of standardization samples, steep item gradients, and insufficient floors…

“One code to find them all”: a perl tool to conveniently parse RepeatMasker output files

PubMed Central

2014-01-01

Background Of the different bioinformatic methods used to recover transposable elements (TEs) in genome sequences, one of the most commonly used procedures is the homology-based method proposed by the RepeatMasker program. RepeatMasker generates several output files, including the .out file, which provides annotations for all detected repeats in a query sequence. However, a remaining challenge consists of identifying the different copies of TEs that correspond to the identified hits. This step is essential for any evolutionary/comparative analysis of the different copies within a family. Different possibilities can lead to multiple hits corresponding to a unique copy of an element, such as the presence of large deletions/insertions or undetermined bases, and distinct consensus corresponding to a single full-length sequence (like for long terminal repeat (LTR)-retrotransposons). These possibilities must be taken into account to determine the exact number of TE copies. Results We have developed a perl tool that parses the RepeatMasker .out file to better determine the number and positions of TE copies in the query sequence, in addition to computing quantitative information for the different families. To determine the accuracy of the program, we tested it on several RepeatMasker .out files corresponding to two organisms (Drosophila melanogaster and Homo sapiens) for which the TE content has already been largely described and which present great differences in genome size, TE content, and TE families. Conclusions Our tool provides access to detailed information concerning the TE content in a genome at the family level from the .out file of RepeatMasker. This information includes the exact position and orientation of each copy, its proportion in the query sequence, and its quality compared to the reference element. In addition, our tool allows a user to directly retrieve the sequence of each copy and obtain the same detailed information at the family level when a local

Retrospection of Chernobyl nuclear accident for decision analysis concerning remedial actions in Ukraine

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

Georgievskiy, Vladimir

2007-07-01

It is considered the efficacy of decisions concerning remedial actions when of-site radiological monitoring in the early and (or) in the intermediate phases was absent or was not informative. There are examples of such situations in the former Soviet Union where many people have been exposed: releases of radioactive materials from 'Krasnoyarsk-26' into Enisey River, releases of radioactive materials from 'Chelabinsk-65' (the Kishtim accident), nuclear tests at the Semipalatinsk Test Site, the Chernobyl nuclear accident etc. If monitoring in the early and (or) in the intermediate phases is absent the decisions concerning remedial actions are usually developed on the basemore » of permanent monitoring. However decisions of this kind may be essentially erroneous. For these cases it is proposed to make retrospection of radiological data of the early and intermediate phases of nuclear accident and to project decisions concerning remedial actions on the base of both retrospective data and permanent monitoring data. In this Report the indicated problem is considered by the example of the Chernobyl accident for Ukraine. Their of-site radiological monitoring in the early and intermediate phases was unsatisfactory. In particular, the pasture-cow-milk monitoring had not been made. All official decisions concerning dose estimations had been made on the base of measurements of {sup 137}Cs in body (40 measurements in 135 days and 55 measurements in 229 days after the Chernobyl accident). For the retrospection of radiological data of the Chernobyl accident dynamic model has been developed. This model has structure similar to the structure of Pathway model and Farmland model. Parameters of the developed model have been identified for agricultural conditions of Russia and Ukraine. By means of this model dynamics of 20 radionuclides in pathways and dynamics of doses have been estimated for the early, intermediate and late phases of the Chernobyl accident. The main results are

The role of flight planning in aircrew decision performance

NASA Technical Reports Server (NTRS)

Pepitone, Dave; King, Teresa; Murphy, Miles

1989-01-01

The role of flight planning in increasing the safety and decision-making performance of the air transport crews was investigated in a study that involved 48 rated airline crewmembers on a B720 simulator with a model-board-based visual scene and motion cues with three degrees of freedom. The safety performance of the crews was evaluated using videotaped replays of the flight. Based on these evaluations, the crews could be divided into high- and low-safety groups. It was found that, while collecting information before flights, the high-safety crews were more concerned with information about alternative airports, especially the fuel required to get there, and were characterized by making rapid and appropriate decisions during the emergency part of the flight scenario, allowing these crews to make an early diversion to other airports. These results suggest that contingency planning that takes into account alternative courses of action enhances rapid and accurate decision-making under time pressure.

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.

Post-decision consolidation in large group decision-making.

PubMed

Bäck, Emma A; Esaiasson, Peter; Gilljam, Mikael; Svenson, Ola; Lindholm, Torun

2011-08-01

Decision-makers tend to change the psychological attractiveness of decision alternatives in favor of their own preferred alternative after the decision is made. In two experiments, the present research examined whether such decision consolidation occurs also among individual group members in a large group decision-making situation. High-school students were presented with a decision scenario on an important issue in their school. The final decision was made by in-group authority, out-group authority or by majority after a ballot voting. Results showed that individual members of large groups changed the attractiveness of their preferred alternative from a pre- to a post-decision phase, that these consolidation effects increased when decisions were made by in-group members, and when participants identified strongly with their school. Implications of the findings for understanding of group behavior and subgroup relations are discussed. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Early abortion services in the United States: a provider survey.

PubMed

Benson, Janie; Clark, Kathryn Andersen; Gerhardt, Ann; Randall, Lynne; Dudley, Susan

2003-04-01

The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to FDA approval of mifepristone. Early abortion services were available at 59% of sites, and establishing services was less difficult than or about what was anticipated. Sites generally found it easier to begin offering early surgical abortion than early medical abortion. Physician participation was found to be critical to implementing early services. At sites where some but not all providers offered early abortion, variations in service availability resulted. Given the option of reconsidering early services, virtually all sites would make the same decision again. These data suggest that developing mentoring relationships between experienced early abortion providers/sites and those not offering early services, and training physicians and other staff, are likely to be effective approaches to expanding service availability.

Auditory motion processing after early blindness

PubMed Central

Jiang, Fang; Stecker, G. Christopher; Fine, Ione

2014-01-01

Studies showing that occipital cortex responds to auditory and tactile stimuli after early blindness are often interpreted as demonstrating that early blind subjects “see” auditory and tactile stimuli. However, it is not clear whether these occipital responses directly mediate the perception of auditory/tactile stimuli, or simply modulate or augment responses within other sensory areas. We used fMRI pattern classification to categorize the perceived direction of motion for both coherent and ambiguous auditory motion stimuli. In sighted individuals, perceived motion direction was accurately categorized based on neural responses within the planum temporale (PT) and right lateral occipital cortex (LOC). Within early blind individuals, auditory motion decisions for both stimuli were successfully categorized from responses within the human middle temporal complex (hMT+), but not the PT or right LOC. These findings suggest that early blind responses within hMT+ are associated with the perception of auditory motion, and that these responses in hMT+ may usurp some of the functions of nondeprived PT. Thus, our results provide further evidence that blind individuals do indeed “see” auditory motion. PMID:25378368

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

The importance of early investigation and publishing in an emergent health and environment crisis.

PubMed

Murase, Kaori

2016-10-01

To minimize the damage resulting from a long-term environmental disaster such as the 2011 Fukushima nuclear accident in Japan, early disclosure of research data by scientists and prompt decision making by government authorities are required in place of careful, time-consuming research and deliberation about the consequences and cause of the accident. A Bayesian approach with flexible statistical modeling helps scientists and encourages government authorities to make decisions based on environmental data available in the early stages of a disaster. It is evident from Fukushima and similar accidents that classical research methods involving statistical methodologies that require rigorous experimental design and complex data sets are too cumbersome and delay important actions that may be critical in the early stages of an environmental disaster. Integr Environ Assess Manag 2016;12:680-682. © 2016 SETAC. © 2016 SETAC.

Ethics and Early Intervention: Toward More Relationship-Focused Interventions.

ERIC Educational Resources Information Center

Able-Boone, Harriet

1996-01-01

The ethical issues surrounding early intervention services to young children with disabilities are discussed. The conflict between parental autonomy and paternalistic interventions is evaluated. Value-based intervention decisions, such as parent choice of alternative therapies, refusal of services, and family-centered versus child-centered care,…

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

Humans Optimize Decision-Making by Delaying Decision Onset

PubMed Central

Teichert, Tobias; Ferrera, Vincent P.; Grinband, Jack

2014-01-01

Why do humans make errors on seemingly trivial perceptual decisions? It has been shown that such errors occur in part because the decision process (evidence accumulation) is initiated before selective attention has isolated the relevant sensory information from salient distractors. Nevertheless, it is typically assumed that subjects increase accuracy by prolonging the decision process rather than delaying decision onset. To date it has not been tested whether humans can strategically delay decision onset to increase response accuracy. To address this question we measured the time course of selective attention in a motion interference task using a novel variant of the response signal paradigm. Based on these measurements we estimated time-dependent drift rate and showed that subjects should in principle be able trade speed for accuracy very effectively by delaying decision onset. Using the time-dependent estimate of drift rate we show that subjects indeed delay decision onset in addition to raising response threshold when asked to stress accuracy over speed in a free reaction version of the same motion-interference task. These findings show that decision onset is a critical aspect of the decision process that can be adjusted to effectively improve decision accuracy. PMID:24599295

Brain signatures of moral sensitivity in adolescents with early social deprivation.

PubMed

Escobar, María Josefina; Huepe, David; Decety, Jean; Sedeño, Lucas; Messow, Marie Kristin; Baez, Sandra; Rivera-Rei, Álvaro; Canales-Johnson, Andrés; Morales, Juan Pablo; Gómez, David Maximiliano; Schröeder, Johannes; Manes, Facundo; López, Vladimir; Ibánez, Agustín

2014-06-19

The present study examined neural responses associated with moral sensitivity in adolescents with a background of early social deprivation. Using high-density electroencephalography (hdEEG), brain activity was measured during an intentional inference task, which assesses rapid moral decision-making regarding intentional or unintentional harm to people and objects. We compared the responses to this task in a socially deprived group (DG) with that of a control group (CG). The event-related potentials (ERPs) results showed atypical early and late frontal cortical markers associated with attribution of intentionality during moral decision-making in DG (especially regarding intentional harm to people). The source space of the hdEEG showed reduced activity for DG compared with CG in the right prefrontal cortex, bilaterally in the ventromedial prefrontal cortex (vmPFC), and right insula. Moreover, the reduced response in vmPFC for DG was predicted by higher rates of externalizing problems. These findings demonstrate the importance of the social environment in early moral development, supporting a prefrontal maturation model of social deprivation.

Prestimulus alpha power predicts fidelity of sensory encoding in perceptual decision making

PubMed Central

Lou, Bin; Li, Yun; Philiastides, Marios G.; Sajda, Paul

2013-01-01

Pre-stimulus α power has been shown to correlate with the behavioral accuracy of perceptual decisions. In most cases, these correlations have been observed by comparing α power for different behavioral outcomes (e.g. correct vs incorrect trials). In this paper we investigate such covariation within the context of behaviorally-latent fluctuations in task-relevant post-stimulus neural activity. Specially we consider variations of pre-stimulus α power with post-stimulus EEG components in a two alternative forced choice visual discrimination task. EEG components, discriminative of stimulus class, are identified using a linear multivariate classifier and only the variability of the components for correct trials (regardless of stimulus class, and for nominally identical stimuli) are correlated with the corresponding pre-stimulus α power. We find a significant relationship between the mean and variance of the pre-stimulus α power and the variation of the trial-to-trial magnitude of an early post-stimulus EEG component. This relationship is not seen for a later EEG component that is also discriminative of stimulus class and which has been previously linked to the quality of evidence driving the decision process. Our results suggest that early perceptual representations, rather than temporally later neural correlates of the perceptual decision, are modulated by pre-stimulus state. PMID:24185020

Learning for Semantic Parsing Using Statistical Syntactic Parsing Techniques

DTIC Science & Technology

2010-05-01

Workshop on Supervisory Con- trol of Learning and Adaptive Systems. San Jose, CA. Roland Kuhn and Renato De Mori (1995). The application of semantic...Processing (EMNLP-09), pp. 1–10. Suntec,Singapore. Ana-Maria Popescu, Alex Armanasu, Oren Etzioni, David Ko and Alexander Yates (2004). Modern natural

Differences in oncologist communication across age groups and contributions to adjuvant decision outcomes.

PubMed

Step, Mary M; Siminoff, Laura A; Rose, Julia H

2009-11-01

The objective of this study was to assess potential age-related differences in oncologist communication during conversations about adjuvant therapy decisions and subsequent patient decision outcomes. Communication was observed between a cross-section of female patients aged 40 to 80 with early-stage breast cancer (n=180) and their oncologists (n=36) in 14 academic and community oncology practices in two states. Sources of data included audio recordings of visits, followed by post-visit patient interviews. Communication during the visit was assessed using the Siminoff Communication Content and Affect Program. Patient outcome measures included self-reported satisfaction with decision, decision conflict, and decision regret. Results showed that oncologists were significantly more fluent and more direct with older than middle-aged patients and trended toward expressing their own treatment preferences more with older patients. Satisfaction with treatment decisions was highest for women in their 50s and 60s. Decision conflict was significantly associated with more discussion of oncologist treatment preferences and prognosis. Decision regret was significantly associated with patient age and education. Older adults considering adjuvant therapy may find that oncologists' communication accommodations to perceived deficiencies in older adult cognition or communication challenge their decision-making involvement. Oncologists should carefully assess patient decision-making preferences and be mindful of accommodating their speech to age-related stereotypes.

Automation: Decision Aid or Decision Maker?

NASA Technical Reports Server (NTRS)

Skitka, Linda J.

1998-01-01

This study clarified that automation bias is something unique to automated decision making contexts, and is not the result of a general tendency toward complacency. By comparing performance on exactly the same events on the same tasks with and without an automated decision aid, we were able to determine that at least the omission error part of automation bias is due to the unique context created by having an automated decision aid, and is not a phenomena that would occur even if people were not in an automated context. However, this study also revealed that having an automated decision aid did lead to modestly improved performance across all non-error events. Participants in the non- automated condition responded with 83.68% accuracy, whereas participants in the automated condition responded with 88.67% accuracy, across all events. Automated decision aids clearly led to better overall performance when they were accurate. People performed almost exactly at the level of reliability as the automation (which across events was 88% reliable). However, also clear, is that the presence of less than 100% accurate automated decision aids creates a context in which new kinds of errors in decision making can occur. Participants in the non-automated condition responded with 97% accuracy on the six "error" events, whereas participants in the automated condition had only a 65% accuracy rate when confronted with those same six events. In short, the presence of an AMA can lead to vigilance decrements that can lead to errors in decision making.

To Stay or to Go? Narratives of Early-Stage Sociologists about Persisting in Academia

ERIC Educational Resources Information Center

Wöhrer, Veronika

2014-01-01

Based on analyses of life course questionnaires, semi-structured qualitative interviews and focus group interviews carried out with early-stage sociologists over a period of 8 years, this paper presents analyzes of continuity and change in the decisions made by early-stage researchers in regard to their work and careers. The longitudinal approach…

Interpersonal relationship modulates the behavioral and neural responses during moral decision-making.

PubMed

Zhan, Youlong; Xiao, Xiao; Li, Jin; Liu, Lei; Chen, Jie; Fan, Wei; Zhong, Yiping

2018-04-13

Interpersonal relationship (IR) may play an important role in moral decision-making. However, it is little known about how IR influences neural and behavioral responses during moral decision-making. The present study utilized the dilemma scenario-priming paradigm to examine the time course of the different intimate IR (friend, acquaintance, or stranger) impacts on the emotional and cognitive processes during moral decision-making. Results showed that participants made less altruistic decisions with increased decision times and experienced more unpleasure for strangers versus friends and acquaintances. Moreover, at the early moral intuitional process, there was no significance difference observed at N1 under different intimate IR; however, at the emotional process, larger P260 which reflects the dilemma conflicts and negative emotional responses, was elicited when moral decision-making for strangers; at the later cognitive process, such difference was also observed at LPP (300-450 ms) which indexes the later top-down cognitive appraisal and reasoning processes. However, such differences were not observed between friends and acquaintances. Results indicate that IR modulates the emotional and cognitive processes during moral decision-making, suggesting that the closer the IR is, the weaker the dilemma conflicts and emotional responses are, and the more efficient this conflicts are solved. Copyright © 2018 Elsevier B.V. All rights reserved.

The Intimate Geographies of Panic Disorder: Parsing Anxiety through Psychopharmacological Dissection.

PubMed

Callard, Felicity

2016-01-01

The category of panic disorder was significantly indebted to early psychopharmacological experiments (in the late 1950s and early 1960s) by the psychiatrist Donald Klein, in collaboration with Max Fink. Klein's technique of "psychopharmacological dissection" underpinned his transformation of clinical accounts of anxiety and was central in effecting the shift from agoraphobic anxiety (with its spatial imaginary of city squares and streets) to panic. This technique disaggregated the previously unitary affect of anxiety-as advanced in psychoanalytic accounts-into two physiological and phenomenological kinds. "Psychopharmacological dissection" depended on particular modes of clinical observation to assess drug action and to interpret patient behavior. The "intimate geographies" out of which panic disorder emerged comprised both the socio-spatial dynamics of observation on the psychiatric ward and Klein's use of John Bowlby's model of separation anxiety-as it played out between the dyad of infant and mother-to interpret his adult patients' affectively disordered behavior. This essay, in offering a historical geography of mid-twentieth-century anxiety and panic, emphasizes the importance of socio-spatial setting in understanding how clinical and scientific experimentation opens up new ways in which affects can be expressed, shaped, observed, and understood.

Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial [ISRCTN22532458].

PubMed

Nagle, C; Gunn, J; Bell, R; Lewis, S; Meiser, B; Metcalfe, S; Ukoumunne, O C; Halliday, J

2008-02-01

To evaluate the effectiveness of a decision aid for prenatal testing of fetal abnormalities compared with a pamphlet in supporting women's decision making. A cluster randomised controlled trial. Primary health care. Women in early pregnancy consulting a GP. GPs were randomised to provide women with either a decision aid or a pamphlet. The decision aid was a 24-page booklet designed using the Ottowa Decision Framework. The pamphlet was an existing resource available in the trial setting. Validated scales were used to measure the primary outcomes, informed choice and decisional conflict, and the secondary outcomes, anxiety, depression, attitudes to the pregnancy/fetus and acceptability of the resource. Outcomes were measured at 14 weeks of gestation from questionnaires that women completed and returned by post. Women in the intervention group were more likely to make an informed decision 76% (126/165) than those in the control group 65% (107/165) (adjusted OR 2.08; 95% CI 1.14-3.81). A greater proportion of women in the intervention group 88% (147/167) had a 'good' level of knowledge than those in the control group 72% (123/171) (adjusted OR 3.43; 95% CI 1.79-6.58). Mean (SD) decisional conflict scores were low in both groups, decision aid 1.71 (0.49), pamphlet 1.65 (0.55) (adjusted mean difference 0.10; 95% CI -0.02 to 0.22). There was no strong evidence of differences between the trial arms in the measures of psychological or acceptability outcomes. A tailored prenatal testing decision aid plays an important role in improving women's knowledge of first and second trimester screening tests and assisting them to make decisions about screening and diagnostic tests that are consistent with their values.

Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics.

PubMed

Allen, Peter J; Dorozenko, Kate P; Roberts, Lynne D

2016-01-01

Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these "experts" were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid

Reflecting on the Challenges of Informal Contexts: Early Field Experiences with Technology in Teacher Education

ERIC Educational Resources Information Center

Lux, Nick; Obery, Amanda; Cornish, Jamie; Grimberg, Bruna Irene; Hartshorn, Anthony

2017-01-01

Early field experiences, or those that come early in a teacher's preparation before more formalized opportunities like practicum and student teaching, can provide a venue for pre service teachers to practice technology-specific instructional decision-making and reflective practice. Although research exists on the potential roles of field…

Knowledge base and sensor bus messaging service architecture for critical tsunami warning and decision-support

NASA Astrophysics Data System (ADS)

Sabeur, Z. A.; Wächter, J.; Middleton, S. E.; Zlatev, Z.; Häner, R.; Hammitzsch, M.; Loewe, P.

2012-04-01

The intelligent management of large volumes of environmental monitoring data for early tsunami warning requires the deployment of robust and scalable service oriented infrastructure that is supported by an agile knowledge-base for critical decision-support In the TRIDEC project (TRIDEC 2010-2013), a sensor observation service bus of the TRIDEC system is being developed for the advancement of complex tsunami event processing and management. Further, a dedicated TRIDEC system knowledge-base is being implemented to enable on-demand access to semantically rich OGC SWE compliant hydrodynamic observations and operationally oriented meta-information to multiple subscribers. TRIDEC decision support requires a scalable and agile real-time processing architecture which enables fast response to evolving subscribers requirements as the tsunami crisis develops. This is also achieved with the support of intelligent processing services which specialise in multi-level fusion methods with relevance feedback and deep learning. The TRIDEC knowledge base development work coupled with that of the generic sensor bus platform shall be presented to demonstrate advanced decision-support with situation awareness in context of tsunami early warning and crisis management.

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…

Decision making.

PubMed

Chambers, David W

2011-01-01

A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

Preparing for floods: flood forecasting and early warning

NASA Astrophysics Data System (ADS)

Cloke, Hannah

2016-04-01

Flood forecasting and early warning has continued to stride ahead in strengthening the preparedness phases of disaster risk management, saving lives and property and reducing the overall impact of severe flood events. For example, continental and global scale flood forecasting systems such as the European Flood Awareness System and the Global Flood Awareness System provide early information about upcoming floods in real time to various decisionmakers. Studies have found that there are monetary benefits to implementing these early flood warning systems, and with the science also in place to provide evidence of benefit and hydrometeorological institutional outlooks warming to the use of probabilistic forecasts, the uptake over the last decade has been rapid and sustained. However, there are many further challenges that lie ahead to improve the science supporting flood early warning and to ensure that appropriate decisions are made to maximise flood preparedness.

Decision technology.

PubMed

Edwards, W; Fasolo, B

2001-01-01

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

Developmental influences on fertility decisions by women: an evolutionary perspective.

PubMed

Coall, D A; Tickner, M; McAllister, L S; Sheppard, P

2016-04-19

Developmental environments are crucial for shaping our life course. Elements of the early social and biological environments have been consistently associated with reproduction in humans. To date, a strong focus has been on the relationship between early stress, earlier menarche and first child birth in women. These associations, found predominately in high-income countries, have been usefully interpreted within life-history theory frameworks. Fertility, on the other hand--a missing link between an individual's early environment, reproductive strategy and fitness--has received little attention. Here, we synthesize this literature by examining the associations between early adversity, age at menarche and fertility and fecundity in women. We examine the evidence that potential mechanisms such as birth weight, childhood body composition, risky health behaviours and developmental influences on attractiveness link the early environment and fecundity and fertility. The evidence that menarche is associated with fertility and fecundity is good. Currently, owing to the small number of correlational studies and mixed methodologies, the evidence that early adversity predicts fecundity and fertility is not conclusive. This area of research is in its infancy; studies examining early adversity and adult fertility decisions that can also examine likely biological, social and psychological pathways present opportunities for future fertility research. © 2016 The Author(s).

Developmental influences on fertility decisions by women: an evolutionary perspective

PubMed Central

Tickner, M.; McAllister, L. S.; Sheppard, P.

2016-01-01

Developmental environments are crucial for shaping our life course. Elements of the early social and biological environments have been consistently associated with reproduction in humans. To date, a strong focus has been on the relationship between early stress, earlier menarche and first child birth in women. These associations, found predominately in high-income countries, have been usefully interpreted within life-history theory frameworks. Fertility, on the other hand—a missing link between an individual's early environment, reproductive strategy and fitness—has received little attention. Here, we synthesize this literature by examining the associations between early adversity, age at menarche and fertility and fecundity in women. We examine the evidence that potential mechanisms such as birth weight, childhood body composition, risky health behaviours and developmental influences on attractiveness link the early environment and fecundity and fertility. The evidence that menarche is associated with fertility and fecundity is good. Currently, owing to the small number of correlational studies and mixed methodologies, the evidence that early adversity predicts fecundity and fertility is not conclusive. This area of research is in its infancy; studies examining early adversity and adult fertility decisions that can also examine likely biological, social and psychological pathways present opportunities for future fertility research. PMID:27022073

Living kidney donation: considerations and decision-making.

PubMed

Agerskov, Hanne; Bistrup, Claus; Ludvigsen, Mette Spliid; Pedersen, Birthe D

2014-06-01

When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre. The aim was to investigate early experiences in the process of becoming a living kidney donor (LKD). The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion. Two themes emerged: the decision-making process and dilemmas in decision-making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient-considerations that demonstrate that a range of dilemmas can occur during the decision-making process. The desire to help was prominent and was of significance in decision-making. The study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

The Stochastic Early Reaction, Inhibition, and late Action (SERIA) model for antisaccades

PubMed Central

2017-01-01

The antisaccade task is a classic paradigm used to study the voluntary control of eye movements. It requires participants to suppress a reactive eye movement to a visual target and to concurrently initiate a saccade in the opposite direction. Although several models have been proposed to explain error rates and reaction times in this task, no formal model comparison has yet been performed. Here, we describe a Bayesian modeling approach to the antisaccade task that allows us to formally compare different models on the basis of their evidence. First, we provide a formal likelihood function of actions (pro- and antisaccades) and reaction times based on previously published models. Second, we introduce the Stochastic Early Reaction, Inhibition, and late Action model (SERIA), a novel model postulating two different mechanisms that interact in the antisaccade task: an early GO/NO-GO race decision process and a late GO/GO decision process. Third, we apply these models to a data set from an experiment with three mixed blocks of pro- and antisaccade trials. Bayesian model comparison demonstrates that the SERIA model explains the data better than competing models that do not incorporate a late decision process. Moreover, we show that the early decision process postulated by the SERIA model is, to a large extent, insensitive to the cue presented in a single trial. Finally, we use parameter estimates to demonstrate that changes in reaction time and error rate due to the probability of a trial type (pro- or antisaccade) are best explained by faster or slower inhibition and the probability of generating late voluntary prosaccades. PMID:28767650

Prospective Clinical Utility Study of the Use of the 21-Gene Assay in Adjuvant Clinical Decision Making in Women With Estrogen Receptor-Positive Early Invasive Breast Cancer: Results From the SWITCH Study

PubMed Central

Pivot, Xavier B.; Jacot, William; Naman, Hervé L.; Spaeth, Dominique; Misset, Jean-Louis; Largillier, Rémy; Sautiere, Jean-Loup; de Roquancourt, Anne; Pomel, Christophe; Rouanet, Philippe; Rouzier, Roman; Penault-Llorca, Frederique M.

2015-01-01

Background. The 21-gene Oncotype DX Recurrence Score assay is a validated assay to help decide the appropriate treatment for estrogen receptor-positive (ER+), early-stage breast cancer (EBC) in the adjuvant setting. The choice of adjuvant treatments might vary considerably in different countries according to various treatment guidelines. This prospective multicenter study is the first to assess the impact of the Oncotype DX assay in the French clinical setting. Methods. A total of 100 patients with ER+, human epidermal growth factor receptor 2-negative EBC, and node-negative (pN0) disease or micrometastases in up to 3 lymph nodes (pN1mi) were enrolled. Treatment recommendations, physicians’ confidence before and after knowing the Recurrence Score value, and physicians’ perception of the assay were recorded. Results. Of the 100 patients, 95 were evaluable (83 pN0, 12 pN1mi). Treatment recommendations changed in 37% of patients, predominantly from chemoendocrine to endocrine treatment alone. The proportion of patients recommended chemotherapy decreased from 52% pretest to 25% post-test. Of patients originally recommended chemotherapy, 61% were recommended endocrine treatment alone after receiving the Recurrence Score result. For both pN0 and pN1mi patients, post-test recommendations appeared to follow the Recurrence Score result for low and high values. Physicians’ confidence improved significantly. Conclusion. These are the first prospective data on the impact of the Oncotype DX assay on adjuvant treatment decisions in France. Using the assay was associated with a significant change in treatment decisions and an overall reduction in chemotherapy use. These data are consistent with those presented from European and non-European studies. Implications for Practice: This study shows that in estrogen receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer (either node-negative or with micrometastases in up to 3 lymph nodes

Engaging patients in health care decisions in the emergency department through shared decision-making: a systematic review.

PubMed

Flynn, Darren; Knoedler, Meghan A; Hess, Erik P; Murad, M Hassan; Erwin, Patricia J; Montori, Victor M; Thomson, Richard G

2012-08-01

children with small lacerations; 2) options for rehydrating children presenting with vomiting or diarrhea or both; 3) risk of bacteremia (and associated complications), tests, and treatment options for febrile children; and 4) short-term risk of acute coronary syndrome (ACS) in adults with low-risk nontraumatic chest pain. Three studies had poor IPDASi probabilities and development process scores and lacked development informed by theory or involvement of clinicians and patients in development and usability testing. Overall, DSIs were associated with improvements in patients' knowledge and satisfaction with the explanation of their care, preferences for involvement, and engagement in decision-making and demonstrated utility for eliciting patients' preferences and values about management and treatment options. Two computerized DSIs (designed to predict risk of ACS in adults presenting to the ED with chest pain) were shown to reduce health care use without evidence of harm. None of the studies reported lack of feasibility of SDM in the ED. Early investigation of SDM in the ED suggests that patients may benefit from involvement in decision-making and offers no empirical evidence to suggest that SDM is not feasible. Future work is needed to develop and test additional SDM interventions in the ED and to identify contextual barriers and facilitators to implementation in practice. © 2012 by the Society for Academic Emergency Medicine.

Sleep dysfunctions influence decision making in undemented Parkinson's disease patients: a study in a virtual supermarket.

PubMed

Albani, Giovanni; Raspelli, Simona; Carelli, Laura; Priano, Lorenzo; Pignatti, Riccardo; Morganti, Francesca; Gaggioli, Andrea; Weiss, Patrice L; Kizony, Rachel; Katz, Noomi; Mauro, Alessandro; Riva, Giuseppe

2011-01-01

In the early-middle stages of Parkinson's disease (PD), polysomnographic studies show early alterations of the structure of the sleep, which may explain frequent symptoms reported by patients, such as daytime drowsiness, loss of attention and concentration, feeling of tiredness. The aim of this study was to verify if there is a correlation between the sleep dysfunction and decision making ability. We used a Virtual Reality version of the Multiple Errand Test (VMET), developed using the NeuroVR free software (http://www.neurovr2.org), to evaluate decision-making ability in 12 PD not-demented patients and 14 controls. Five of our not-demented 12 PD patients showed abnormalities in the polysomnographic recordings associated to significant differences in the VMET performance.

Alterations of decision making and underlying neural correlates after resection of a mediofrontal cortical dysplasia: A single case study.

PubMed

Labudda, Kirsten; Brand, Matthias; Mertens, Markus; Ebner, Alois; Markowitsch, Hans J; Woermann, Friedrich G

2010-02-01

We investigated the impact of a congenital prefrontal lesion and its resection on decision making under risk and under ambiguity in a patient with right mediofrontal cortical dysplasia. Both kinds of decision making are normally associated with the medial prefrontal cortex. We additionally studied pre- and postsurgical fMRI activations when processing information relevant for risky decision making. Results indicate selective impairments of ambiguous decision making pre- and postsurgically. Decision making under risk was intact. In contrast to healthy subjects the patient exhibited no activation within the dysplastic anterior cingulate cortex but left-sided orbitofrontal activation on the fMRI task suggesting early reorganization processes.

Evaluating the Adequacy of Social-Emotional Measures in Early Childhood

ERIC Educational Resources Information Center

Gokiert, Rebecca J.; Georgis, Rebecca; Tremblay, Melissa; Krishnan, Vijaya; Vandenberghe, Christine; Lee, Clara