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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-12

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

Convergence to consensus in heterogeneous groups and the emergence of informal leadership.

PubMed

Gavrilets, Sergey; Auerbach, Jeremy; van Vugt, Mark

2016-07-14

When group cohesion is essential, groups must have efficient strategies in place for consensus decision-making. Recent theoretical work suggests that shared decision-making is often the most efficient way for dealing with both information uncertainty and individual variation in preferences. However, some animal and most human groups make collective decisions through particular individuals, leaders, that have a disproportionate influence on group decision-making. To address this discrepancy between theory and data, we study a simple, but general, model that explicitly focuses on the dynamics of consensus building in groups composed by individuals who are heterogeneous in preferences, certain personality traits (agreeability and persuasiveness), reputation, and social networks. We show that within-group heterogeneity can significantly delay democratic consensus building as well as give rise to the emergence of informal leaders, i.e. individuals with a disproportionately large impact on group decisions. Our results thus imply strong benefits of leadership particularly when groups experience time pressure and significant conflict of interest between members (due to various between-individual differences). Overall, our models shed light on why leadership and decision-making hierarchies are widespread, especially in human groups.

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

DTIC Science & Technology

1981-09-29

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

An integrated experiment for identification of best decision styles and teamworks with respect to HSE and ergonomics program: The case of a large oil refinery.

PubMed

Azadeh, A; Mokhtari, Z; Sharahi, Z Jiryaei; Zarrin, M

2015-12-01

Decision making failure is a predominant human error in emergency situations. To demonstrate the subject model, operators of an oil refinery were asked to answer a health, safety and environment HSE-decision styles (DS) questionnaire. In order to achieve this purpose, qualitative indicators in HSE and ergonomics domain have been collected. Decision styles, related to the questions, have been selected based on Driver taxonomy of human decision making approach. Teamwork efficiency has been assessed based on different decision style combinations. The efficiency has been ranked based on HSE performance. Results revealed that efficient decision styles resulted from data envelopment analysis (DEA) optimization model is consistent with the plant's dominant styles. Therefore, improvement in system performance could be achieved using the best operator for critical posts or in team arrangements. This is the first study that identifies the best decision styles with respect to HSE and ergonomics factors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Composite collective decision-making

PubMed Central

Czaczkes, Tomer J.; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen

2015-01-01

Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. PMID:26019155

Analyzing the effectiveness of teaching and factors in clinical decision-making.

PubMed

Hsieh, Ming-Chen; Lee, Ming-Shinn; Chen, Tsung-Ying; Tsai, Tsuen-Chiuan; Pai, Yi-Fong; Sheu, Min-Muh

2017-01-01

The aim of this study is to prepare junior physicians, clinical education should focus on the teaching of clinical decision-making. This research is designed to explore teaching of clinical decision-making and to analyze the benefits of an "Analogy guide clinical decision-making" as a learning intervention for junior doctors. This study had a "quasi-experimental design" and was conducted in a medical center in eastern Taiwan. Participants and Program Description: Thirty junior doctors and three clinical teachers were involved in the study. The experimental group (15) received 1 h of instruction from the "Analogy guide for teaching clinical decision-making" every day for 3 months. Program Evaluation: A "Clinical decision-making self-evaluation form" was used as the assessment tool to evaluate participant learning efficiency before and after the teaching program. Semi-structured qualitative research interviews were also conducted. We found using the analogy guide for teaching clinical decision-making could help enhance junior doctors' self-confidence. Important factors influencing clinical decision-making included workload, decision-making, and past experience. Clinical teaching using the analogy guide for clinical decision-making may be a helpful tool for training and can contribute to a more comprehensive understanding of decision-making.

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

PubMed

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

2016-04-01

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

An Assessment Framework for Making Compensatory Mitigation Determinations in California

EPA Science Inventory

Efficient gathering and use of assessment information will improve the ecological effectiveness of compensatory mitigation. It also will make for more efficient regulatory decision-making. Recognizing these facts, the California Water Board worked in collaboration with the USEPA...

Planning and conducting meetings effectively, part I: planning a meeting.

PubMed

Harolds, Jay

2011-12-01

Meetings are held by leaders for many purposes, including conveying information, raising morale, asking for opinions, brain storming, making people part of the problem-solving process, building trust, getting to a consensus, and making decisions. However, many meetings waste time, some undermine the leader's power, and some decrease morale. Part I of this series of articles gives some tips on basic planning for decision-making meetings. Part II of this series of articles analyzes selected components of decision-making meetings. Part III of this series will be on how the chairperson keeps decision-making meetings on track to make them efficient and productive.

Scalable methodology for large scale building energy improvement: Relevance of calibration in model-based retrofit analysis

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

Heo, Yeonsook; Augenbroe, Godfried; Graziano, Diane

2015-05-01

The increasing interest in retrofitting of existing buildings is motivated by the need to make a major contribution to enhancing building energy efficiency and reducing energy consumption and CO2 emission by the built environment. This paper examines the relevance of calibration in model-based analysis to support decision-making for energy and carbon efficiency retrofits of individual buildings and portfolios of buildings. The authors formulate a set of real retrofit decision-making situations and evaluate the role of calibration by using a case study that compares predictions and decisions from an uncalibrated model with those of a calibrated model. The case study illustratesmore » both the mechanics and outcomes of a practical alternative to the expert- and time-intense application of dynamic energy simulation models for large-scale retrofit decision-making under uncertainty.« less

A conceptual framework for automating the operational and strategic decision-making process in the health care delivery system.

PubMed

Ruohonen, Toni; Ennejmy, Mohammed

2013-01-01

Making reliable and justified operational and strategic decisions is a really challenging task in the health care domain. So far, the decisions have been made based on the experience of managers and staff, or they are evaluated with traditional methods, using inadequate data. As a result of this kind of decision-making process, attempts to improve operations usually have failed or led to only local improvements. Health care organizations have a lot of operational data, in addition to clinical data, which is the key element for making reliable and justified decisions. However, it is progressively problematic to access it and make usage of it. In this paper we discuss about the possibilities how to exploit operational data in the most efficient way in the decision-making process. We'll share our future visions and propose a conceptual framework for automating the decision-making process.

Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries.

PubMed

Baji, Petra; García-Goñi, Manuel; Gulácsi, László; Mentzakis, Emmanouil; Paolucci, Francesco

2016-09-01

In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.

Convergence to consensus in heterogeneous groups and the emergence of informal leadership

PubMed Central

Gavrilets, Sergey; Auerbach, Jeremy; van Vugt, Mark

2016-01-01

When group cohesion is essential, groups must have efficient strategies in place for consensus decision-making. Recent theoretical work suggests that shared decision-making is often the most efficient way for dealing with both information uncertainty and individual variation in preferences. However, some animal and most human groups make collective decisions through particular individuals, leaders, that have a disproportionate influence on group decision-making. To address this discrepancy between theory and data, we study a simple, but general, model that explicitly focuses on the dynamics of consensus building in groups composed by individuals who are heterogeneous in preferences, certain personality traits (agreeability and persuasiveness), reputation, and social networks. We show that within-group heterogeneity can significantly delay democratic consensus building as well as give rise to the emergence of informal leaders, i.e. individuals with a disproportionately large impact on group decisions. Our results thus imply strong benefits of leadership particularly when groups experience time pressure and significant conflict of interest between members (due to various between-individual differences). Overall, our models shed light on why leadership and decision-making hierarchies are widespread, especially in human groups. PMID:27412692

Composite collective decision-making.

PubMed

Czaczkes, Tomer J; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen

2015-06-22

Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Priority setting in the Austrian healthcare system: results from a discrete choice experiment and implications for mental health.

PubMed

Mentzakis, Emmanouil; Paolucci, Francesco; Rubicko, Georg

2014-06-01

The impact of mental conditions is expected to be among the highest ranked causes of illness in high income countries by 2020. With changing health needs, policy makers have to make choices in an environment with increasingly constrained resources and competing demands. Discrete choice experiments have been identified as a useful approach to inform and support decision-making in health care systems and, in particular, its rationing. Policymakers, researchers and health practitioners from Austria participated in an experiment designed to elicit preferences for efficiency and equity in a generic priority setting framework. Using aggregate criteria an empirical measure of the efficiency/equity trade-off is calculated and a selection of health care interventions, including mental health, are ranked in composite league tables (CLTs). With the exception of severity of the condition, all equity parameters decrease attractiveness of an intervention, whereas the opposite holds for all three efficiency criteria. The efficiency/equity ratio (i.e. decision-makers' preference for efficiency over equity) is 3.5 and 5 for interventions targeted at younger and middle age populations, respectively, while for older populations this ratio is negative implying a rejection of all equity criteria. Irrespective of such differences interventions targeting mental health rank highly on all CLTs. Based on system-wide generic decision making criteria, mental health is shown to be a top priority for Austria. Preference-based approaches might offer complementary information to policymakers in priority setting decisions and a useful tool to support rationale rather than ad hoc decision-making.

Specific Barriers and Drivers in Different Stages of Decision-Making about Energy Efficiency Upgrades in Private Homes

PubMed Central

Klöckner, Christian A.; Nayum, Alim

2016-01-01

Energy efficiency upgrades of privately owned homes like adding to the insulation layers in the walls, roof or floor, or replacing windows with more efficiently insulated versions can contribute significantly to reducing the energy impact of the building sector and thus also the CO2 footprint of a household. However, even in countries like Norway that have a rather high rate of renovation, energy upgrades are not always integrated into such a refurbishment project. This study tests which structural and internal psychological barriers hinder and which drivers foster decision-making to implement such measures, once a renovation project is planned. With a theoretical background in stage-based models of decision-making 24 barriers and drivers were tested for their specific effect in the stages of decision-making. The four stages of decision-making assumed in this study were (1) “not being in a decision mode,” (2) “deciding what to do,” (3) “deciding how to do it,” and (4) “planning implementation.” Based on an online survey of 3787 Norwegian households, it was found that the most important barriers toward deciding to implement energy efficiency upgrades were not owning the dwelling and feeling the right time had not come yet. The most important drivers of starting to decide were higher expected comfort levels, better expected living conditions, and an expected reduction of energy costs. For the transition from deciding what to do to how to do it, not managing to make a decision and feeling the right point in time has not come yet were the strongest barriers, easily accessible information and an expected reduction of energy costs were the most important drivers. The final transition from deciding how to do the upgrades to planning implementation was driven by expecting a payoff within a reasonable time frame and higher expected comfort levels; the most important barriers were time demands for supervising contractors and—again—a feeling that the right point in time has not come yet. Implications for policy-making and marketing are discussed. PMID:27660618

Specific Barriers and Drivers in Different Stages of Decision-Making about Energy Efficiency Upgrades in Private Homes.

PubMed

Klöckner, Christian A; Nayum, Alim

2016-01-01

Energy efficiency upgrades of privately owned homes like adding to the insulation layers in the walls, roof or floor, or replacing windows with more efficiently insulated versions can contribute significantly to reducing the energy impact of the building sector and thus also the CO2 footprint of a household. However, even in countries like Norway that have a rather high rate of renovation, energy upgrades are not always integrated into such a refurbishment project. This study tests which structural and internal psychological barriers hinder and which drivers foster decision-making to implement such measures, once a renovation project is planned. With a theoretical background in stage-based models of decision-making 24 barriers and drivers were tested for their specific effect in the stages of decision-making. The four stages of decision-making assumed in this study were (1) "not being in a decision mode," (2) "deciding what to do," (3) "deciding how to do it," and (4) "planning implementation." Based on an online survey of 3787 Norwegian households, it was found that the most important barriers toward deciding to implement energy efficiency upgrades were not owning the dwelling and feeling the right time had not come yet. The most important drivers of starting to decide were higher expected comfort levels, better expected living conditions, and an expected reduction of energy costs. For the transition from deciding what to do to how to do it, not managing to make a decision and feeling the right point in time has not come yet were the strongest barriers, easily accessible information and an expected reduction of energy costs were the most important drivers. The final transition from deciding how to do the upgrades to planning implementation was driven by expecting a payoff within a reasonable time frame and higher expected comfort levels; the most important barriers were time demands for supervising contractors and-again-a feeling that the right point in time has not come yet. Implications for policy-making and marketing are discussed.

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

PubMed Central

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

2016-01-01

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

Towards Supporting Patient Decision-making In Online Diabetes Communities

PubMed Central

Zhang, Jing; Marmor, Rebecca; Huh, Jina

2017-01-01

As of 2014, 29.1 million people in the US have diabetes. Patients with diabetes have evolving information needs around complex lifestyle and medical decisions. As their conditions progress, patients need to sporadically make decisions by understanding alternatives and comparing options. These moments along the decision-making process present a valuable opportunity to support their information needs. An increasing number of patients visit online diabetes communities to fulfill their information needs. To understand how patients attempt to fulfill the information needs around decision-making in online communities, we reviewed 801 posts from an online diabetes community and included 79 posts for in-depth content analysis. The findings revealed motivations for posters’ inquiries related to decision-making including the changes in disease state, increased self-awareness, and conflict of information received. Medication and food were the among the most popular topics discussed as part of their decision-making inquiries. Additionally, We present insights for automatically identifying those decision-making inquiries to efficiently support information needs presented in online health communities. PMID:29854261

Age differences in dual information-processing modes: implications for cancer decision making.

PubMed

Peters, Ellen; Diefenbach, Michael A; Hess, Thomas M; Västfjäll, Daniel

2008-12-15

Age differences in affective/experiential and deliberative processes have important theoretical implications for cancer decision making, as cancer is often a disease of older adulthood. The authors examined evidence for adult age differences in affective and deliberative information processes, reviewed the sparse evidence about age differences in decision making, and introduced how dual process theories and their findings might be applied to cancer decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age, particularly when decisions are unfamiliar and the information is numeric. However, age-related adaptive processes, including an increased focus on emotional goals and greater experience, can influence decision making and potentially offset age-related declines. A better understanding of the mechanisms that underlie cancer decision processes in our aging population should ultimately allow us to help older adults to better help themselves.

Age Differences in Dual Information-Processing Modes: Implications for Cancer Decision Making

PubMed Central

Peters, Ellen; Diefenbach, Michael A.; Hess, Thomas M.; Västfjäll, Daniel

2008-01-01

Age differences in affective/experiential and deliberative processes have important theoretical implications for cancer decision making as cancer is often a disease of older adulthood. We examine evidence for adult age differences in affective and deliberative information processes, review the sparse evidence about age differences in decision making and introduce how dual process theories and their findings might be applied to cancer decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age, particularly when decisions are unfamiliar and the information is numeric. However, age-related adaptive processes, including an increased focus on emotional goals and greater experience, can influence decision making and potentially offset age-related declines. A better understanding of the mechanisms that underlie cancer decision processes in our aging population should ultimately allow us to help older adults to better help themselves. PMID:19058148

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

PubMed Central

2011-01-01

Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Conclusions Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making. PMID:21214905

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

PubMed

Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

2011-01-07

No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.

Comparison of fusion methods from the abstract level and the rank level in a dispersed decision-making system

NASA Astrophysics Data System (ADS)

Przybyła-Kasperek, M.; Wakulicz-Deja, A.

2017-05-01

Issues related to decision making based on dispersed knowledge are discussed in the paper. A dispersed decision-making system, which was proposed by the authors in previous articles, is used in this paper. In the system, a process of combining classifiers into coalitions with a negotiation stage is realized. The novelty that is proposed in this article involves the use of six different methods of conflict analysis that are known from the literature.The main purpose of the tests, which were performed, was to compare the methods from the two groups - the abstract level and the rank level. An additional aim was to investigate the efficiency of the fusion methods used in a dispersed system with a dynamic structure with the efficiency that is obtained when no structure is used. Conclusions were drawn that, in most cases, the use of a dispersed system improves the efficiency of inference.

Factors Affecting the Corporate Decision-Making Process of Air Transport Manufacturers

NASA Technical Reports Server (NTRS)

Ollila, R. G.; Hill, J. D.; Noton, B. R.; Duffy, M. A.; Epstein, M. M.

1976-01-01

Fuel economy is a pivotal question influencing the future sale and utilization of commercial aircraft. The NASA Aircraft Energy Efficiency (ACEE) Program Office has a program intended to accelerate the readiness of advanced technologies for energy efficient aircraft. Because the decision to develop a new airframe or engine is a major financial hazard for manufacturers, it is important to know what factors influence the decision making process. A method is described for identifying and ranking individuals and organizations involved at each stage of commercial air transport development, and the barriers that must be overcome in adopting new technologies.

NREL Collaborates with Trucking Industry to Prioritize R&D Opportunities |

Science.gov Websites

Department drive decision-making and improve efficiency, informing long-term, high-risk research such as the Rosa Using Data to Drive Decision Making NREL's fleet test and evaluation team conducts real-world 21CTP an example of NREL's data evaluation and decision support capabilities. Using data collected in

Evaluation of NASA-sponsored research on capital investment decision making in the civil aviation industry

NASA Technical Reports Server (NTRS)

Donovan, D. J.

1977-01-01

Significant findings of three studies undertaken to provide the NASA Aircraft Energy Efficiency (ACEE) Office with information regarding how aircraft manufacturers and commercial airlines make investment decisions concerning the acquisition of new and derivative technology are analyzed and their general implications explored. Topics discussed include: the market for airline aircraft, factors affecting the corporate decision making process of air transport manufacturers, and flight equipment purchasing practices of representative air carriers.

Opioid Modulation of Value-Based Decision-Making in Healthy Humans.

PubMed

Eikemo, Marie; Biele, Guido; Willoch, Frode; Thomsen, Lotte; Leknes, Siri

2017-08-01

Modifying behavior to maximize reward is integral to adaptive decision-making. In rodents, the μ-opioid receptor (MOR) system encodes motivation and preference for high-value rewards. Yet it remains unclear whether and how human MORs contribute to value-based decision-making. We reasoned that if the human MOR system modulates value-based choice, this would be reflected by opposite effects of agonist and antagonist drugs. In a double-blind pharmacological cross-over study, 30 healthy men received morphine (10 mg), placebo, and the opioid antagonist naltrexone (50 mg). They completed a two-alternative decision-making task known to induce a considerable bias towards the most frequently rewarded response option. To quantify MOR involvement in this bias, we fitted accuracy and reaction time data with the drift-diffusion model (DDM) of decision-making. The DDM analysis revealed the expected bidirectional drug effects for two decision subprocesses. MOR stimulation with morphine increased the preference for the stimulus with high-reward probability (shift in starting point). Compared to placebo, morphine also increased, and naltrexone reduced, the efficiency of evidence accumulation. Since neither drug affected motor-coordination, speed-accuracy trade-off, or subjective state (indeed participants were still blinded after the third session), we interpret the MOR effects on evidence accumulation efficiency as a consequence of changes in effort exerted in the task. Together, these findings support a role for the human MOR system in value-based choice by tuning decision-making towards high-value rewards across stimulus domains.

Risk manager formula for success: Influencing decision making.

PubMed

Midgley, Mike

2017-10-01

Providing the ultimate decision makers with a quantitative risk analysis based on thoughtful assessment by the organization's experts enables an efficient decision. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Health technology assessment in Saudi Arabia.

PubMed

Al-Aqeel, Sinaa

2018-05-16

The Saudi government, similar to any other government, is committed to making public spending more efficient, using resources more effectively, and limiting waste. Health technology assessment (HTA) is a tool that informs policy and decision makers regarding the formulation of safe and effective policies that are patient-focused and help to achieve efficiency when allocating limited health-care resources. Areas covered: After a brief description of HTA in the international context, this review provides a brief introduction to Saudi Arabia's health-care system, followed by a delineation of the decision maker(s) and influencers and the decision-making process for pricing and reimbursement. The article then discusses the current status of HTA in Saudi Arabia and proposes four strategic objectives that can form the first step in the development of a formal HTA process. Expert commentary: In Saudi Arabia, facilitators for incorporating HTA into the decision-making process exist. Future local research is needed to guide the implementation of full HTA.

EFFICIENTLY ESTABLISHING CONCEPTS OF INFERENTIAL STATISTICS AND HYPOTHESIS DECISION MAKING THROUGH CONTEXTUALLY CONTROLLED EQUIVALENCE CLASSES

PubMed Central

Fienup, Daniel M; Critchfield, Thomas S

2010-01-01

Computerized lessons that reflect stimulus equivalence principles were used to teach college students concepts related to inferential statistics and hypothesis decision making. Lesson 1 taught participants concepts related to inferential statistics, and Lesson 2 taught them to base hypothesis decisions on a scientific hypothesis and the direction of an effect. Lesson 3 taught the conditional influence of inferential statistics over decisions regarding the scientific and null hypotheses. Participants entered the study with low scores on the targeted skills and left the study demonstrating a high level of accuracy on these skills, which involved mastering more relations than were taught formally. This study illustrates the efficiency of equivalence-based instruction in establishing academic skills in sophisticated learners. PMID:21358904

Discrete event simulation for healthcare organizations: a tool for decision making.

PubMed

Hamrock, Eric; Paige, Kerrie; Parks, Jennifer; Scheulen, James; Levin, Scott

2013-01-01

Healthcare organizations face challenges in efficiently accommodating increased patient demand with limited resources and capacity. The modern reimbursement environment prioritizes the maximization of operational efficiency and the reduction of unnecessary costs (i.e., waste) while maintaining or improving quality. As healthcare organizations adapt, significant pressures are placed on leaders to make difficult operational and budgetary decisions. In lieu of hard data, decision makers often base these decisions on subjective information. Discrete event simulation (DES), a computerized method of imitating the operation of a real-world system (e.g., healthcare delivery facility) over time, can provide decision makers with an evidence-based tool to develop and objectively vet operational solutions prior to implementation. DES in healthcare commonly focuses on (1) improving patient flow, (2) managing bed capacity, (3) scheduling staff, (4) managing patient admission and scheduling procedures, and (5) using ancillary resources (e.g., labs, pharmacies). This article describes applicable scenarios, outlines DES concepts, and describes the steps required for development. An original DES model developed to examine crowding and patient flow for staffing decision making at an urban academic emergency department serves as a practical example.

Informed use of patients' records on trusted health care services.

PubMed

Sahama, Tony; Miller, Evonne

2011-01-01

Health care is an information-intensive business. Sharing information in health care processes is a smart use of data enabling informed decision-making whilst ensuring. the privacy and security of patient information. To achieve this, we propose data encryption techniques embedded Information Accountability Framework (IAF) that establishes transitions of the technological concept, thus enabling understanding of shared responsibility, accessibility, and efficient cost effective informed decisions between health care professionals and patients. The IAF results reveal possibilities of efficient informed medical decision making and minimisation of medical errors. Of achieving this will require significant cultural changes and research synergies to ensure the sustainability, acceptability and durability of the IAF.

Evaluation of Rutter Sigma S6 Ice Navigation Radar on USCGC Healy during Arctic Shield 2014

DTIC Science & Technology

2015-03-01

useful in making decisions about the pressure ridges ahead of time instead of making an immediate decision. Figure 33. CG radar display of... use the radar to help chart an efficient path through an ice field to reduce transit time and fuel expenses. This includes a clear picture of the ice...a ship would be able to use the radar to help chart an efficient path through an ice field to reduce transit time and fuel expenses. This includes

Reexamining Our Bias against Heuristics

ERIC Educational Resources Information Center

McLaughlin, Kevin; Eva, Kevin W.; Norman, Geoff R.

2014-01-01

Using heuristics offers several cognitive advantages, such as increased speed and reduced effort when making decisions, in addition to allowing us to make decision in situations where missing data do not allow for formal reasoning. But the traditional view of heuristics is that they trade accuracy for efficiency. Here the authors discuss sources…

Structured decision making for managing pneumonia epizootics in bighorn sheep

USGS Publications Warehouse

Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.

2016-01-01

Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and realistic because they explicitly account for important considerations managers implicitly weigh when making decisions, including competing management objectives, uncertainty in potential outcomes, and risk tolerance.

Shy herbivores forage more efficiently than bold ones regardless of information-processing overload.

PubMed

Tan, Ming Kai; Chang, Chia-Chen; Tan, Hugh T W

2018-04-01

The neural constraint hypothesis is central to understanding decision-making by foraging herbivorous insects which make decisions less efficiently when they face multiple choices for numerous resource types and/or at high densities instead of a fewer choices. Previous studies have also shown the relationship between personality type and decision-making style. How personality types correlate with foraging efficiency among herbivores is however, largely untested. To answer this question, we used a widespread, polyphagous, floriphilic katydid, Phaneroptera brevis (Orthoptera: Tettigoniidae) and two naturalised, Asteraceae, food plants, Bidens pilosa and Sphagneticola trilobata, as model systems. After we determined each katydid's exploration and boldness levels, we examined its foraging efficiency across different combinations of floral resource choice and density. We showed: (1) For the first time within the Tettigonioidea lineage that this katydid exhibits different personality types in exploration and boldness. (2) Contrary to our prediction, we did not find any support for the neural constraint hypothesis because more floral resource choice at a high density did not reduce foraging efficiency. (3) Surprisingly, bold katydids tend to be less efficient foragers than shy ones. Our findings have enhanced understanding of herbivore behavioural ecology and knowledge to better deal with potential pest herbivores. Copyright © 2018 Elsevier B.V. All rights reserved.

Retrieval of publications addressing shared decision making: an evaluation of full-text searches on medical journal websites.

PubMed

Blanc, Xavier; Collet, Tinh-Hai; Auer, Reto; Iriarte, Pablo; Krause, Jan; Légaré, France; Cornuz, Jacques; Clair, Carole

2015-04-07

Full-text searches of articles increase the recall, defined by the proportion of relevant publications that are retrieved. However, this method is rarely used in medical research due to resource constraints. For the purpose of a systematic review of publications addressing shared decision making, a full-text search method was required to retrieve publications where shared decision making does not appear in the title or abstract. The objective of our study was to assess the efficiency and reliability of full-text searches in major medical journals for identifying shared decision making publications. A full-text search was performed on the websites of 15 high-impact journals in general internal medicine to look up publications of any type from 1996-2011 containing the phrase "shared decision making". The search method was compared with a PubMed search of titles and abstracts only. The full-text search was further validated by requesting all publications from the same time period from the individual journal publishers and searching through the collected dataset. The full-text search for "shared decision making" on journal websites identified 1286 publications in 15 journals compared to 119 through the PubMed search. The search within the publisher-provided publications of 6 journals identified 613 publications compared to 646 with the full-text search on the respective journal websites. The concordance rate was 94.3% between both full-text searches. Full-text searching on medical journal websites is an efficient and reliable way to identify relevant articles in the field of shared decision making for review or other purposes. It may be more widely used in biomedical research in other fields in the future, with the collaboration of publishers and journals toward open-access data.

Decision making in a human population living sustainably.

PubMed

Hicks, John S; Burgman, Mark A; Marewski, Julian N; Fidler, Fiona; Gigerenzer, Gerd

2012-10-01

The Tiwi people of northern Australia have managed natural resources continuously for 6000-8000 years. Tiwi management objectives and outcomes may reflect how they gather information about the environment. We qualitatively analyzed Tiwi documents and management techniques to examine the relation between the social and physical environment of decision makers and their decision-making strategies. We hypothesized that principles of bounded rationality, namely, the use of efficient rules to navigate complex decision problems, explain how Tiwi managers use simple decision strategies (i.e., heuristics) to make robust decisions. Tiwi natural resource managers reduced complexity in decision making through a process that gathers incomplete and uncertain information to quickly guide decisions toward effective outcomes. They used management feedback to validate decisions through an information loop that resulted in long-term sustainability of environmental use. We examined the Tiwi decision-making processes relative to management of barramundi (Lates calcarifer) fisheries and contrasted their management with the state government's management of barramundi. Decisions that enhanced the status of individual people and their attainment of aspiration levels resulted in reliable resource availability for Tiwi consumers. Different decision processes adopted by the state for management of barramundi may not secure similarly sustainable outcomes. ©2012 Society for Conservation Biology.

Aging and the neuroeconomics of decision making: A review.

PubMed

Brown, Stephen B R E; Ridderinkhof, K Richard

2009-12-01

Neuroeconomics refers to a combination of paradigms derived from neuroscience, psychology, and economics for the study of decision making and is an area that has received considerable scientific attention in the recent literature. Using realistic laboratory tasks, researchers seek to study the neurocognitive processes underlying economic decision making and outcome-based decision learning, as well as individual differences in these processes and the social and affective factors that modulate them. To this point, one question has remained largely unanswered: What happens to decision-making processes and their neural substrates during aging? After all, aging is associated with neurocognitive change, which may affect outcome-based decision making. In our study, we use the subjective expected utility model-a well-established decision-making model in economics-as a descriptive framework. After a short survey of the brain areas and neurotransmitter systems associated with outcome-based decision making-and of the effects of aging thereon-we review a number of decision-making studies. Their general data pattern indicates that the decision-making process is changed by age: The elderly perform less efficiently than younger participants, as demonstrated, for instance, by the smaller total rewards that the elderly acquire in lab tasks. These findings are accounted for in terms of age-related deficiencies in the probability and value parameters of the subjective expected utility model. Finally, we discuss some implications and suggestions for future research.

Administrative Technology and the School Executive: Applying the Systems Approach to Educational Administration.

ERIC Educational Resources Information Center

Knezevich, Stephen J., Ed.

In this era of rapid social change, educational administrators have discovered that new approaches to problem solving and decision making are needed. Systems analysis could afford a promising approach to administrative problems by providing a number of systematic techniques designed to sharpen administrative decision making, enhance efficiency,…

Certainty, leaps of faith, and tradition: rethinking clinical interventions.

PubMed

Dzurec, L C

1998-12-01

Clinical decision making requires that clinicians think quickly and in ways that will foster optimal, safe client care. Tradition influences clinical decision making, enhancing efficiency of resulting nursing action; however, since many decisions must be based on data that are either uncertain, incomplete, or indirect, clinicians are readily ensnared in processes involving potentially faulty logic associated with tradition. The author addresses the tenacity of tradition and then focuses on three processes--consensus formation, the grounding of certainty in inductive reasoning, and affirming the consequent--that have affected clinical decision making. For some recipients of care, tradition has had a substantial and invalid influence on their ability to access care.

Decisions under distress: stress profiles influence anchoring and adjustment.

PubMed

Kassam, Karim S; Koslov, Katrina; Mendes, Wendy Berry

2009-11-01

People frequently make decisions under stress. Understanding how stress affects decision making is complicated by the fact that not all stress responses are created equal. Challenge states, for example, occur when individuals appraise a stressful situation as demanding, but believe they have the personal resources to cope, and are characterized by efficient cardiovascular reactivity and approach motivation. Threat states, in contrast, occur when situational demands are perceived to outweigh resources and are characterized by less efficient cardiovascular reactivity and withdrawal motivation. We randomly assigned participants to social-feedback conditions (i.e., positive or negative feedback) designed to engender challenge or threat, or a no-stress condition. Participants then completed an anchoring-and-adjustment questionnaire. Those assigned to the challenge condition adjusted more from self-generated anchors than those assigned to the threat condition. Cardiovascular responses mediated the relationship between condition and adjustment. This study demonstrates the importance of considering profiles of cardiovascular reactivity when examining the influence of stress on decision making.

Decisions Under Distress Stress Profiles Influence Anchoring and Adjustment

PubMed Central

Kassam, Karim S.; Koslov, Katrina; Mendes, Wendy Berry

2009-01-01

People frequently make decisions under stress. Understanding how stress affects decision making is complicated by the fact that not all stress responses are created equal. Challenge states, for example, occur when individuals appraise a stressful situation as demanding, but believe they have the personal resources to cope, and are characterized by efficient cardiovascular reactivity and approach motivation. Threat states, in contrast, occur when situational demands are perceived to outweigh resources and are characterized by less efficient cardiovascular reactivity and withdrawal motivation. We randomly assigned participants to social-feedback conditions (i.e., positive or negative feedback) designed to engender challenge or threat, or a no-stress condition. Participants then completed an anchoring-and-adjustment questionnaire. Those assigned to the challenge condition adjusted more from self-generated anchors than those assigned to the threat condition. Cardiovascular responses mediated the relationship between condition and adjustment. This study demonstrates the importance of considering profiles of cardiovascular reactivity when examining the influence of stress on decision making. PMID:19843261

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

NASA Astrophysics Data System (ADS)

Cui, Chenxuan

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

[The Role and Function of Informatics Nurses in Information Technology Decision-Making].

PubMed

Lee, Tso-Ying

2017-08-01

The medical environment has changed greatly with the coming of the information age, and, increasingly, the operating procedures for medical services have been altered in keeping with the trend toward mobile, paperless services. Informatization has the potential to improve the working efficiency of medical personnel, enhance patient care safety, and give medical organizations a positive image. Informatics nurses play an important role in the decision-making processes that accompany informatization. As one of the decision-making links in the information technology lifecycle, this role affects the success of the development and operation of information systems. The present paper examines the functions and professional knowledge that informatics nurses must possess during the technology lifecycle, the four stages of which include: planning, analysis, design/development/revision, and implementation/assessment/support/maintenance. The present paper further examines the decision-making shortcomings and errors that an informatics nurses may make during the decision-making process. We hope that this paper will serve as an effective and useful reference for informatics nurses during the informatization decision-making process.

Integrating strategic and tactical decisions in livestock supply chain using bi-level programming, case study: Iran poultry supply chain.

PubMed

Teimoury, Ebrahim; Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

Inventory management has frequently been targeted by researchers as one of the most pivotal problems in supply chain management. With the expansion of research studies on inventory management in supply chains, perishable inventory has been introduced and its fundamental differences from non-perishable inventory have been emphasized. This article presents livestock as a type of inventory that has been less studied in the literature. Differences between different inventory types, affect various levels of strategic, tactical and operational decision-making. In most articles, different levels of decision-making are discussed independently and sequentially. In this paper, not only is the livestock inventory introduced, but also a model has been developed to integrate decisions across different levels of decision-making using bi-level programming. Computational results indicate that the proposed bi-level approach is more efficient than the sequential decision-making approach.

Integrating strategic and tactical decisions in livestock supply chain using bi-level programming, case study: Iran poultry supply chain

PubMed Central

Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

Inventory management has frequently been targeted by researchers as one of the most pivotal problems in supply chain management. With the expansion of research studies on inventory management in supply chains, perishable inventory has been introduced and its fundamental differences from non-perishable inventory have been emphasized. This article presents livestock as a type of inventory that has been less studied in the literature. Differences between different inventory types, affect various levels of strategic, tactical and operational decision-making. In most articles, different levels of decision-making are discussed independently and sequentially. In this paper, not only is the livestock inventory introduced, but also a model has been developed to integrate decisions across different levels of decision-making using bi-level programming. Computational results indicate that the proposed bi-level approach is more efficient than the sequential decision-making approach. PMID:28982180

Mission at Mubasi - A Simulation for Leadership Development

NASA Technical Reports Server (NTRS)

Cummings, Pau; Aude, Steven; Fallesen, Jon

2012-01-01

The United States Army is investing in simulations as a way of providing practice for leader decision making. Such simulations, grounded in lessons learned from deployment experienced leaders, place less experienced and more junior leaders in challenging situations they might soon be confronted with. And given increased demands on the Army to become more efficient, while maintaining acceptable levels of mission readiness, simulations offer a cost effective complement to live field training. So too, the design parameters of such a simulation can be made to reinforce specific behavior responses which teach leaders known theory and application of effective (and ineffective) decision making. With this in mind, the Center for Army Leadership (CAL) determined that decision-making was of critical importance. Specifically, the following aspects of decision-making were viewed as particularly important for today's Army leaders: 1) Decision dilemmas, in the form of equally appealing or equally unappealing choices, such that there is no clear "right" or "wrong" choice 2) Making decisions with incomplete or ambiguous information, and 3) Predicting and experiencing second- and third-order consequences of decisions. It is decision making in such a setting or environment that Army leaders are increasingly confronted with given the full spectrum of military operations they must be prepared for. This paper details the approach and development of this decision making simulation.

Decision-making in diabetes mellitus type 1.

PubMed

Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

2013-01-01

Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.

Developing the U.S. Wildland Fire Decision Support System

Treesearch

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

2011-01-01

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

Naturalistic decision-making in expert badminton players.

PubMed

Macquet, A C; Fleurance, P

2007-09-01

This paper reports on a study of naturalistic decision-making in expert badminton players. These decisions are frequently taken under time-pressured conditions, yet normally lead to successful performance. Two male badminton teams participated in this study. Self-confrontation interviews were used to collect data. Inductive data analysis revealed three types of intentions during a rally: to maintain the rally; to take the advantage; and to finish the point. It also revealed eight types of decision taken in this situation: to ensure an action; to observe the opponent's response to an action; to realize a limited choice; to influence the opponent's decision; to put pressure on an opponent; to surprise the opponent; to reproduce an efficient action; and to play wide. A frequent decision was to put pressure on the opponent. Different information and knowledge was linked to specific decisions. The results are discussed in relation to research that has considered naturalistic decision-making.

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

PubMed

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

PubMed Central

Dolan, James G.

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

Range Sensor-Based Efficient Obstacle Avoidance through Selective Decision-Making.

PubMed

Shim, Youngbo; Kim, Gon-Woo

2018-03-29

In this paper, we address a collision avoidance method for mobile robots. Many conventional obstacle avoidance methods have been focused solely on avoiding obstacles. However, this can cause instability when passing through a narrow passage, and can also generate zig-zag motions. We define two strategies for obstacle avoidance, known as Entry mode and Bypass mode. Entry mode is a pattern for passing through the gap between obstacles, while Bypass mode is a pattern for making a detour around obstacles safely. With these two modes, we propose an efficient obstacle avoidance method based on the Expanded Guide Circle (EGC) method with selective decision-making. The simulation and experiment results show the validity of the proposed method.

Intersubjective decision-making for computer-aided forging technology design

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

ANFIS multi criteria decision making for overseas construction projects: a methodology

NASA Astrophysics Data System (ADS)

Utama, W. P.; Chan, A. P. C.; Zulherman; Zahoor, H.; Gao, R.; Jumas, D. Y.

2018-02-01

A critical part when a company targeting a foreign market is how to make a better decision in connection with potential project selection. Since different attributes of information are often incomplete, imprecise and ill-defined in overseas projects selection, the process of decision making by relying on the experiences and intuition is a risky attitude. This paper aims to demonstrate a decision support method in deciding overseas construction projects (OCPs). An Adaptive Neuro-Fuzzy Inference System (ANFIS), the amalgamation of Neural Network and Fuzzy Theory, was used as decision support tool to decide to go or not go on OCPs. Root mean square error (RMSE) and coefficient of correlation (R) were employed to identify the ANFIS system indicating an optimum and efficient result. The optimum result was obtained from ANFIS network with two input membership functions, Gaussian membership function (gaussmf) and hybrid optimization method. The result shows that ANFIS may help the decision-making process for go/not go decision in OCPs.

Eco-Efficiency Analysis of biotechnological processes.

PubMed

Saling, Peter

2005-07-01

Eco-Efficiency has been variously defined and analytically implemented by several workers. In most cases, Eco-Efficiency is taken to mean the ecological optimization of overall systems while not disregarding economic factors. Eco-Efficiency should increase the positive ecological performance of a commercial company in relation to economic value creation--or to reduce negative effects. Several companies use Eco-Efficiency Analysis for decision-making processes; and industrial examples of best practices in developing and implementing Eco-Efficiency have been reviewed. They clearly demonstrate the environmental and business benefits of Eco-Efficiency. An instrument for the early recognition and systematic detection of economic and environmental opportunities and risks for production processes in the chemical industry began use in 1997, since when different new features have been developed, leading to many examples. This powerful Eco-Efficiency Analysis allows a feasibility evaluation of existing and future business activities and is applied by BASF. In many cases, decision-makers are able to choose among alternative processes for making a product.

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

NASA Astrophysics Data System (ADS)

Fleischmann, Kenneth R.

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

Simulation and Modeling Efforts to Support Decision Making in Healthcare Supply Chain Management

PubMed Central

Lazarova-Molnar, Sanja

2014-01-01

Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM) by improving the decision making pertaining processes' efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM) has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges. PMID:24683333

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

ERIC Educational Resources Information Center

McCready, John W.

2010-01-01

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

Notification Event Architecture for Traveler Screening: Predictive Traveler Screening Using Event Driven Business Process Management

ERIC Educational Resources Information Center

Lynch, John Kenneth

2013-01-01

Using an exploratory model of the 9/11 terrorists, this research investigates the linkages between Event Driven Business Process Management (edBPM) and decision making. Although the literature on the role of technology in efficient and effective decision making is extensive, research has yet to quantify the benefit of using edBPM to aid the…

The Governance and Decision Making Processes of the Arizona Board of Regents and Universities.

ERIC Educational Resources Information Center

Schneider, Jacqueline; Johnson, Edward

One of the working papers in the final report of the Arizona Board of Regents' (ABOR) Task Force on Excellence, Efficiency and Competitiveness, this document looks at ABOR and at the governance and decision making processes of Arizona's three public universities. ABOR is a body corporate charged with the governance of the three universities, which…

A decision technology system for health care electronic commerce.

PubMed

Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

1999-08-01

Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.

Role of Technology in Decision Making: Exploring Land-Use Decisions

ERIC Educational Resources Information Center

Zaino, Maureen A.

2012-01-01

Increases in population, climatic changes, and other environmental issues are current challenges affecting the U.S. Geological Survey's (USGS) decision to examine land-use trends and emphasize efficient use and reuse of limited resources. Because of global concerns involving limited natural resources, researchers recognize land-use decision…

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

Science.gov Websites

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

Does decentralization influence efficiency of health units? A study of opinion and perception of health workers in Odisha.

PubMed

Panda, Bhuputra; Thakur, Harshad P; Zodpey, Sanjay P

2016-10-31

Health systems in low and middle income countries are struggling to improve efficiency in the functioning of health units of which workforce is one of the most critical building blocks. In India, Rogi Kalyan Samiti (RKS) was established at every health unit as institutions of local decision making in order to improve productive efficiency and quality. Measuring efficiency of health units is a complex task. This study aimed at assessing the perception (opinion and satisfaction) of health workers about influence of RKS on improving efficiency of peripheral decision making health units (DMHU); examining differences between priority and non-priority set-ups; identifying predictors of satisfaction at work; and discussing suggestions to improve performance. Following a cross-sectional, comparative study design, 130 health workers from 30 institutions were selected through a multi-stage stratified random sampling. A semi-structured questionnaire was administered to assess perception and opinion of health workers about influence of RKS on efficiency of decision making at local level, motivation and performance of staff, and availability of funds; improvement of quality of services, and coordination among co-workers; and participation of community in local decision making. Three districts with highest infant mortality rate (IMR), one each, from 3 zones of Odisha and 3 with lowest IMR were selected on the basis of IMR estimates of 2011. The former constituted priority districts (PD) and the latter, non-priority districts (NPD). Composite scores were developed and compared between PD and NPD. Adjusted linear regression was conducted to identify predictors of satisfaction at work. A majority of respondents felt that RKS was efficient in decision making that resulted in improvement of all critical parameters of health service delivery, including quality; this was significantly higher in PD. Further, higher proportion of respondents from PD was highly satisfied with the current set of provisions and manners of functioning of the sample health units. Active community engagement, participation of elected representatives, selection of a pro-active Chairman, and training to RKS members were suggested as the immediate priority action points for the state government. Mean scores differed significantly between PD and NPD with regard to: influence of RKS on individual-centric, organizational-centric and patient-centric performance, and the responsibilities to be entrusted with RKS. Absenteeism was strongly associated with satisfaction and local self-governance. Work-related factors, systemic factors, local accountability and patients' involvement were found to be the key predictors of satisfaction of health workforce. The understanding on quality improvement strategies was found to be very poor among the health workers. Tailor-made capacity building measures at district and sub-district levels could be critical to equip the peripheral health units to achieve the universal health coverage goals. Work environment, systemic factors and accountability need to be addressed on priority for retention of health workforce. The hypothesized link between efficient local decision making, perception of health workers about efficiency of health units and the health status of population needs further investigation.

Comparing perceptual and preferential decision making.

PubMed

Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

Interpatch foraging in honeybees-rational decision making at secondary hubs based upon time and motivation.

PubMed

Najera, Daniel A; McCullough, Erin L; Jander, Rudolf

2012-11-01

For honeybees, Apis mellifera, the hive has been well known to function as a primary decision-making hub, a place from which foragers decide among various directions, distances, and times of day to forage efficiently. Whether foraging honeybees can make similarly complex navigational decisions from locations away from the hive is unknown. To examine whether or not such secondary decision-making hubs exist, we trained bees to forage at four different locations. Specifically, we trained honeybees to first forage to a distal site "CT" 100 m away from the hive; if food was present, they fed and then chose to go home. If food was not present, the honeybees were trained to forage to three auxiliary sites, each at a different time of the day: A in the morning, B at noon, and C in the afternoon. The foragers learned to check site CT for food first and then efficiently depart to the correct location based upon the time of day if there was no food at site CT. Thus, the honeybees were able to cognitively map motivation, time, and five different locations (Hive, CT, A, B, and C) in two spatial dimensions; these are the contents of the cognitive map used by the honeybees here. While at site CT, we verified that the honeybees could choose between 4 different directions (to A, B, C, and the Hive) and thus label it as a secondary decision-making hub. The observed decision making uncovered here is inferred to constitute genuine logical operations, involving a branched structure, based upon the premises of motivational state, and spatiotemporal knowledge.

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.

Neural mechanisms regulating different forms of risk-related decision-making: Insights from animal models.

PubMed

Orsini, Caitlin A; Moorman, David E; Young, Jared W; Setlow, Barry; Floresco, Stan B

2015-11-01

Over the past 20 years there has been a growing interest in the neural underpinnings of cost/benefit decision-making. Recent studies with animal models have made considerable advances in our understanding of how different prefrontal, striatal, limbic and monoaminergic circuits interact to promote efficient risk/reward decision-making, and how dysfunction in these circuits underlies aberrant decision-making observed in numerous psychiatric disorders. This review will highlight recent findings from studies exploring these questions using a variety of behavioral assays, as well as molecular, pharmacological, neurophysiological, and translational approaches. We begin with a discussion of how neural systems related to decision subcomponents may interact to generate more complex decisions involving risk and uncertainty. This is followed by an overview of interactions between prefrontal-amygdala-dopamine and habenular circuits in regulating choice between certain and uncertain rewards and how different modes of dopamine transmission may contribute to these processes. These data will be compared with results from other studies investigating the contribution of some of these systems to guiding decision-making related to rewards vs. punishment. Lastly, we provide a brief summary of impairments in risk-related decision-making associated with psychiatric disorders, highlighting recent translational studies in laboratory animals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Making better decisions in groups

PubMed Central

Frith, Chris D.

2017-01-01

We review the literature to identify common problems of decision-making in individuals and groups. We are guided by a Bayesian framework to explain the interplay between past experience and new evidence, and the problem of exploring the space of hypotheses about all the possible states that the world could be in and all the possible actions that one could take. There are strong biases, hidden from awareness, that enter into these psychological processes. While biases increase the efficiency of information processing, they often do not lead to the most appropriate action. We highlight the advantages of group decision-making in overcoming biases and searching the hypothesis space for good models of the world and good solutions to problems. Diversity of group members can facilitate these achievements, but diverse groups also face their own problems. We discuss means of managing these pitfalls and make some recommendations on how to make better group decisions. PMID:28878973

Taking risks and taking advice: The role of experience in airline pilot diversions

NASA Technical Reports Server (NTRS)

Cohen, Marvin S.

1993-01-01

The research asks how pilots make diversion decisions, what factors determine whether they are make well or poorly, and how they may be improved. The results support the view that experienced decision makers may solve problems in a way that is qualitatively different from the approaches of less experienced decision makers. The results also support a concept of expertise that goes beyond a stock of specialized recognitional templates, to include domain-specific methods for processing information. Such metacognitive skills evolve through long experience. They may enhance both the accuracy and the efficiency of decision processes.

Developing Digital Dashboard Management for Learning System Dynamic Cooperative Simulation Behavior of Indonesia. (Study on Cooperative Information Organization in the Ministry of Cooperatives and SME)

NASA Astrophysics Data System (ADS)

Eni, Yuli; Aryanto, Rudy

2014-03-01

There are problems being experienced by the Ministry of cooperatives and SME (Small and Medium Enterprise) including the length of time in the decision by the Government to establish a policy that should be taken for local cooperatives across the province of Indonesia. The decision-making process is still analyzed manually, so that sometimes the decisions taken are also less appropriate, effective and efficient. The second problem is the lack of monitoring data cooperative process province that is too much, making it difficult for the analysis of dynamic information to be useful. Therefore the authors want to fix the system that runs by using digital dashboard management system supported by the modeling of system dynamics. In addition, the author also did the design of a system that can support the system. Design of this system is aimed to ease the experts, head, and the government to decide (DSS - Decision Support System) accurately effectively and efficiently, because in the system are raised alternative simulation in a description of the decision to be taken and the result from the decision. The system is expected to be designed dan simulated can ease and expedite the decision making. The design of dynamic digital dashboard management conducted by method of OOAD (Objects Oriented Analysis and Design) complete with UML notation.

Problem Solving and Decision Making. MAS-105. Waste Isolation Division (WID). Management and Supervisor Training (MAST) Program.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This module is part of a set of management and supervisor training (MAST) materials developed by the Department of Energy for the Waste Isolation Division. Its stated purpose is to enable trainees to solve problems and make decisions in an efficient and effective manner. The first section of the module is an introduction that includes a terminal…

Sequential decision making in computational sustainability via adaptive submodularity

USGS Publications Warehouse

Krause, Andreas; Golovin, Daniel; Converse, Sarah J.

2015-01-01

Many problems in computational sustainability require making a sequence of decisions in complex, uncertain environments. Such problems are generally notoriously difficult. In this article, we review the recently discovered notion of adaptive submodularity, an intuitive diminishing returns condition that generalizes the classical notion of submodular set functions to sequential decision problems. Problems exhibiting the adaptive submodularity property can be efficiently and provably near-optimally solved using simple myopic policies. We illustrate this concept in several case studies of interest in computational sustainability: First, we demonstrate how it can be used to efficiently plan for resolving uncertainty in adaptive management scenarios. Secondly, we show how it applies to dynamic conservation planning for protecting endangered species, a case study carried out in collaboration with the US Geological Survey and the US Fish and Wildlife Service.

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

PubMed

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

2013-03-06

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

Age differences in the effects of conscious and unconscious thought in decision making.

PubMed

Queen, Tara L; Hess, Thomas M

2010-06-01

The roles of unconscious and conscious thought in decision making were investigated to examine both (a) boundary conditions associated with the efficacy of each type of thought and (b) age differences in intuitive versus deliberative thought. Participants were presented with 2 decision tasks, one requiring active deliberation and the other intuitive processing. Young and older adults then engaged in conscious or unconscious thought processing before making a decision. A manipulation check revealed that young adults were more accurate in their representations of the decision material than older adults, which accounted for much of the age-related variation in performance when the full sample was considered. When only accurate participants were considered, decision making was best when there was congruence between the nature of the information and the thought condition. Thus, unconscious thought was more appropriate when participants relied on intuitive rather than deliberative processing to make their decision, whereas the converse was true with conscious thought. Although older adults displayed somewhat less efficient deliberative processing, their ability to process information at the intuitive level was relatively preserved. Additionally, both young and older adults displayed choice-supportive memory. (c) 2010 APA, all rights reserved

Age Differences in the Effects of Conscious and Unconscious Thought in Decision Making

PubMed Central

Queen, Tara L.; Hess, Thomas M.

2010-01-01

The roles of unconscious and conscious thought in decision making were investigated to examine both (a) boundary conditions associated with the efficacy of each type of thought and (b) age differences in intuitive versus deliberative thought. Participants were presented with two decision tasks, one requiring active deliberation and the other intuitive processing. Younger and older adults then engaged in conscious or unconscious thought processing before making a decision. A manipulation check revealed that younger adults were more accurate in their representations of the decision material than older adults, which accounted for much of the age-related variation in performance when the full sample was considered. When only considering accurate participants, decision making was best when there was congruence between the nature of the information and the thought condition. Thus, unconscious thought was more appropriate when the decision relied on intuitive rather than deliberative processing, whereas the converse was true with conscious thought. Although older adults displayed somewhat less efficient deliberative processing, their ability to process information at the intuitive level was relatively preserved. Additionally, both young and older adults displayed choice-supportive memory. PMID:20545411

Asynchronous decision making in a memorized paddle pressing task

NASA Astrophysics Data System (ADS)

Dankert, James R.; Olson, Byron; Si, Jennie

2008-12-01

This paper presents a method for asynchronous decision making using recorded neural data in a binary decision task. This is a demonstration of a technique for developing motor cortical neural prosthetics that do not rely on external cued timing information. The system presented in this paper uses support vector machines and leaky integrate-and-fire elements to predict directional paddle presses. In addition to the traditional metrics of accuracy, asynchronous systems must also optimize the time needed to make a decision. The system presented is able to predict paddle presses with a median accuracy of 88% and all decisions are made before the time of the actual paddle press. An alternative bit rate measure of performance is defined to show that the system proposed here is able to perform the task with the same efficiency as the rats.

Effect of Implicit Perceptual-Motor Training on Decision-Making Skills and Underpinning Gaze Behavior in Combat Athletes.

PubMed

Milazzo, Nicolas; Farrow, Damian; Fournier, Jean F

2016-08-01

This study investigated the effect of a 12-session, implicit perceptual-motor training program on decision-making skills and visual search behavior of highly skilled junior female karate fighters (M age = 15.7 years, SD = 1.2). Eighteen participants were required to make (physical or verbal) reaction decisions to various attacks within different fighting scenarios. Fighters' performance and eye movements were assessed before and after the intervention, and during acquisition through the use of video-based and on-mat decision-making tests. The video-based test revealed that following training, only the implicit perceptual-motor group (n = 6) improved their decision-making accuracy significantly compared to a matched motor training (placebo, n = 6) group and a control group (n = 6). Further, the implicit training group significantly changed their visual search behavior by focusing on fewer locations for longer durations. In addition, the session-by-session analysis showed no significant improvement in decision accuracy between training session 1 and all the other sessions, except the last one. Coaches should devote more practice time to implicit learning approaches during perceptual-motor training program to achieve significant decision-making improvements and more efficient visual search strategy with elite athletes. © The Author(s) 2016.

Transcranial Direct Current Stimulation Does Not Influence the Speed-Accuracy Tradeoff in Perceptual Decision-making: Evidence from Three Independent Studies.

PubMed

de Hollander, Gilles; Labruna, Ludovica; Sellaro, Roberta; Trutti, Anne; Colzato, Lorenza S; Ratcliff, Roger; Ivry, Richard B; Forstmann, Birte U

2016-09-01

In perceptual decision-making tasks, people balance the speed and accuracy with which they make their decisions by modulating a response threshold. Neuroimaging studies suggest that this speed-accuracy tradeoff is implemented in a corticobasal ganglia network that includes an important contribution from the pre-SMA. To test this hypothesis, we used anodal transcranial direct current stimulation (tDCS) to modulate neural activity in pre-SMA while participants performed a simple perceptual decision-making task. Participants viewed a pattern of moving dots and judged the direction of the global motion. In separate trials, they were cued to either respond quickly or accurately. We used the diffusion decision model to estimate the response threshold parameter, comparing conditions in which participants received sham or anodal tDCS. In three independent experiments, we failed to observe an influence of tDCS on the response threshold. Additional, exploratory analyses showed no influence of tDCS on the duration of nondecision processes or on the efficiency of information processing. Taken together, these findings provide a cautionary note, either concerning the causal role of pre-SMA in decision-making or on the utility of tDCS for modifying response caution in decision-making tasks.

Using Visualization in Cockpit Decision Support Systems

NASA Technical Reports Server (NTRS)

Aragon, Cecilia R.

2005-01-01

In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems.

PubMed

Mutemwa, Richard I

2006-01-01

At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of decentralized district health systems. The underlying logic was that effective and efficient HMIS would provide district health managers with the information required to make effective strategic decisions that are the vehicle for district performance and sustainability in these decentralized health systems. However, this argument is rooted in normative management and decision theory without significant unequivocal empirical corroboration. Indeed, extensive empirical evidence continues to indicate that managers' decision-making behaviour and the existence of other forms of information outside the HMIS, within the organizational environment, suggest a far more tenuous relationship between the presence of organizational management information systems (such as HMIS) and effective strategic decision-making. This qualitative comparative case-study conducted in two districts of Zambia focused on investigating the presence and behaviour of five formally identified, different information forms, including that from HMIS, in the strategic decision-making process. The aim was to determine the validity of current arguments for HMIS, and establish implications for current HMIS policies. Evidence from the eight strategic decision-making processes traced in the study confirmed the existence of different forms of information in the organizational environment, including that provided by the conventional HMIS. These information forms attach themselves to various organizational management processes and key aspects of organizational routine. The study results point to the need for a radical re-think of district health management information solutions in ways that account for the existence of other information forms outside the formal HMIS in the district health system.

Energy efficiency business options for industrial end users in Latin American competitive energy markets: The case of Colombia

NASA Astrophysics Data System (ADS)

Botero, Sergio

2002-01-01

Energy markets today in Latin America and worldwide are being restructured from monopolies, either state-owned or privately-owned, to be more openly competitive and incorporate more participation from the private sector. Thus, the schemes that were formerly developed to foster end use energy efficiency are no longer applicable because they were based on mandatory regulations made with political decisions, without sufficiently considering economic feasibility. A consensus exists that the only way energy efficiency could survive in this new paradigm is by being market oriented, giving better services, and additional options to users. However; there is very little information on what end users prefer, and which options would most satisfy customers. Using Colombia as a case study, this research determines and categorizes the energy efficiency business options for large energy end users that can freely participate in the competitive energy market. The energy efficiency market is understood as a market of services aiming to increase efficiency in energy use. These services can be grouped into seven business options. A survey, following the descriptive method, was sent to energy end users in order to determine their preferences for specific energy efficiency business options, as well as the decision-making criteria taken into account for such options. This data was categorized in ten industry groups. As a conclusion, energy efficiency providers should adapt not only to the economic activity or processes of each customer, but also to the potential business options. It was also found that not all industries consider performance contracting as their most preferred option, as a matter of fact, some industries show much higher preference for conventional business options. Among end users, the divergence in option preferences contrasted with the convergence in decision-making criteria. The decision-making criteria "cost-benefit ratio" overwhelmed all other criterion. End users appear to chose a specific energy efficiency option based mostly on obtaining better economic returns, giving low consideration to other criterion that feature differences among the energy efficiency options.

The role (or not) of economic evaluation at the micro level: can Bourdieu's theory provide a way forward for clinical decision-making?

PubMed

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2010-06-01

Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making. Copyright 2010 Elsevier Ltd. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Adeleke, Adeyinka

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

Application of multi-criteria decision-making on strategic municipal solid waste management in Dalmatia, Croatia.

PubMed

Vego, Goran; Kucar-Dragicević, Savka; Koprivanac, Natalija

2008-11-01

The efficiency of providing a waste management system in the coastal part of Croatia consisting of four Dalmatian counties has been modelled. Two multi-criteria decision-making (MCDM) methods, PROMETHEE and GAIA, were applied to assist with the systematic analysis and evaluation of the alternatives. The analysis covered two levels; first, the potential number of waste management centres resulting from possible inter-county cooperation; and second, the relative merits of siting of waste management centres in the coastal or hinterland zone was evaluated. The problem was analysed according to several criteria; and ecological, economic, social and functional criteria sets were identified as relevant to the decision-making process. The PROMETHEE and GAIA methods were shown to be efficient tools for analysing the problem considered. Such an approach provided new insights to waste management planning at the strategic level, and gave a reason for rethinking some of the existing strategic waste management documents in Croatia.

Resource Analysis of Cognitive Process Flow Used to Achieve Autonomy

DTIC Science & Technology

2016-03-01

to be used as a decision - making aid to guide system designers and program managers not necessarily familiar with cognitive pro- cessing, or resource...implementing end-to-end cognitive processing flows multiplies and the impact of these design decisions on efficiency and effectiveness increases [1]. The...end-to-end cognitive systems and alternative computing technologies, then system design and acquisition personnel could make systematic analyses and

Understanding Optimal Military Decision Making: Year 2 Progress Report

DTIC Science & Technology

2014-01-01

measures. ARMY RELEVANCY AND MILITARY APPLICATION AREAS Objectively defining, measuring, and developing a means to assess military optimal decision making...has the potential to enhance training and refine procedures supporting more efficient learning and task accomplishment. Through the application of...26.79 (12.39) 7.94 (62.38) N/A = Not applicable ; as it is not possible to calculate this particular variable. Table 2. Descriptive statistics of

Effects of Age and Initial Risk Perception on Balloon Analog Risk Task: The Mediating Role of Processing Speed and Need for Cognitive Closure

PubMed Central

Koscielniak, Maciej; Rydzewska, Klara; Sedek, Grzegorz

2016-01-01

According to the dual-process theoretical perspective adopted in the presented research, the efficiency of deliberative processes in decision making declines with age, but experiential processes are relatively well-preserved. The age-related differences in deliberative and experiential processes in risky decision-making were examined in this research by applying the Balloon Analog Risk Task (BART). We analyzed the influence of age on risk acceptance and decision-making performance in two age groups of female participants (younger adults, n = 81; older adults, n = 76), with additional experimental manipulation of initial risk perception. We predicted and confirmed that aging significantly worsens performance on the behavioral BART measures due to age-related decline in deliberative processes. Older participants were found to exhibit significantly higher risk aversion and lower BART performance, and the effect of age was mediated by cognitive (processing speed) and motivational (need for cognitive closure) mechanisms. Moreover, older adults adapt to the initial failure (vs. success) similarly, as younger adults due to preserved efficiency of experiential processes. These results suggest future directions for minimizing negative effects of aging in risky decision-making and indicate compensatory processes, which are preserved during aging. PMID:27199877

[Shared decision-making in mental health care: a role model from youth mental health care].

PubMed

Westermann, G M A; Maurer, J M G

2015-01-01

In the communication and interaction between doctor and patient in Western health care there has been a paradigm shift from the paternalistic approach to shared decision-making. To summarise the background situation, recent developments and the current level of shared decision-making in (youth) mental health care. We conducted a critical review of the literature relating to the methodology development, research and the use of counselling and decision-making in mental health care. The majority of patients, professionals and other stakeholders consider shared decision-making to be desirable and important for improving the quality and efficiency of care. Up till recently most research and studies have concentrated on helping patients to develop decision-making skills and on showing patients how and where to access information. At the moment more attention is being given to the development of skills and circumstances that will increase patients' interaction with care professionals and patients' emotional involvement in shared decision-making. In mental health for children and adolescents, more often than in adult mental health care, it has been customary to give more attention to these aspects of shared decision-making, particularly during counselling sessions that mark the transition from diagnosis to treatment. This emphasis has been apparent for a long time in textbooks, daily practice, methodology development and research in youth mental health care. Currently, a number of similar developments are taking place in adult mental health care. Although most health professionals support the policy of shared decision-making, the implementation of the policy in mental health care is still at an early stage. In practice, a number of obstacles still have to be surmounted. However, the experience gained with counselling and decision-making in (youth) mental health care may serve as an example to other sections of mental health care and play an important role in the further development of shared decision-making.

Development of a requirements management system for technical decision - making processes in the geological disposal project

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

Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

2007-07-01

NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help formore » comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on the initial stage including work analysis/modeling and the system conceptualization. (authors)« less

Sensitivity of super-efficient data envelopment analysis results to individual decision-making units: an example of surgical workload by specialty.

PubMed

Dexter, Franklin; O'Neill, Liam; Xin, Lei; Ledolter, Johannes

2008-12-01

We use resampling of data to explore the basic statistical properties of super-efficient data envelopment analysis (DEA) when used as a benchmarking tool by the manager of a single decision-making unit. Our focus is the gaps in the outputs (i.e., slacks adjusted for upward bias), as they reveal which outputs can be increased. The numerical experiments show that the estimates of the gaps fail to exhibit asymptotic consistency, a property expected for standard statistical inference. Specifically, increased sample sizes were not always associated with more accurate forecasts of the output gaps. The baseline DEA's gaps equaled the mode of the jackknife and the mode of resampling with/without replacement from any subset of the population; usually, the baseline DEA's gaps also equaled the median. The quartile deviations of gaps were close to zero when few decision-making units were excluded from the sample and the study unit happened to have few other units contributing to its benchmark. The results for the quartile deviations can be explained in terms of the effective combinations of decision-making units that contribute to the DEA solution. The jackknife can provide all the combinations contributing to the quartile deviation and only needs to be performed for those units that are part of the benchmark set. These results show that there is a strong rationale for examining DEA results with a sensitivity analysis that excludes one benchmark hospital at a time. This analysis enhances the quality of decision support using DEA estimates for the potential ofa decision-making unit to grow one or more of its outputs.

Enhancing the value delivered by the statistician throughout drug discovery and development: putting statistical science into regulated pharmaceutical innovation.

PubMed

Enas, G G; Andersen, J S

With the dawn of the 21st century, the pharmaceutical industry faces a dramatically different constellation of business and scientific predictors of success than those of just a few years ago. Significant advances in science at the genetic, molecular and cellular levels, combined with progress demonstrated around the globe with drug regulations, have increased business and competitive opportunities. This has occurred in search of better and cheaper medicines that reach patients with unmet medical needs as quickly as possible. Herein lie new opportunities for those who can help business and regulatory leaders make good decisions about drug development and market authorization as quickly and efficiently as possible in the presence of uncertainty. The statistician is uniquely trained and qualified to render such value. We show how the statistician can contribute to the process of drug innovation from the very early stages of drug discovery until patients, payers and regulators are satisfied. Indeed, the very nature of regulated innovation demands that efficient and effective processes are implemented which yield the right information for good decision making. The statistician can take the lead in setting a strategy that directs such processes in the direction of greatest value. This demands skills that enable one to identify important sources of variability and uncertainty and then leverage those skills to make decisions. If such decisions call for more information, then the statistician can render experimental designs which generate the right information needed to make the decision in an efficient, timely manner. To add value to the enterprise, statisticians will have to become more intimately associated with business and regulatory decisions by building on their traditional roles (for example, numerical analyst, tactician) and unique skill sets (for example, analysis, computation, logical thought and work process, precision, accuracy). Business and regulatory savvy, coupled with excellent communication and interpersonal skills, will allow statisticians to help create the knowledge needed to drive success in the future. Copyright 2001 John Wiley & Sons, Ltd.

Variability in visual working memory ability limits the efficiency of perceptual decision making.

PubMed

Ester, Edward F; Ho, Tiffany C; Brown, Scott D; Serences, John T

2014-04-02

The ability to make rapid and accurate decisions based on limited sensory information is a critical component of visual cognition. Available evidence suggests that simple perceptual discriminations are based on the accumulation and integration of sensory evidence over time. However, the memory system(s) mediating this accumulation are unclear. One candidate system is working memory (WM), which enables the temporary maintenance of information in a readily accessible state. Here, we show that individual variability in WM capacity is strongly correlated with the speed of evidence accumulation in speeded two-alternative forced choice tasks. This relationship generalized across different decision-making tasks, and could not be easily explained by variability in general arousal or vigilance. Moreover, we show that performing a difficult discrimination task while maintaining a concurrent memory load has a deleterious effect on the latter, suggesting that WM storage and decision making are directly linked.

Informing the Gestalt: An Ethical Framework for Allocating Scarce Federal Public Health and Medical Resources to States During Disasters

PubMed Central

Knebel, Ann R.; Sharpe, Virginia A.; Danis, Marion; Toomey, Lauren M.; Knickerbocker, Deborah K.

2017-01-01

During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters. PMID:24612854

Performance measures to assess resiliency and efficiency of transit systems [research brief].

DOT National Transportation Integrated Search

2017-03-01

Transit agencies, like other transportation agencies, are interested in assessing the short-, mid-, and long-term performance of their infrastructure with the objectives of making better decisions that will enhance resiliency and efficiency. This rep...

Decision feedback loop for tracking a polyphase modulated carrier

NASA Technical Reports Server (NTRS)

Simon, M. K. (Inventor)

1974-01-01

A multiple phase modulated carrier tracking loop for use in a frequency shift keying system is described in which carrier tracking efficiency is improved by making use of the decision signals made on the data phase transmitted in each T-second interval. The decision signal is used to produce a pair of decision-feedback quadrature signals for enhancing the loop's performance in developing a loop phase error signal.

Desktop microsimulation: a tool to improve efficiency in the medical office practice.

PubMed

Montgomery, James B; Linville, Beth A; Slonim, Anthony D

2013-01-01

Because the economic crisis in the United States continues to have an impact on healthcare organizations, industry leaders must optimize their decision making. Discrete-event computer simulation is a quality tool with a demonstrated track record of improving the precision of analysis for process redesign. However, the use of simulation to consolidate practices and design efficiencies into an unfinished medical office building was a unique task. A discrete-event computer simulation package was used to model the operations and forecast future results for four orthopedic surgery practices. The scenarios were created to allow an evaluation of the impact of process change on the output variables of exam room utilization, patient queue size, and staff utilization. The model helped with decisions regarding space allocation and efficient exam room use by demonstrating the impact of process changes in patient queues at check-in/out, x-ray, and cast room locations when compared to the status quo model. The analysis impacted decisions on facility layout, patient flow, and staff functions in this newly consolidated practice. Simulation was found to be a useful tool for process redesign and decision making even prior to building occupancy. © 2011 National Association for Healthcare Quality.

Beyond Frontiers: Comparing the Efficiency of Higher Education Decision-Making Units across More than One Country

ERIC Educational Resources Information Center

Agasisti, Tommaso; Johnes, Geraint

2009-01-01

We employ Data Envelopment Analysis to compute the technical efficiency of Italian and English higher education institutions. Our results show that, in relation to the country-specific frontier, institutions in both countries are typically very efficient. However, institutions in England are more efficient than those in Italy when we compare…

Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

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

Stern, Marc J., E-mail: mjstern@vt.ed; Predmore, S. Andrew, E-mail: sapredmo@vt.ed

2011-04-15

The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second withmore » the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.« less

Smart Networking Decisions: A Kase Study.

ERIC Educational Resources Information Center

Sturgeon, Julie

1999-01-01

Describes one decision-making approach for quickly implementing a communications network into a school district. The use of volunteer labor for wiring installation, computer selection focusing on standardization to aid in troubleshooting, and an intranet system to achieve efficiency and learning opportunities for teachers and administrative…

Do humans make good decisions?

PubMed Central

Summerfield, Christopher; Tsetsos, Konstantinos

2014-01-01

Human performance on perceptual classification tasks approaches that of an ideal observer, but economic decisions are often inconsistent and intransitive, with preferences reversing according to the local context. We discuss the view that suboptimal choices may result from the efficient coding of decision-relevant information, a strategy that allows expected inputs to be processed with higher gain than unexpected inputs. Efficient coding leads to ‘robust’ decisions that depart from optimality but maximise the information transmitted by a limited-capacity system in a rapidly-changing world. We review recent work showing that when perceptual environments are variable or volatile, perceptual decisions exhibit the same suboptimal context-dependence as economic choices, and propose a general computational framework that accounts for findings across the two domains. PMID:25488076

Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making.

PubMed

Peters, Ellen; Hess, Thomas M; Västfjäll, Daniel; Auman, Corinne

2007-03-01

Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory (Kahneman & Tversky, 1979) and how prospect theory and theories regarding age differences in information processing can inform one another. © 2007 Association for Psychological Science.

Resilience thinking and a decision-analytic approach to conservation: strange bedfellows or essential partners?

USGS Publications Warehouse

Johnson, Fred A.; Williams, Byron K.; Nichols, James D.

2013-01-01

There has been some tendency to view decision science and resilience theory as opposing approaches, or at least as contending perspectives, for natural resource management. Resilience proponents have been especially critical of optimization in decision science, at least for those cases where it is focused on the aggressive pursuit of efficiency. In general, optimization of resource systems is held to reduce spatial, temporal, or organizational heterogeneity that would otherwise limit efficiency, leading to homogenization of a system and making it less able to cope with unexpected changes or disturbances. For their part, decision analysts have been critical of resilience proponents for not providing much practical advice to decision makers. We believe a key source of tension between resilience thinking and application of decision science is the pursuit of efficiency in the latter (i.e., choosing the “best” management action or strategy option to maximize productivity of one or few resource components), vs. a desire in the former to keep options open (i.e., maintaining and enhancing diversity). It seems obvious, however, that with managed natural systems, there must be a principle by which to guide decision making, which at a minimumallows for a comparison of projected outcomes associated with decision alternatives. This is true even if the primary concern of decision making is the preservation of system resilience. We describe how a careful framing of conservation problems, especially in terms of management objectives and predictive models, can help reduce the purported tension between resiliencethinking and decision analysis. In particular, objective setting in conservation problems needs to be more attuned to the dynamics of ecological systems and to the possibility of deep uncertainties that underlie the risk of unintended, if not irreversible, outcomes. Resilience thinking also leads to the suggestion that model development should focus more on process rather than pattern, on multiple scales of influence, and on phenomena that can create alternative stability regimes. Although we acknowledge the inherent difficulties in modeling ecological processes, we stress that formulation of useful models need not depend on a thorough mechanistic understanding or precise parameterization, assuming that uncertainty is acknowledged and treated in a systematic manner.

Nature of collective decision-making by simple yes/no decision units.

PubMed

Hasegawa, Eisuke; Mizumoto, Nobuaki; Kobayashi, Kazuya; Dobata, Shigeto; Yoshimura, Jin; Watanabe, Saori; Murakami, Yuuka; Matsuura, Kenji

2017-10-31

The study of collective decision-making spans various fields such as brain and behavioural sciences, economics, management sciences, and artificial intelligence. Despite these interdisciplinary applications, little is known regarding how a group of simple 'yes/no' units, such as neurons in the brain, can select the best option among multiple options. One prerequisite for achieving such correct choices by the brain is correct evaluation of relative option quality, which enables a collective decision maker to efficiently choose the best option. Here, we applied a sensory discrimination mechanism using yes/no units with differential thresholds to a model for making a collective choice among multiple options. The performance corresponding to the correct choice was shown to be affected by various parameters. High performance can be achieved by tuning the threshold distribution with the options' quality distribution. The number of yes/no units allocated to each option and its variability profoundly affects performance. When this variability is large, a quorum decision becomes superior to a majority decision under some conditions. The general features of this collective decision-making by a group of simple yes/no units revealed in this study suggest that this mechanism may be useful in applications across various fields.

A University Admissions System

ERIC Educational Resources Information Center

Ittig, Peter T.

1977-01-01

Presents a mathematical programming model that will make admit/reject decisions for freshman university applicants. The model is intended to aid reviewers in producing better, more consistent decisions. The author shows that a linear programming formulation will provide an efficient and practical solution for all but a very few applicants.…

Integrated Risk-Informed Decision-Making for an ALMR PRISM

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

Muhlheim, Michael David; Belles, Randy; Denning, Richard S.

Decision-making is the process of identifying decision alternatives, assessing those alternatives based on predefined metrics, selecting an alternative (i.e., making a decision), and then implementing that alternative. The generation of decisions requires a structured, coherent process, or a decision-making process. The overall objective for this work is that the generalized framework is adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace ormore » supplement human decision makers with reconfigurable decision-making modules that can perform a given set of tasks rationally, consistently, and reliably. Risk-informed decision-making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The probabilistic portion of the decision-making engine of the supervisory control system is based on the control actions associated with an ALMR PRISM. Newly incorporated into the probabilistic models are the prognostic/diagnostic models developed by Pacific Northwest National Laboratory. These allow decisions to incorporate the health of components into the decision–making process. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic portion of the decision-making engine uses thermal-hydraulic modeling and components for an advanced liquid-metal reactor Power Reactor Inherently Safe Module. The deterministic multi-attribute decision-making framework uses various sensor data (e.g., reactor outlet temperature, steam generator drum level) and calculates its position within the challenge state, its trajectory, and its margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. The metrics that are evaluated are based on reactor trip set points. The integration of the deterministic calculations using multi-physics analyses and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermalhydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies, and developing a user interface to mimic display panels at a modern nuclear power plant.« less

[Hospital efficiency measured by bed space use in a secondary care hospital].

PubMed

Moreno-Martínez, Roberto; Martínez-Cruz, Rocío Alejandra

2015-01-01

In recognition that the availability of resources in the medical facility forms part of the factors that influence the quality of healthcare, it is of vital importance to measure their outcome. The aim of this study was determine the efficiency of the medical facility through the use of beds in a secondary level hospital. Through the Health Information Management System (HIMS), we examined statistical reports from July 2012 to June 2013 including variables such as expenses, patient days, occupancy rate, average length of stay by specialty and medical division, results were obtained for each strategic indicator, and these results were related assumptions proposing to assess hospital efficiency. Overall, we identified optimal efficiency of the medical facility without analysis of services, leads to deteriorating and low efficiency. The overall outcome of the five indicators applied overlooked saturation of services within the medical unit. However, the overall analysis shows the problem, noting the advantage of evaluating the same scenario from different perspectives. The include indicators measuring hospital efficiency resource based bed, allows considering deficiencies identified, so that decision making is strengthened the decision making health.

An Evaluation on Factors Influencing Decision making for Malaysia Disaster Management: The Confirmatory Factor Analysis Approach

NASA Astrophysics Data System (ADS)

Zubir, S. N. A.; Thiruchelvam, S.; Mustapha, K. N. M.; Che Muda, Z.; Ghazali, A.; Hakimie, H.

2017-12-01

For the past few years, natural disaster has been the subject of debate in disaster management especially in flood disaster. Each year, natural disaster results in significant loss of life, destruction of homes and public infrastructure, and economic hardship. Hence, an effective and efficient flood disaster management would assure non-futile efforts for life saving. The aim of this article is to examine the relationship between approach, decision maker, influence factor, result, and ethic to decision making for flood disaster management in Malaysia. The key elements of decision making in the disaster management were studied based on the literature. Questionnaire surveys were administered among lead agencies at East Coast of Malaysia in the state of Kelantan and Pahang. A total of 307 valid responses had been obtained for further analysis. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were carried out to analyse the measurement model involved in the study. The CFA for second-order reflective and first-order reflective measurement model indicates that approach, decision maker, influence factor, result, and ethic have a significant and direct effect on decision making during disaster. The results from this study showed that decision- making during disaster is an important element for disaster management to necessitate a successful collaborative decision making. The measurement model is accepted to proceed with further analysis known as Structural Equation Modeling (SEM) and can be assessed for the future research.

Lexical Familiarity and Processing Efficiency: Individual Differences in Naming, Lexical Decision, and Semantic Categorization

PubMed Central

Lewellen, Mary Jo; Goldinger, Stephen D.; Pisoni, David B.; Greene, Beth G.

2012-01-01

College students were separated into 2 groups (high and low) on the basis of 3 measures: subjective familiarity ratings of words, self-reported language experiences, and a test of vocabulary knowledge. Three experiments were conducted to determine if the groups also differed in visual word naming, lexical decision, and semantic categorization. High Ss were consistently faster than low Ss in naming visually presented words. They were also faster and more accurate in making difficult lexical decisions and in rejecting homophone foils in semantic categorization. Taken together, the results demonstrate that Ss who differ in lexical familiarity also differ in processing efficiency. The relationship between processing efficiency and working memory accounts of individual differences in language processing is also discussed. PMID:8371087

Development of Encoding and Decision Processes in Visual Recognition.

ERIC Educational Resources Information Center

Newcombe, Nora; MacKenzie, Doris L.

This experiment examined two processes which might account for developmental increases in accuracy in visual recognition tasks: age-related increases in efficiency of scanning during inspection, and age-related increases in the ability to make decisions systematically during test. Critical details necessary for recognition were highlighted as…

78 FR 53436 - Improving Performance of Federal Permitting and Review of Infrastructure Projects

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... an efficient decision-making process within each agency; to the extent possible, unifying and... IIP Process, the developer is encouraged to inform DOE in writing as soon as possible of its decision... to improve the performance of Federal siting, permitting, and review processes for infrastructure...

How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

USGS Publications Warehouse

Caughlan, L.

2002-01-01

Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

A Robust Decision-Making Technique for Water Management under Decadal Scale Climate Variability

NASA Astrophysics Data System (ADS)

Callihan, L.; Zagona, E. A.; Rajagopalan, B.

2013-12-01

Robust decision making, a flexible and dynamic approach to managing water resources in light of deep uncertainties associated with climate variability at inter-annual to decadal time scales, is an analytical framework that detects when a system is in or approaching a vulnerable state. It provides decision makers the opportunity to implement strategies that both address the vulnerabilities and perform well over a wide range of plausible future scenarios. A strategy that performs acceptably over a wide range of possible future states is not likely to be optimal with respect to the actual future state. The degree of success--the ability to avoid vulnerable states and operate efficiently--thus depends on the skill in projecting future states and the ability to select the most efficient strategies to address vulnerabilities. This research develops a robust decision making framework that incorporates new methods of decadal scale projections with selection of efficient strategies. Previous approaches to water resources planning under inter-annual climate variability combining skillful seasonal flow forecasts with climatology for subsequent years are not skillful for medium term (i.e. decadal scale) projections as decision makers are not able to plan adequately to avoid vulnerabilities. We address this need by integrating skillful decadal scale streamflow projections into the robust decision making framework and making the probability distribution of this projection available to the decision making logic. The range of possible future hydrologic scenarios can be defined using a variety of nonparametric methods. Once defined, an ensemble projection of decadal flow scenarios are generated from a wavelet-based spectral K-nearest-neighbor resampling approach using historical and paleo-reconstructed data. This method has been shown to generate skillful medium term projections with a rich variety of natural variability. The current state of the system in combination with the probability distribution of the projected flow ensembles enables the selection of appropriate decision options. This process is repeated for each year of the planning horizon--resulting in system outcomes that can be evaluated on their performance and resiliency. The research utilizes the RiverSMART suite of software modeling and analysis tools developed under the Bureau of Reclamation's WaterSMART initiative and built around the RiverWare modeling environment. A case study is developed for the Gunnison and Upper Colorado River Basins. The ability to mitigate vulnerability using the framework is gauged by system performance indicators that measure the ability of the system to meet various water demands (i.e. agriculture, environmental flows, hydropower etc.). Options and strategies for addressing vulnerabilities include measures such as conservation, reallocation and adjustments to operational policy. In addition to being able to mitigate vulnerabilities, options and strategies are evaluated based on benefits, costs and reliability. Flow ensembles are also simulated to incorporate mean and variance from climate change projections for the planning horizon and the above robust decision-making framework is applied to evaluate its performance under changing climate.

A Grounded Theory Study of Aircraft Maintenance Technician Decision-Making

NASA Astrophysics Data System (ADS)

Norcross, Robert

Aircraft maintenance technician decision-making and actions have resulted in aircraft system errors causing aircraft incidents and accidents. Aircraft accident investigators and researchers examined the factors that influence aircraft maintenance technician errors and categorized the types of errors in an attempt to prevent similar occurrences. New aircraft technology introduced to improve aviation safety and efficiency incur failures that have no information contained in the aircraft maintenance manuals. According to the Federal Aviation Administration, aircraft maintenance technicians must use only approved aircraft maintenance documents to repair, modify, and service aircraft. This qualitative research used a grounded theory approach to explore the decision-making processes and actions taken by aircraft maintenance technicians when confronted with an aircraft problem not contained in the aircraft maintenance manuals. The target population for the research was Federal Aviation Administration licensed aircraft and power plant mechanics from across the United States. Nonprobability purposeful sampling was used to obtain aircraft maintenance technicians with the experience sought in the study problem. The sample population recruitment yielded 19 participants for eight focus group sessions to obtain opinions, perceptions, and experiences related to the study problem. All data collected was entered into the Atlas ti qualitative analysis software. The emergence of Aircraft Maintenance Technician decision-making themes regarding Aircraft Maintenance Manual content, Aircraft Maintenance Technician experience, and legal implications of not following Aircraft Maintenance Manuals surfaced. Conclusions from this study suggest Aircraft Maintenance Technician decision-making were influenced by experience, gaps in the Aircraft Maintenance Manuals, reliance on others, realizing the impact of decisions concerning aircraft airworthiness, management pressures, and legal concerns related to decision-making. Recommendations included an in-depth systematic review of the Aircraft Maintenance Manuals, development of a Federal Aviation Administration approved standardized Aircraft Maintenance Technician decision-making flow diagram, and implementation of risk based decision-making training. The benefit of this study is to save the airline industry revenue by preventing poor decision-making practices that result in inefficient maintenance actions and aircraft incidents and accidents.

Intelligent Work Process Engineering System

NASA Technical Reports Server (NTRS)

Williams, Kent E.

2003-01-01

Optimizing performance on work activities and processes requires metrics of performance for management to monitor and analyze in order to support further improvements in efficiency, effectiveness, safety, reliability and cost. Information systems are therefore required to assist management in making timely, informed decisions regarding these work processes and activities. Currently information systems regarding Space Shuttle maintenance and servicing do not exist to make such timely decisions. The work to be presented details a system which incorporates various automated and intelligent processes and analysis tools to capture organize and analyze work process related data, to make the necessary decisions to meet KSC organizational goals. The advantages and disadvantages of design alternatives to the development of such a system will be discussed including technologies, which would need to bedesigned, prototyped and evaluated.

Structured decision making: Chapter 5

USGS Publications Warehouse

Runge, Michael C.; Grand, James B.; Mitchell, Michael S.; Krausman, Paul R.; Cain, James W. III

2013-01-01

Wildlife management is a decision-focused discipline. It needs to integrate traditional wildlife science and social science to identify actions that are most likely to achieve the array of desires society has surrounding wildlife populations. Decision science, a vast field with roots in economics, operations research, and psychology, offers a rich set of tools to help wildlife managers frame, decompose, analyze, and synthesize their decisions. The nature of wildlife management as a decision science has been recognized since the inception of the field, but formal methods of decision analysis have been underused. There is tremendous potential for wildlife management to grow further through the use of formal decision analysis. First, the wildlife science and human dimensions of wildlife disciplines can be readily integrated. Second, decisions can become more efficient. Third, decisions makers can communicate more clearly with stakeholders and the public. Fourth, good, intuitive wildlife managers, by explicitly examining how they make decisions, can translate their art into a science that is readily used by the next generation.

Using evidence-based algorithms to improve clinical decision making: the case of a first-time anterior shoulder dislocation.

PubMed

Federer, Andrew E; Taylor, Dean C; Mather, Richard C

2013-09-01

Decision making in health care has evolved substantially over the last century. Up until the late 1970s, medical decision making was predominantly intuitive and anecdotal. It was based on trial and error and involved high levels of problem solving. The 1980s gave way to empirical medicine, which was evidence based probabilistic, and involved pattern recognition and less problem solving. Although this represented a major advance in the quality of medical decision making, limitations existed. The advantages of the gold standard of the randomized controlled clinical trial (RCT) are well-known and this technique is irreplaceable in its ability to answer critical clinical questions. However, the RCT does have drawbacks. RCTs are expensive and can only capture a snapshot in time. As treatments change and new technologies emerge, new expensive clinical trials must be undertaken to reevaluate them. Furthermore, in order to best evaluate a single intervention, other factors must be controlled. In addition, the study population may not match that of another organization or provider. Although evidence-based medicine has provided powerful data for clinicians, effectively and efficiently tailoring it to the individual has not yet evolved. We are now in a period of transition from this evidence-based era to one dominated by the personalization and customization of care. It will be fueled by policy decisions to shift financial responsibility to the patient, creating a powerful and sophisticated consumer, unlike any patient we have known before. The challenge will be to apply medical evidence and personal preferences to medical decisions and deliver it efficiently in the increasingly busy clinical setting. In this article, we provide a robust review of the concepts of customized care and some of techniques to deliver it. We will illustrate this through a personalized decision model for the treatment decision after a first-time anterior shoulder dislocation.

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

PubMed

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

2017-04-01

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

Expert-novice differences in cognitive and execution skills during tennis competition.

PubMed

Del Villar, Fernando; García González, Luis; Iglesias, Damián; Perla Moreno, M; Cervelló, Eduardo M

2007-04-01

This study deals with decision and execution behavior of tennis players during competition. The study is based on the expert-novice paradigm and aims to identify differences between both groups in the decision-making and execution variables in serve and shot actions in tennis. Six expert players (elite Spanish tennis players) and six novice players (grade school tennis players) took part in this study. To carry out this study, the observation protocol defined by McPherson and Thomas in 1989, in which control, decision-making and execution variables were included, was used, where it was applied to the performance of the tennis player in a real match situation. In the analysis, significant differences between experts and novices in decision-making and execution variables are found wherein it can be observed that experts display a greater ability to make the appropriate decisions, selecting the most tactical responses to put pressure on the opponent. Expert tennis players were also able to carry out forceful executions to their opponent with greater efficiency, making the opponent's response to a large extent more difficult. These findings are in accordance with those of McPherson and colleagues.

Integration of Dynamic Models in Range Operations

NASA Technical Reports Server (NTRS)

Bardina, Jorge; Thirumalainambi, Rajkumar

2004-01-01

This work addresses the various model interactions in real-time to make an efficient internet based decision making tool for Shuttle launch. The decision making tool depends on the launch commit criteria coupled with physical models. Dynamic interaction between a wide variety of simulation applications and techniques, embedded algorithms, and data visualizations are needed to exploit the full potential of modeling and simulation. This paper also discusses in depth details of web based 3-D graphics and applications to range safety. The advantages of this dynamic model integration are secure accessibility and distribution of real time information to other NASA centers.

Multi-objective decision-making model based on CBM for an aircraft fleet

NASA Astrophysics Data System (ADS)

Luo, Bin; Lin, Lin

2018-04-01

Modern production management patterns, in which multi-unit (e.g., a fleet of aircrafts) are managed in a holistic manner, have brought new challenges for multi-unit maintenance decision making. To schedule a good maintenance plan, not only does the individual machine maintenance have to be considered, but also the maintenance of the other individuals have to be taken into account. Since most condition-based maintenance researches for aircraft focused on solely reducing maintenance cost or maximizing the availability of single aircraft, as well as considering that seldom researches concentrated on both the two objectives: minimizing cost and maximizing the availability of a fleet (total number of available aircraft in fleet), a multi-objective decision-making model based on condition-based maintenance concentrated both on the above two objectives is established. Furthermore, in consideration of the decision maker may prefer providing the final optimal result in the form of discrete intervals instead of a set of points (non-dominated solutions) in real decision-making problem, a novel multi-objective optimization method based on support vector regression is proposed to solve the above multi-objective decision-making model. Finally, a case study regarding a fleet is conducted, with the results proving that the approach efficiently generates outcomes that meet the schedule requirements.

Research-based-decision-making in Canadian health organizations: a behavioural approach.

PubMed

Jbilou, Jalila; Amara, Nabil; Landry, Réjean

2007-06-01

Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build networks, develop partnerships between professionals locally, regionally and nationally, and also act as change agents in the dissemination and adoption of knowledge and innovations in health services. However, the research focused on knowledge use as a support to decision-making, further research is needed to identify and evaluate effective incentives and strategies to implement so as to enhance RBDM adoption among health decision makers and more theoretical development are to complete in this perspective.

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

NASA Astrophysics Data System (ADS)

Porello, Daniele

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

Dopamine Modulates the Efficiency of Sensory Evidence Accumulation During Perceptual Decision Making.

PubMed

Beste, Christian; Adelhöfer, Nico; Gohil, Krutika; Passow, Susanne; Roessner, Veit; Li, Shu-Chen

2018-04-02

Perceptual decision making is the process through which available sensory information is gathered and processed to guide our choices. However, the neuropsychopharmacological basis of this important cognitive function is largely elusive. Yet, theoretical considerations suggest that the dopaminergic system may play an important role. In a double-blind, randomized, placebo-controlled study design, we examined the effect of methylphenidate in 2 dosages (0.25 mg/kg and 0.5 mg/kg body weight) in separate groups of healthy young adults. We used a moving dots task in which the coherency of the direction of moving dots stimuli was manipulated in 3 levels (5%, 15%, and 35%). Drift diffusion modelling was applied to behavioral data to capture subprocesses of perceptual decision making. The findings show that only the drift rate (v), reflecting the efficiency of sensory evidence accumulation, but not the decision criterion threshold (a) or the duration of nondecisional processes (Ter), is affected by methylphenidate vs placebo administration. Compared with placebo, administering 0.25 mg/kg methylphenidate increased v, but only in the 35% coherence condition. Administering 0.5 mg/kg methylphenidate did not induce modulations. The data suggest that dopamine selectively modulates the efficacy of evidence accumulation during perceptual decision making. This modulation depends on 2 factors: (1) the degree to which the dopaminergic system is modulated using methylphenidate (i.e., methylphenidate dosage) and (2) the signal-to-noise ratio of the visual information. Dopamine affects sensory evidence accumulation only when dopamine concentration is not shifted beyond an optimal level and the incoming information is less noisy.

Drug reimbursement decision-making in Thailand, China, and South Korea.

PubMed

Ngorsuraches, Surachat; Meng, Wei; Kim, Bo-Yeon; Kulsomboon, Vithaya

2012-01-01

To provide a comparison of national drug reimbursement decision-making, including an update of economic evaluation roles and barriers, in Thailand, China, and South Korea. Documentary reviews supplemented by experiences of policymakers. National health insurance policy in all the three countries has been developed toward coverage for all. It leads to higher health-care expenditures and requires a good reimbursement system for health-care services, including drugs. Drug reimbursement decision-making in these countries is to develop a reimbursement list with the help of various committees having different roles. Primarily, they assess the clinical and safety evidence. Economic evidence, including budget impact and pharmacoeconomic evaluation, has also been very important for their reimbursement decision-making. This evidence is sometimes used in negotiation mechanism, which allows pharmaceutical companies to lower their drug prices and leads to lower overall drug expenditures. Several common barriers, for example, human capacity and data availability, for obtaining economic evidence in all the three countries, however, still exist. Drug reimbursement decision-making in Thailand, China, and South Korea is in its transition period. It seems to run in the same direction, for example, guideline development and pharmacoeconomic evaluation agency establishment. Pharmacoeconomic evaluation plays important roles in the efficiency of drug reimbursement decision-making, even though there are several barriers to be overcome. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Decision-making deficit of a patient with axonal damage after traumatic brain injury.

PubMed

Yasuno, Fumihiko; Matsuoka, Kiwamu; Kitamura, Soichiro; Kiuchi, Kuniaki; Kosaka, Jun; Okada, Koji; Tanaka, Syohei; Shinkai, Takayuki; Taoka, Toshiaki; Kishimoto, Toshifumi

2014-02-01

Patients with traumatic brain injury (TBI) were reported to have difficulty making advantageous decisions, but the underlying deficits of the network of brain areas involved in this process were not directly examined. We report a patient with TBI who demonstrated problematic behavior in situations of risk and complexity after cerebral injury from a traffic accident. The Iowa gambling task (IGT) was used to reveal his deficits in the decision-making process. To examine underlying deficits of the network of brain areas, we examined T1-weighted structural MRI, diffusion tensor imaging (DTI) and Tc-ECD SPECT in this patient. The patient showed abnormality in IGT. DTI-MRI results showed a significant decrease in fractional anisotropy (FA) in the fasciculus between the brain stem and cortical regions via the thalamus. He showed significant decrease in gray matter volumes in the bilateral insular cortex, hypothalamus, and posterior cingulate cortex, possibly reflecting Wallerian degeneration secondary to the fasciculus abnormalities. SPECT showed significant blood flow decrease in the broad cortical areas including the ventromedial prefrontal cortex (VM). Our study showed that the patient had dysfunctional decision-making process. Microstructural abnormality in the fasciculus, likely from the traffic accident, caused reduced afferent feedback to the brain, resulting in less efficient decision-making. Our findings support the somatic-marker hypothesis (SMH), where somatic feedback to the brain influences the decision-making process. Copyright © 2013 Elsevier Inc. All rights reserved.

Improving Professional Judgments of Risk and Amenability in Juvenile Justice

PubMed Central

Mulvey, Edward P.; Iselin, Anne-Marie R.

2013-01-01

Summary The dual requirement to ensure community safety and promote a youthful offender’s positive development permeates policy and frames daily practice in juvenile justice. Balancing those two demands, explain Edward Mulvey and Anne-Marie Iselin, requires justice system professionals at all levels to make extremely difficult decisions about the likely risk and amenability to treatment of adolescent offenders. Mulvey and Iselin point out that although various forms of “structured” decision-making instruments are used widely in other fields, juvenile justice professionals today make limited use of these tools. Instead, they make decisions based mainly on their intuition about whether the adolescent before them is more likely to harm the community or to use justice system services to turn his life around. The reluctance of busy court professionals to use these structured decision-making tools, they say, arises partly from their heavy work load. But it also grows out of the ethos of the juvenile court itself. Restricting an adolescent’s freedom or access to interventions based on a tallying of empirical data is antithetical to viewing each adolescent as a unique individual whose life chances may remain intact with developmentally appropriate intervention. Mulvey and Iselin recommend and examine three ways to integrate structured judgment approaches into the juvenile justice system that both capitalize on their strengths and support the court’s attempts to provide fair, individualized justice. First, more reliance on actuarial methods at detention and intake would promote more efficient and equitable screening of cases for subsequent court involvement. Second, the use of structured decision making by probation officers could provide more consistent and valid guidance for the court when formulating dispositions. Finally, implementing structured data systems to chart the progress of adolescents in placement could allow judges to oversee service providers more effectively. The challenge for the juvenile system, say the authors, will be to harness the new capacities of the science of decision making and of computer technology to increase the efficiency of its limited resources for the benefit both of the community and of the adolescents in the system. PMID:21337997

Geospatial Based Information System Development in Public Administration for Sustainable Development and Planning in Urban Environment

NASA Astrophysics Data System (ADS)

Kouziokas, Georgios N.

2016-09-01

It is generally agreed that the governmental authorities should actively encourage the development of an efficient framework of information and communication technology initiatives so as to advance and promote sustainable development and planning strategies. This paper presents a prototype Information System for public administration which was designed to facilitate public management and decision making for sustainable development and planning. The system was developed by using several programming languages and programming tools and also a Database Management System (DBMS) for storing and managing urban data of many kinds. Furthermore, geographic information systems were incorporated into the system in order to make possible to the authorities to deal with issues of spatial nature such as spatial planning. The developed system provides a technology based management of geospatial information, environmental and crime data of urban environment aiming at improving public decision making and also at contributing to a more efficient sustainable development and planning.

The politics of end-of-life decision-making: computerised decision-support tools, physicians' jurisdiction and morality.

PubMed

Jennings, Beth

2006-04-01

With the increasing corporate and governmental rationalisation of medical care, the mandate of efficiency has caused many to fear that concern for the individual patient will be replaced with impersonal, rule-governed allocation of medical resources. Largely ignored is the role of moral principles in medical decision-making. This analysis comes from an ethnographic study conducted from 1999-2001 in three US Intensive Care Units, two of which were using the computerised decision-support tool, APACHE III (Acute Physiological and Chronic Health Evaluation III), which notably predicts the probability that a patient will die. It was found that the use of APACHE presents a paradox regarding concern for the individual patient. To maintain jurisdiction over the care of patients, physicians share the data with the payers and regulators of care to prove they are using resources effectively and efficiently, yet they use the system in conjunction with moral principles to justify treating each patient as unique. Thus, concern for the individual patient is not lessened with the use of this system. However, physicians do not share the data with patients or surrogate decision-makers because they fear they will be viewed as more interested in profits than patients.

Nicotine replacement therapy decision based on fuzzy multi-criteria analysis

NASA Astrophysics Data System (ADS)

Tarmudi, Zamali; Matmali, Norfazillah; Abdullah, Mohd Lazim

2017-08-01

It has been observed that Nicotine Replacement Therapy (NRT) is one of the alternatives to control and reduce smoking addiction among smokers. Since the decision to choose the best NRT alternative involves uncertainty, ambiguity factors and diverse input datasets, thus, this paper proposes a fuzzy multi-criteria analysis (FMA) to overcome these issues. It focuses on how the fuzzy approach can unify the diversity of datasets based on NRT's decision-making problem. The analysis done employed the advantage of the cost-benefit criterion to unify the mixture of dataset input. The performance matrix was utilised to derive the performance scores. An empirical example regarding the NRT's decision-making problem was employed to illustrate the proposed approach. Based on the calculations, this analytical approach was found to be highly beneficial in terms of usability. It was also very applicable and efficient in dealing with the mixture of input datasets. Hence, the decision-making process can easily be used by experts and patients who are interested to join the therapy/cessation program.

Energy-Efficient Design for Florida Educational Facilities.

ERIC Educational Resources Information Center

Florida Solar Energy Center, Cape Canaveral.

This manual provides a detailed simulation analysis of a variety of energy conservation measures (ECMs) with the intent of giving educational facility design teams in Florida a basis for decision making. The manual's three sections cover energy efficiency design considerations that appear throughout the following design processes: schematic…

Modeling Common-Sense Decisions

NASA Astrophysics Data System (ADS)

Zak, Michail

This paper presents a methodology for efficient synthesis of dynamical model simulating a common-sense decision making process. The approach is based upon the extension of the physics' First Principles that includes behavior of living systems. The new architecture consists of motor dynamics simulating actual behavior of the object, and mental dynamics representing evolution of the corresponding knowledge-base and incorporating it in the form of information flows into the motor dynamics. The autonomy of the decision making process is achieved by a feedback from mental to motor dynamics. This feedback replaces unavailable external information by an internal knowledgebase stored in the mental model in the form of probability distributions.

An Integrated Decision Support System for Planning and Measuring Institutional Efficiency. AIR 1992 Annual Forum Paper.

ERIC Educational Resources Information Center

Minnaar, Phil C.

This paper presents a model for obtaining and organizing managment information for decision making in university planning, developed by the Bureau for Management Information of the University of South Africa. The model identifies the fundamental entities of the university as environment, finance, physical facilities, assets, personnel, and…

Ethanol or Biodiesel? A Systems-Analysis Decision

ERIC Educational Resources Information Center

Dinan, Frank; Stabler, Tom

2008-01-01

This case study stresses the need to broadly consider an entire system, including all of the energy inputs and outputs involved, to determine the real efficiency of that system. It also asks its student audience to consider the role that scientific input plays in policy decision-making processes. It emphasizes that, despite the importance of this…

WeightLifter: Visual Weight Space Exploration for Multi-Criteria Decision Making.

PubMed

Pajer, Stephan; Streit, Marc; Torsney-Weir, Thomas; Spechtenhauser, Florian; Muller, Torsten; Piringer, Harald

2017-01-01

A common strategy in Multi-Criteria Decision Making (MCDM) is to rank alternative solutions by weighted summary scores. Weights, however, are often abstract to the decision maker and can only be set by vague intuition. While previous work supports a point-wise exploration of weight spaces, we argue that MCDM can benefit from a regional and global visual analysis of weight spaces. Our main contribution is WeightLifter, a novel interactive visualization technique for weight-based MCDM that facilitates the exploration of weight spaces with up to ten criteria. Our technique enables users to better understand the sensitivity of a decision to changes of weights, to efficiently localize weight regions where a given solution ranks high, and to filter out solutions which do not rank high enough for any plausible combination of weights. We provide a comprehensive requirement analysis for weight-based MCDM and describe an interactive workflow that meets these requirements. For evaluation, we describe a usage scenario of WeightLifter in automotive engineering and report qualitative feedback from users of a deployed version as well as preliminary feedback from decision makers in multiple domains. This feedback confirms that WeightLifter increases both the efficiency of weight-based MCDM and the awareness of uncertainty in the ultimate decisions.

Development and initial evaluation of a treatment decision dashboard.

PubMed

Dolan, James G; Veazie, Peter J; Russ, Ann J

2013-04-21

For many healthcare decisions, multiple alternatives are available with different combinations of advantages and disadvantages across several important dimensions. The complexity of current healthcare decisions thus presents a significant barrier to informed decision making, a key element of patient-centered care.Interactive decision dashboards were developed to facilitate decision making in Management, a field marked by similarly complicated choices. These dashboards utilize data visualization techniques to reduce the cognitive effort needed to evaluate decision alternatives and a non-linear flow of information that enables users to review information in a self-directed fashion. Theoretically, both of these features should facilitate informed decision making by increasing user engagement with and understanding of the decision at hand. We sought to determine if the interactive decision dashboard format can be successfully adapted to create a clinically realistic prototype patient decision aid suitable for further evaluation and refinement. We created a computerized, interactive clinical decision dashboard and performed a pilot test of its clinical feasibility and acceptability using a multi-method analysis. The dashboard summarized information about the effectiveness, risks of side effects and drug-drug interactions, out-of-pocket costs, and ease of use of nine analgesic treatment options for knee osteoarthritis. Outcome evaluations included observations of how study participants utilized the dashboard, questionnaires to assess usability, acceptability, and decisional conflict, and an open-ended qualitative analysis. The study sample consisted of 25 volunteers - 7 men and 18 women - with an average age of 51 years. The mean time spent interacting with the dashboard was 4.6 minutes. Mean evaluation scores on scales ranging from 1 (low) to 7 (high) were: mechanical ease of use 6.1, cognitive ease of use 6.2, emotional difficulty 2.7, decision-aiding effectiveness 5.9, clarification of values 6.5, reduction in decisional uncertainty 6.1, and provision of decision-related information 6.0. Qualitative findings were similarly positive. Interactive decision dashboards can be adapted for clinical use and have the potential to foster informed decision making. Additional research is warranted to more rigorously test the effectiveness and efficiency of patient decision dashboards for supporting informed decision making and other aspects of patient-centered care, including shared decision making.

76 FR 58252 - Applications for New Awards; Statewide, Longitudinal Data Systems Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... DEPARTMENT OF EDUCATION Applications for New Awards; Statewide, Longitudinal Data Systems Program... analysis and informed decision- making at all levels of the education system, increase the efficiency with... accountability systems, and simplify the processes used by SEAs to make education data transparent through...

Criteria for assessing problem solving and decision making in complex environments

NASA Technical Reports Server (NTRS)

Orasanu, Judith

1993-01-01

Training crews to cope with unanticipated problems in high-risk, high-stress environments requires models of effective problem solving and decision making. Existing decision theories use the criteria of logical consistency and mathematical optimality to evaluate decision quality. While these approaches are useful under some circumstances, the assumptions underlying these models frequently are not met in dynamic time-pressured operational environments. Also, applying formal decision models is both labor and time intensive, a luxury often lacking in operational environments. Alternate approaches and criteria are needed. Given that operational problem solving and decision making are embedded in ongoing tasks, evaluation criteria must address the relation between those activities and satisfaction of broader task goals. Effectiveness and efficiency become relevant for judging reasoning performance in operational environments. New questions must be addressed: What is the relation between the quality of decisions and overall performance by crews engaged in critical high risk tasks? Are different strategies most effective for different types of decisions? How can various decision types be characterized? A preliminary model of decision types found in air transport environments will be described along with a preliminary performance model based on an analysis of 30 flight crews. The performance analysis examined behaviors that distinguish more and less effective crews (based on performance errors). Implications for training and system design will be discussed.

Reinforcement Learning Multi-Agent Modeling of Decision-Making Agents for the Study of Transboundary Surface Water Conflicts with Application to the Syr Darya River Basin

NASA Astrophysics Data System (ADS)

Riegels, N.; Siegfried, T.; Pereira Cardenal, S. J.; Jensen, R. A.; Bauer-Gottwein, P.

2008-12-01

In most economics--driven approaches to optimizing water use at the river basin scale, the system is modelled deterministically with the goal of maximizing overall benefits. However, actual operation and allocation decisions must be made under hydrologic and economic uncertainty. In addition, river basins often cross political boundaries, and different states may not be motivated to cooperate so as to maximize basin- scale benefits. Even within states, competing agents such as irrigation districts, municipal water agencies, and large industrial users may not have incentives to cooperate to realize efficiency gains identified in basin- level studies. More traditional simulation--optimization approaches assume pre-commitment by individual agents and stakeholders and unconditional compliance on each side. While this can help determine attainable gains and tradeoffs from efficient management, such hardwired policies do not account for dynamic feedback between agents themselves or between agents and their environments (e.g. due to climate change etc.). In reality however, we are dealing with an out-of-equilibrium multi-agent system, where there is neither global knowledge nor global control, but rather continuous strategic interaction between decision making agents. Based on the theory of stochastic games, we present a computational framework that allows for studying the dynamic feedback between decision--making agents themselves and an inherently uncertain environment in a spatially and temporally distributed manner. Agents with decision-making control over water allocation such as countries, irrigation districts, and municipalities are represented by reinforcement learning agents and coupled to a detailed hydrologic--economic model. This approach emphasizes learning by agents from their continuous interaction with other agents and the environment. It provides a convenient framework for the solution of the problem of dynamic decision-making in a mixed cooperative / non-cooperative environment with which different institutional setups and incentive systems can be studied so to identify reasonable ways to reach desirable, Pareto--optimal allocation outcomes. Preliminary results from an application to the Syr Darya river basin in Central Asia will be presented and discussed. The Syr Darya River is a classic example of a transboundary river basin in which basin-wide efficiency gains identified in optimization studies have not been sufficient to induce cooperative management of the river by the riparian states.

Deliberation favours social efficiency by making people disregard their relative shares: evidence from USA and India

PubMed Central

Corgnet, Brice; Espín, Antonio M.; Hernán-González, Roberto

2017-01-01

Groups make decisions on both the production and the distribution of resources. These decisions typically involve a tension between increasing the total level of group resources (i.e. social efficiency) and distributing these resources among group members (i.e. individuals' relative shares). This is the case because the redistribution process may destroy part of the resources, thus resulting in socially inefficient allocations. Here we apply a dual-process approach to understand the cognitive underpinnings of this fundamental tension. We conducted a set of experiments to examine the extent to which different allocation decisions respond to intuition or deliberation. In a newly developed approach, we assess intuition and deliberation at both the trait level (using the Cognitive Reflection Test, henceforth CRT) and the state level (through the experimental manipulation of response times). To test for robustness, experiments were conducted in two countries: the USA and India. Despite absolute-level differences across countries, in both locations we show that: (i) time pressure and low CRT scores are associated with individuals' concerns for their relative shares and (ii) time delay and high CRT scores are associated with individuals' concerns for social efficiency. These findings demonstrate that deliberation favours social efficiency by overriding individuals' intuitive tendency to focus on relative shares. PMID:28386421

Present-value analysis: A systems approach to public decisionmaking for cost effectiveness

NASA Technical Reports Server (NTRS)

Herbert, T. T.

1971-01-01

Decision makers within Governmental agencies and Congress must evaluate competing (and sometimes conflicting) proposals which seek funding and implementation. Present value analysis can be an effective decision making tool by enabling the formal evaluation of the effects of competing proposals on efficient national resource utilization. A project's costs are not only its direct disbursements, but its social costs as well. How much does it cost to have those funds diverted from their use and economic benefit by the private sector to the public project? Comparisons of competing projects' social costs allow decision makers to expand their decision bases by quantifying the projects' impacts upon the economy and the efficient utilization of the country's limited national resources. A conceptual model is established for the choosing of the appropriate discount rate to be used in evaluation decisions through the technique.

Development of a First-of-a-Kind Deterministic Decision-Making Tool for Supervisory Control System

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

Cetiner, Sacit M; Kisner, Roger A; Muhlheim, Michael David

2015-07-01

Decision-making is the process of identifying and choosing alternatives where each alternative offers a different approach or path to move from a given state or condition to a desired state or condition. The generation of consistent decisions requires that a structured, coherent process be defined, immediately leading to a decision-making framework. The overall objective of the generalized framework is for it to be adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or nomore » human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision- making modules that can perform a given set of tasks reliably. Risk-informed decision making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The implementation of the probabilistic portion of the decision-making engine of the proposed supervisory control system was detailed in previous milestone reports. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic multi-attribute decision-making framework uses variable sensor data (e.g., outlet temperature) and calculates where it is within the challenge state, its trajectory, and margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. Metrics to be evaluated include stability, cost, time to complete (action), power level, etc. The integration of deterministic calculations using multi-physics analyses (i.e., neutronics, thermal, and thermal-hydraulics) and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermal-hydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies.« less

Evaluating trade-offs in bull trout reintroduction strategies using structured decision making

USGS Publications Warehouse

Brignon, William R.; Peterson, James T.; Dunham, Jason B.; Schaller, Howard A.; Schreck, Carl B.

2018-01-01

Structured decision making allows reintroduction decisions to be made despite uncertainty by linking reintroduction goals with alternative management actions through predictive models of ecological processes. We developed a decision model to evaluate the trade-offs between six bull trout (Salvelinus confluentus) reintroduction decisions with the goal of maximizing the number of adults in the recipient population without reducing the donor population to an unacceptable level. Sensitivity analyses suggested that the decision identity and outcome were most influenced by survival parameters that result in increased adult abundance in the recipient population, increased juvenile survival in the donor and recipient populations, adult fecundity rates, and sex ratio. The decision was least sensitive to survival parameters associated with the captive-reared population, the effect of naivety on released individuals, and juvenile carrying capacity of the reintroduced population. The model and sensitivity analyses can serve as the foundation for formal adaptive management and improved effectiveness, efficiency, and transparency of bull trout reintroduction decisions.

Integrating Land Cover Modeling and Adaptive Management to Conserve Endangered Species and Reduce Catastrophic Fire Risk

NASA Technical Reports Server (NTRS)

Breininger, David; Duncan, Brean; Eaton, Mitchell; Johnson, Fred; Nichols, James

2014-01-01

Land cover modeling is used to inform land management, but most often via a two-step process where science informs how management alternatives can influence resources and then decision makers can use this to make decisions. A more efficient process is to directly integrate science and decision making, where science allows us to learn to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuels monitoring with decision making focused on dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy, but habitat trajectories suggest tradeoffs. Knowledge about system responses to actions can be informed by applying competing management actions to different land units in the same system state and by ideas about fire behavior. Monitoring and management integration is important to optimize state-specific management decisions and increase knowledge about system responses. We believe this approach has broad utility for and cover modeling programs intended to inform decision making.

The use of economic evaluation in CAM: an introductory framework

PubMed Central

2010-01-01

Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM. PMID:21067622

The use of economic evaluation in CAM: an introductory framework.

PubMed

Ford, Emily; Solomon, Daniela; Adams, Jon; Graves, Nicholas

2010-11-11

For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities.In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

Policy Dimensions of Analytics in Higher Education

ERIC Educational Resources Information Center

Petersen, Rodney J.

2012-01-01

The current higher education landscape is replete with demands for improving accountability, increasing efficiency, and controlling costs. At the same time, information technologies make it easier to collect and analyze information to measure outcomes or to assist in decision making. Consequently, there is a higher demand for better information…

An effective and efficient assessment process

Treesearch

Russell T. Graham; Theresa B. Jain

1999-01-01

Depending on the agency, discipline, or audience, assessments supply data and information to address relevant policy questions and to help make decisions. If properly executed, assessment processes can draw conclusions and make recommendations on how to manage natural resources. Assessments, especially large ones, can be easily influenced by internal and external...

Criteria for Drug Reimbursement Decision-Making: An Emerging Public Health Challenge in Bulgaria

PubMed Central

Iskrov, Georgi; Stefanov, Rumen

2016-01-01

Background: During times of fiscal austerity, means of reimbursement decision-making are of particular interest for public health theory and practice. Introduction of advanced health technologies, growing health expenditures and increased public scrutiny over drug reimbursement decisions have pushed governments to consider mechanisms that promote the use of effective health technologies, while constraining costs. Aims: The study’s aim was to explore the current rationale of the drug reimbursement decision-making framework in Bulgaria. Our pilot research focused on one particular component of this process – the criteria used – because of the critical role that criteria are known to have in setting budgets and priorities in the field of public health. The analysis pursued two objectives: to identify important criteria relevant to drug reimbursement decision-making and to unveil relationships between theory and practice. Study Design: Cross-sectional study. Methods: The study was realized through a closed-ended survey on reimbursement criteria among four major public health stakeholders – medical professionals, patients, health authorities, and industry. Empirical outcomes were then cross-compared with the theoretical framework, as defined by current Bulgarian public health legislation. Analysis outlined what is done and what needs to be done in the field of public health reimbursement decision-making. Results: Bulgarian public health stakeholders agreed on 15 criteria to form a tentative optimal framework for drug reimbursement decision-making. The most apparent gap between the empirically found preferences and the official legislation is the lack of consideration for the strength of evidence in reimbursement decisions. Conclusion: Bulgarian policy makers need to address specific gaps, such as formal consideration for strength of evidence, explicit role of efficiency criteria, and means to effectively empower patient and citizen involvement in public health decision-making. Drug reimbursement criteria have to be integrated into legitimate public health decision support tools that ensure the achievement of national public health objectives. These recommendations could be expanded to all Eastern European countries who share common public health problems. PMID:26966615

Decision Support System for an efficient irrigation water management in semi arid environment

NASA Astrophysics Data System (ADS)

Khan, M. A.; Islam, M.; Hafeez, M. M.; Flugel, W. A.

2009-12-01

A significant increase in agricultural productivity over the last few decades has protected the world from episodes of hunger and food shortages. Water management in irrigated agriculture was instrumental in achieving those gains. Water resources are under high pressure due to rapid population growth and increased competition among various sectors. Access to reliable data on water availability, quantity and quality can provide the necessary foundation for sound management of water resources. There are many traditional methods for matching water demand and supply, however imbalances between demand and supply remain inevitable. It is possible to reduce the imbalances considerably through development of appropriate irrigation water management tool that take into account various factors such as soil type, irrigation water supply, and crop water demand. All components of water balance need to be understood and quantified for efficient and sustainable management of water resources. Application of an intelligent Decision Support System (DSS) is becoming significant. A DSS incorporates knowledge and expertise within the decision support framework. It is an integrated set of data, functions, models and other relevant information that efficiently processes input data, simulates models and displays the results in a user friendly format. It helps in decision-making process, to analyse the problem and explore various scenarios to make the most appropriate decision for water management. This paper deals with the Coleambally Irrigation Area (CIA) located in Murrumbidgee catchment, NSW, Australia. An Integrated River Information System called Coleambally IRIS has been developed to improve the irrigation water management ranging from farm to sub-system and system level. It is a web-based information management system with a focus on time series and geospatial hydrological, climatic and remote sensing data including land cover class, surface temperature, soil moisture, Normalized Difference Vegetation Index (NDVI), Leaf Area Index (LAI) and Evapotranspiration (ET). Coleambally IRIS provides user friendly environment for data input and output, and an adaptable set of functions for data analysis, management and decision making to develops strategies for sustainable irrigation water management. Coleambally IRIS is used to assist the managers of irrigation service provider and the farmers in their decision making by providing relevant information over the web. The developed DSS has been practically used in managing irrigation water under the current drought conditions. The DSS will be further extended for forecasting irrigation water demand in the future.

Diagnostic decision-making and strategies to improve diagnosis.

PubMed

Thammasitboon, Satid; Cutrer, William B

2013-10-01

A significant portion of diagnostic errors arises through cognitive errors resulting from inadequate knowledge, faulty data gathering, and/or faulty verification. Experts estimate that 75% of diagnostic failures can be attributed to clinician diagnostic thinking failure. The cognitive processes that underlie diagnostic thinking of clinicians are complex and intriguing, and it is imperative that clinicians acquire explicit appreciation and application of different cognitive approaches to make decisions better. A dual-process model that unifies many theories of decision-making has emerged as a promising template for understanding how clinicians think and judge efficiently in a diagnostic reasoning process. The identification and implementation of strategies for decreasing or preventing such diagnostic errors has become a growing area of interest and research. Suggested strategies to decrease diagnostic error incidence include increasing clinician's clinical expertise and avoiding inherent cognitive errors to make decisions better. Implementing Interventions focused solely on avoiding errors may work effectively for patient safety issues such as medication errors. Addressing cognitive errors, however, requires equal effort on expanding the individual clinician's expertise. Providing cognitive support to clinicians for robust diagnostic decision-making serves as the final strategic target for decreasing diagnostic errors. Clinical guidelines and algorithms offer another method for streamlining decision-making and decreasing likelihood of cognitive diagnostic errors. Addressing cognitive processing errors is undeniably the most challenging task in reducing diagnostic errors. While many suggested approaches exist, they are mostly based on theories and sciences in cognitive psychology, decision-making, and education. The proposed interventions are primarily suggestions and very few of them have been tested in the actual practice settings. Collaborative research effort is required to effectively address cognitive processing errors. Researchers in various areas, including patient safety/quality improvement, decision-making, and problem solving, must work together to make medical diagnosis more reliable. © 2013 Mosby, Inc. All rights reserved.

Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine.

PubMed

Gómez-Huelgas, R; Pérez-Jiménez, F; Serrano-Ríos, M; González-Santos, P; Román, P; Camafort, M; Conthe, P; García-Alegría, J; Guijarro, R; López-Miranda, J; Tirado-Miranda, R; Valdivielso, P

2014-05-01

Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Eye Movements in Reading as Rational Behavior

ERIC Educational Resources Information Center

Bicknell, Klinton

2011-01-01

Moving one's eyes while reading is one of the most complex everyday tasks humans face. To perform efficiently, readers must make decisions about when and where to move their eyes every 200-300ms. Over the past decades, it has been demonstrated that these fine-grained decisions are influenced by a range of linguistic properties of the text, and…

The madness of crowds phenomenon in the collective decision-making by the cells, the cell's metacognition and cancer

NASA Astrophysics Data System (ADS)

Saakian, David B.

2018-02-01

Recently it has been found that the collective decision-making in the group is efficient only when the confidences (a version of metacognition) of the members are similar, and it has been assumed that the metacognition (self-reference) in general is crucial for the human cooperation. Our goal is to map the decision making by the cells to decision making by humans, looking the analog of metacognition in the cells, accurately calculate the collective sensing of chemical gradients by the cells, and apply our results to cancer. We formulated the model for the chemeosensing by the cells with different diameters, solved it accurately and found that the collective chemosensing is very similar to the collective decision making by humans. We found that the collective sensing of the ligand concentration can be worse than for the most sensitive cell. We introduced the metacognition of the cells, and verify that the metacognition is impaired for the cancer case. We assume as a hypothesis that the impaired cell metacognition in case of cancer does not allow normal multi-cellularity, and cancer can arise when the "two heads are better than one" principle fails, and there is a "madness of crowds" phenomenon instead.

Institutionalizing telemedicine applications: the challenge of legitimizing decision-making.

PubMed

Zanaboni, Paolo; Lettieri, Emanuele

2011-09-28

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

Working memory in children predicts performance on a gambling task.

PubMed

Audusseau, Jean; Juhel, Jacques

2015-01-01

The authors investigated whether working memory (WM) plays a significant role in the development of decision making in children, operationalized by the Children's Gambling Task (CGT). A total of 105 children aged 6-7, 8-9, and 10-11 years old carried out the CGT. Children aged 6-7 years old were found to have a lower performance than older children, which shows that the CGT is sensitive to participant's age. The hypothesis that WM plays a significant role in decision making was then tested following two approaches: (a) an experimental approach, comparing between groups the performance on the CGT in a control condition (the CGT only was administered) to that in a double task condition (participants had to carry out a recall task in addition to the CGT); (b) an interindividual approach, probing the relationship between CGT performance and performance on tasks measuring WM efficiency. The between-groups approach evidenced a better performance in the control group. Moreover, the interindividual approach showed that the higher the participants' WM efficiency was, the higher their performance in the CGT was. Taken together, these two approaches yield converging results that support the hypothesis that WM plays a significant role in decision making in children.

The solution of target assignment problem in command and control decision-making behaviour simulation

NASA Astrophysics Data System (ADS)

Li, Ni; Huai, Wenqing; Wang, Shaodan

2017-08-01

C2 (command and control) has been understood to be a critical military component to meet an increasing demand for rapid information gathering and real-time decision-making in a dynamically changing battlefield environment. In this article, to improve a C2 behaviour model's reusability and interoperability, a behaviour modelling framework was proposed to specify a C2 model's internal modules and a set of interoperability interfaces based on the C-BML (coalition battle management language). WTA (weapon target assignment) is a typical C2 autonomous decision-making behaviour modelling problem. Different from most WTA problem descriptions, here sensors were considered to be available resources of detection and the relationship constraints between weapons and sensors were also taken into account, which brought it much closer to actual application. A modified differential evolution (MDE) algorithm was developed to solve this high-dimension optimisation problem and obtained an optimal assignment plan with high efficiency. In case study, we built a simulation system to validate the proposed C2 modelling framework and interoperability interface specification. Also, a new optimisation solution was used to solve the WTA problem efficiently and successfully.

Attentional Filter Training but Not Memory Training Improves Decision-Making.

PubMed

Schmicker, Marlen; Müller, Patrick; Schwefel, Melanie; Müller, Notger G

2017-01-01

Decision-making has a high practical relevance for daily performance. Its relation to other cognitive abilities such as executive control and memory is not fully understood. Here we asked whether training of either attentional filtering or memory storage would influence decision-making as indexed by repetitive assessments of the Iowa Gambling Task (IGT). The IGT was developed to assess and simulate real-life decision-making (Bechara et al., 2005). In this task, participants gain or lose money by developing advantageous or disadvantageous decision strategies. On five consecutive days we trained 29 healthy young adults (20-30 years) either in working memory (WM) storage or attentional filtering and measured their IGT scores after each training session. During memory training (MT) subjects performed a computerized delayed match-to-sample task where two displays of bars were presented in succession. During filter training (FT) participants had to indicate whether two simultaneously presented displays of bars matched or not. Whereas in MT the relevant target stimuli stood alone, in FT the targets were embedded within irrelevant distractors (bars in a different color). All subjects within each group improved their performance in the trained cognitive task. For the IGT, we observed an increase over time in the amount of money gained in the FT group only. Decision-making seems to be influenced more by training to filter out irrelevant distractors than by training to store items in WM. Selective attention could be responsible for the previously noted relationship between IGT performance and WM and is therefore more important for enhancing efficiency in decision-making.

Making decisions in complex landscapes: Headwater stream management across multiple federal agencies

USGS Publications Warehouse

Katz, Rachel; Grant, Evan H. Campbell; Runge, Michael C.; Connery, Bruce; Crockett, Marquette; Herland, Libby; Johnson, Sheela; Kirk, Dawn; Wofford, Jeb; Bennett, Rick; Nislow, Keith; Norris, Marian; Hocking, Daniel; Letcher, Benjamin; Roy, Allison

2014-01-01

Headwater stream ecosystems are vulnerable to numerous threats associated with climate and land use change. In the northeastern US, many headwater stream species (e.g., brook trout and stream salamanders) are of special conservation concern and may be vulnerable to climate change influences, such as changes in stream temperature and streamflow. Federal land management agencies (e.g., US Fish and Wildlife Service, National Park Service, USDA Forest Service, Bureau of Land Management and Department of Defense) are required to adopt policies that respond to climate change and may have longer-term institutional support to enforce such policies compared to state, local, non-governmental, or private land managers. However, federal agencies largely make management decisions in regards to headwater stream ecosystems independently. This fragmentation of management resources and responsibilities across the landscape may significantly impede the efficiency and effectiveness of conservation actions, and higher degrees of collaboration may be required to achieve conservation goals. This project seeks to provide an example of cooperative landscape decision-making to address the conservation of headwater stream ecosystems. We identified shared and contrasting objectives of each federal agency and potential collaboration opportunities that may increase efficient and effective management of headwater stream ecosystems in two northeastern US watersheds. These workshops provided useful insights into the adaptive capacity of federal institutions to address threats to headwater stream ecosystems. Our ultimate goal is to provide a decision-making framework and analysis that addresses large-scale conservation threats across multiple stakeholders, as a demonstration of cooperative landscape conservation for aquatic ecosystems. Additionally, we aim to provide new scientific knowledge and a regional perspective to resource managers to help inform local management decisions.

Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making.

PubMed

Schroy, Paul C; Mylvaganam, Shamini; Davidson, Peter

2014-02-01

Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established. Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting. Cross-sectional survey. Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence. Perceptions of the impact of the tool on decision-making and implementation issues. Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues. Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed. © 2011 John Wiley & Sons Ltd.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions.

PubMed

Dakin, Helen; Gray, Alastair

2018-05-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of "mutually exclusive." This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were "mutually exclusive" makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making.

Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions

PubMed Central

Dakin, Helen; Gray, Alastair

2018-01-01

Standard guidance for allocating healthcare resources based on cost-effectiveness recommends using different decision rules for independent and mutually exclusive alternatives, although there is some confusion around the definition of “mutually exclusive.” This paper reviews the definitions used in the literature and shows that interactions (i.e., non-additive effects, whereby the effect of giving 2 interventions simultaneously does not equal the sum of their individual effects) are the defining feature of mutually exclusive alternatives: treatments cannot be considered independent if the costs and/or benefits of one treatment are affected by the other treatment. The paper then identifies and categorizes the situations in which interventions are likely to have non-additive effects, including interventions targeting the same goal or clinical event, or life-saving interventions given to overlapping populations. We demonstrate that making separate decisions on interventions that have non-additive effects can prevent us from maximizing health gained from the healthcare budget. In contrast, treating combinations of independent options as though they were “mutually exclusive” makes the analysis more complicated but does not affect the conclusions. Although interactions are considered by the World Health Organization, other decision makers, such as the National Institute for Health and Care Excellence (NICE), currently make independent decisions on treatments likely to have non-additive effects. We propose a framework by which interactions could be considered when selecting, prioritizing, and appraising healthcare technologies to ensure efficient, evidence-based decision making. PMID:29683792

Empathy as a neuropsychological heuristic in social decision-making.

PubMed

Ramsøy, Thomas Zoëga; Skov, Martin; Macoveanu, Julian; Siebner, Hartwig R; Fosgaard, Toke Reinholt

2015-04-01

Decision-making in social dilemmas is suggested to rely on three factors: the valuation of a choice option, the relative judgment of two or more choice alternatives, and individual factors affecting the ease at which judgments and decisions are made. Here, we test whether empathy-an individual's relative ability to understand others' thoughts, emotions, and intentions-acts as an individual factor that alleviates conflict resolution in social decision-making. We test this by using a framed, iterated prisoners' dilemma (PD) game in two settings. In a behavioral experiment, we find that individual differences in empathic ability (the Empathy Quotient, EQ) were related to lower response times in the PD game, suggesting that empathy is related to faster social choices, independent of whether they choose to cooperate or defect. In a subsequent neuroimaging experiment, using functional magnetic resonance imaging, we find that EQ is positively related to individual differences in the engagement of brain structures implemented in mentalizing, including the precuneus, superior temporal sulcus, and dorsolateral prefrontal cortex. These results suggest that empathy is related to the individual difference in the engagement of mentalizing in social dilemmas and that this is related to the efficiency of decision-making in social dilemmas.

Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

PubMed

Goeree, Ron; Diaby, Vakaramoko

2013-12-01

In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

11 CFR 7.7 - Prohibited conduct-General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Government efficiency or economy; (d) Losing independence or impartiality; (e) Making a Government decision... Employees or Commissioners § 7.7 Prohibited conduct—General. A Commissioner or employee shall avoid any...

What makes rating systems tick

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

Vories, R.

How can home buyers tell how much they are going to have to spend on utilities when they buy houses How can a lender determine if a home should be rewarded for its energy efficiency potential How can a real estate agent show a buyer the energy features of a home Home energy rating system (HERS) are one of the most-effective and comprehensive ways of addressing the problem of how to make energy efficiency and its economic impacts more visible and understandable. They attract participation because they make it easier for everyone involved to recognize energy efficiency and weigh itmore » into their decision-making processes. This article describes seven HERS created by localities interested in helping community members better compare the energy efficiency of their current homes or homes for sale. All seven systems were developed primarily for existing homes. Not all are still alive, but their experience is nevertheless worthwhile. Comparing them to each other reveals factors that makes HERS effective. 1 ref.« less

Acute Exposure to Low-to-Moderate Carbon Dioxide Levels and Submariner Decision Making.

PubMed

Rodeheffer, Christopher D; Chabal, Sarah; Clarke, John M; Fothergill, David M

2018-06-01

Submarines routinely operate with higher levels of ambient carbon dioxide (CO2) (i.e., 2000 - 5000 ppm) than what is typically considered normal (i.e., 400 - 600 ppm). Although significant cognitive impairments are rarely reported at these elevated CO2 levels, recent studies using the Strategic Management Simulation (SMS) test have found impairments in decision-making performance during acute CO2 exposure at levels as low as 1000 ppm. This is a potential concern for submarine operations, as personnel regularly make mission-critical decisions that affect the safety and efficiency of the vessel and its crew while exposed to similar levels of CO2. The objective of this study was to determine if submariner decision-making performance is impacted by acute exposure to levels of CO2 routinely present in the submarine atmosphere during sea patrols. Using a subject-blinded balanced design, 36 submarine-qualified sailors were randomly assigned to receive 1 of 3 CO2 exposure conditions (600, 2500, or 15,000 ppm). After a 45-min atmospheric acclimation period, participants completed an 80-min computer-administered SMS test as a measure of decision making. There were no significant differences for any of the nine SMS measures of decision making between the CO2 exposure conditions. In contrast to recent research demonstrating cognitive deficits on the SMS test in students and professional-grade office workers, we were unable to replicate this effect in a submariner population-even with acute CO2 exposures more than an order of magnitude greater than those used in previous studies that demonstrated such effects.Rodeheffer CD, Chabal S, Clarke JM, Fothergill DM. Acute exposure to low-to-moderate carbon dioxide levels and submariner decision making. Aerosp Med Hum Perform. 2018; 89(6):520-525.

Vulnerable patients' perceptions of health care quality and quality data.

PubMed

Raven, Maria Catherine; Gillespie, Colleen C; DiBennardo, Rebecca; Van Busum, Kristin; Elbel, Brian

2012-01-01

Little is known about how patients served by safety-net hospitals utilize and respond to hospital quality data. To understand how vulnerable, lower income patients make health care decisions and define quality of care and whether hospital quality data factor into such decisions and definitions. Mixed quantitative and qualitative methods were used to gather primary data from patients at an urban, tertiary-care safety-net hospital. The study hospital is a member of the first public hospital system to voluntarily post hospital quality data online for public access. Patients were recruited from outpatient and inpatient clinics. Surveys were used to collect data on participants' sociodemographic characteristics, health literacy, health care experiences, and satisfaction variables. Focus groups were used to explore a representative sample of 24 patients' health care decision making and views of quality. Data from focus group transcripts were iteratively coded and analyzed by the authors. Focus group participants were similar to the broader diverse, low-income clinic. Participants reported exercising choice in making decisions about where to seek health care. Multiple sources influenced decision-making processes including participants' own beliefs and values, social influences, and prior experiences. Hospital quality data were notably absent as a source of influence in health care decision making for this population largely because participants were unaware of its existence. Participants' views of hospital quality were influenced by the quality and efficiency of services provided (with an emphasis on the doctor-patient relationship) and patient centeredness. When presented with it, patients appreciated the hospital quality data and, with guidance, were interested in incorporating it into health care decision making. Results suggest directions for optimizing the presentation, content, and availability of hospital quality data. Future research will explore how similar populations form and make choices based on presentation of hospital quality data.

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

Developmental changes and individual differences in risk and perspective taking in adolescence.

PubMed

Crone, Eveline A; Bullens, L; van der Plas, E A A; Kijkuit, E J; Zelazo, P D

2008-01-01

Despite the assumed prevalence of risk-taking behavior in adolescence, the laboratory evidence of risk taking remains scarce, and the individual variation poorly understood. Drawing from neuroscience studies, we tested whether risk and reward orientation are influenced by the perspective that adolescents take when making risky decisions. Perspective taking was manipulated by cuing participants prior to each choice whether the decision was made for "self," or from the perspective of an "other" (the experimenter in Experiment 1; a hypothetical peer in Experiment 2). In Experiment 1, we show a developmental decrease in risk-taking behavior across different stages of adolescence. In addition, all age groups made fewer risky choices for the experimenter, but the difference between self and other was larger in early adolescence. In Experiment 2, we show that high sensation-seeking (SS) adolescents make more risky choices than low SS adolescents, but both groups make a similar differentiation for other individuals (low risk-taking or high risk-taking peers). Together, the results show that younger adolescents and high SS adolescents make more risky choices for themselves, but can appreciate that others may make fewer risky choices. The developmental change toward more rational decisions versus emotional, impulsive decisions may reflect, in part, more efficient integration of others' perspectives into one's decision making. These developmental results are discussed regarding brain systems important for risk taking and perspective taking.

Fuzzy methods in decision making process - A particular approach in manufacturing systems

NASA Astrophysics Data System (ADS)

Coroiu, A. M.

2015-11-01

We are living in a competitive environment, so we can see and understand that the most of manufacturing firms do the best in order to accomplish meeting demand, increasing quality, decreasing costs, and delivery rate. In present a stake point of interest is represented by the development of fuzzy technology. A particular approach for this is represented through the development of methodologies to enhance the ability to managed complicated optimization and decision making aspects involving non-probabilistic uncertainty with the reason to understand, development, and practice the fuzzy technologies to be used in fields such as economic, engineering, management, and societal problems. Fuzzy analysis represents a method for solving problems which are related to uncertainty and vagueness; it is used in multiple areas, such as engineering and has applications in decision making problems, planning and production. As a definition for decision making process we can use the next one: result of mental processes based upon cognitive process with a main role in the selection of a course of action among several alternatives. Every process of decision making can be represented as a result of a final choice and the output can be represented as an action or as an opinion of choice. Different types of uncertainty can be discovered in a wide variety of optimization and decision making problems related to planning and operation of power systems and subsystems. The mixture of the uncertainty factor in the construction of different models serves for increasing their adequacy and, as a result, the reliability and factual efficiency of decisions based on their analysis. Another definition of decision making process which came to illustrate and sustain the necessity of using fuzzy method: the decision making is an approach of choosing a strategy among many different projects in order to achieve some purposes and is formulated as three different models: high risk decision, usual risk decision and low risk decision - some specific formulas of fuzzy logic. The fuzzy set concepts has some certain parameterization features which are certain extensions of crisp and fuzzy relations respectively and have a rich potential for application to the decision making problems. The proposed approach from this paper presents advantages of fuzzy approach, in comparison with other paradigm and presents a particular way in which fuzzy logic can emerge in decision making process and planning process with implication, as a simulation, in manufacturing - involved in measuring performance of advanced manufacturing systems. Finally, an example is presented to illustrate our simulation.

Risk Decision Making Model for Reservoir Floodwater resources Utilization

NASA Astrophysics Data System (ADS)

Huang, X.

2017-12-01

Floodwater resources utilization(FRU) can alleviate the shortage of water resources, but there are risks. In order to safely and efficiently utilize the floodwater resources, it is necessary to study the risk of reservoir FRU. In this paper, the risk rate of exceeding the design flood water level and the risk rate of exceeding safety discharge are estimated. Based on the principle of the minimum risk and the maximum benefit of FRU, a multi-objective risk decision making model for FRU is constructed. Probability theory and mathematical statistics method is selected to calculate the risk rate; C-D production function method and emergy analysis method is selected to calculate the risk benefit; the risk loss is related to flood inundation area and unit area loss; the multi-objective decision making problem of the model is solved by the constraint method. Taking the Shilianghe reservoir in Jiangsu Province as an example, the optimal equilibrium solution of FRU of the Shilianghe reservoir is found by using the risk decision making model, and the validity and applicability of the model are verified.

Simulating Spatial Growth Patterns in Developing Countries: A Case of Shama in the Western Region of Ghana.

NASA Astrophysics Data System (ADS)

Inkoom, J. N.; Nyarko, B. K.

2014-12-01

The integration of geographic information systems (GIS) and agent-based modelling (ABM) can be an efficient tool to improve spatial planning practices. This paper utilizes GIS and ABM approaches to simulate spatial growth patterns of settlement structures in Shama. A preliminary household survey on residential location decision-making choice served as the behavioural rule for household agents in the model. Physical environment properties of the model were extracted from a 2005 image implemented in NetLogo. The resulting growth pattern model was compared with empirical growth patterns to ascertain the model's accuracy. The paper establishes that the development of unplanned structures and its evolving structural pattern are a function of land price, proximity to economic centres, household economic status and location decision-making patterns. The application of the proposed model underlines its potential for integration into urban planning policies and practices, and for understanding residential decision-making processes in emerging cities in developing countries. Key Words: GIS; Agent-based modelling; Growth patterns; NetLogo; Location decision making; Computational Intelligence.

Economic evaluation of pharmacogenomics: a value-based approach to pragmatic decision making in the face of complexity.

PubMed

Snyder, Susan R; Mitropoulou, Christina; Patrinos, George P; Williams, Marc S

2014-01-01

Evidence of the value of pharmacogenomic testing is needed to inform policymakers and clinicians for decision making related to adoption and coverage, and to facilitate prioritization for research and development. Pharmacogenomics has an important role in creating a more efficient healthcare system, and this article addresses how economic evaluation can strategically target evidence gaps for public health priorities with examples from pharmacogenomic medicine. This article begins with a review of the need for and use of economic evaluations in value-based decision making for pharmacogenomic testing. Three important gaps are described with examples demonstrating how they can be addressed: (1) projected impact of hypothetical new technology, (2) pre-implementation assessment of a specific technology, and (3) post-implementation assessment from relevant analytical stakeholder perspectives. Additional needs, challenges and approaches specific to pharmacogenomic economic evaluation in the developing world are also identified. These pragmatic approaches can provide much needed evidence to support real-world value-based decision making for pharmacogenomic-based screening and treatment strategies. © 2014 S. Karger AG, Basel.

Efficiency Analysis: Enhancing the Statistical and Evaluative Power of the Regression-Discontinuity Design.

ERIC Educational Resources Information Center

Madhere, Serge

An analytic procedure, efficiency analysis, is proposed for improving the utility of quantitative program evaluation for decision making. The three features of the procedure are explained: (1) for statistical control, it adopts and extends the regression-discontinuity design; (2) for statistical inferences, it de-emphasizes hypothesis testing in…

A Prototype Decision Support System for the Location of Military Water Points.

DTIC Science & Technology

1980-06-01

create an environ- ment which is conductive to an efficient man/machine decision making system . This could be accomplished by designing the operating...Figure 12. Flowchart of Program COMPUTE 50 Procedure This Decision Support System was designed to be interactive. That is, it requests data from the user...Pg. 82-114, 1974. 24. Geoffrion, A.M. and G.W. Graves, "Multicomodity Distribution System Design by Benders Partition", Management Science, Vol. 20, Pg

Bayesian Decision Support

NASA Astrophysics Data System (ADS)

Berliner, M.

2017-12-01

Bayesian statistical decision theory offers a natural framework for decision-policy making in the presence of uncertainty. Key advantages of the approach include efficient incorporation of information and observations. However, in complicated settings it is very difficult, perhaps essentially impossible, to formalize the mathematical inputs needed in the approach. Nevertheless, using the approach as a template is useful for decision support; that is, organizing and communicating our analyses. Bayesian hierarchical modeling is valuable in quantifying and managing uncertainty such cases. I review some aspects of the idea emphasizing statistical model development and use in the context of sea-level rise.

The determinants of strategic thinking in preschool children.

PubMed

Brocas, Isabelle; Carrillo, Juan D

2018-01-01

Strategic thinking is an essential component of rational decision-making. However, little is known about its developmental aspects. Here we show that preschoolers can reason strategically in simple individual decisions that require anticipating a limited number of future decisions. This ability is transferred only partially to solve more complex individual decision problems and to efficiently interact with others. This ability is also more developed among older children in the classroom. Results indicate that while preschoolers potentially have the capacity to think strategically, it does not always translate into the ability to behave strategically.

The determinants of strategic thinking in preschool children

PubMed Central

Brocas, Isabelle

2018-01-01

Strategic thinking is an essential component of rational decision-making. However, little is known about its developmental aspects. Here we show that preschoolers can reason strategically in simple individual decisions that require anticipating a limited number of future decisions. This ability is transferred only partially to solve more complex individual decision problems and to efficiently interact with others. This ability is also more developed among older children in the classroom. Results indicate that while preschoolers potentially have the capacity to think strategically, it does not always translate into the ability to behave strategically. PMID:29851954

Wisconsin System for Instructional Management: Terminal Operator Manual. Practical Paper No. 19.

ERIC Educational Resources Information Center

Bozeman, William C.; And Others

The Wisconsin System for Instructional Management (WIS-SIM) is a computer managed instruction (CMI) system designed to improve instructional decision making in order to maximize the educational progress of each child while making efficient use of the available human, material, and financial resources within an organizational structure such as the…

Implementation of Computer Based Management Information Systems: A Behavioral Perspective.

ERIC Educational Resources Information Center

Lilly, Edward R.

In the past decade significant advances have taken place in the development of management information systems (MIS) to support managerial decision making. Recent literature has shown, however, that educators have yet to make full and efficient use of these computer-based systems. A number of authors have discussed factors that may affect…

Efficiency, Accountability, and Equity Issues in Title I Schoolwide Program Implementation. Research in Educational Productivity.

ERIC Educational Resources Information Center

Wong, Kenneth K., Ed.; Wang, Margaret C., Ed.

This collection of conference papers includes: (1) "Using Market Forces to Make Title I More Effective" (Marci Kanstoroom and Tyce Palmaffy); (2) "Making Economically Grounded Decisions about Comprehensive School Reform Models: Considerations of Costs, Effects, and Contexts" (Jennifer King Rice); (3) "Does Title I Money…

Political anticipation: observing and understanding global socio-economic trends with a view to guide the decision-making processes

NASA Astrophysics Data System (ADS)

Caillol, Marie-Hélène

2012-01-01

Political anticipation (PA), as practiced by Laboratoire Européen d'Anticipation Politique, is a method for improving the capacity to understand trends and forecast events with the aim of influencing events on a large or small scale. Our operational definition of anticipation is 'To foresee in order to act.' Intended to be efficient and of immediate use, PA is conceived as a decision-making tool for all types of decision-makers: politicians, economists, administrators, business leaders, private investors, educators, as well as heads of households. Everyone, in a professional or private role, makes important decisions (for employees, for business operations and commerce, for family, for investments, for jurisdictions, and for the country and economic zone, among other areas in which the polis is involved). Given the dynamics of reality in our times, every decision appears as a wager on the future. It is also related to the wish or desire to obtain the best outcome for risk assumed (which a wager entails) and the effort expended.

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.

Development and initial evaluation of a treatment decision dashboard

PubMed Central

2013-01-01

Background For many healthcare decisions, multiple alternatives are available with different combinations of advantages and disadvantages across several important dimensions. The complexity of current healthcare decisions thus presents a significant barrier to informed decision making, a key element of patient-centered care. Interactive decision dashboards were developed to facilitate decision making in Management, a field marked by similarly complicated choices. These dashboards utilize data visualization techniques to reduce the cognitive effort needed to evaluate decision alternatives and a non-linear flow of information that enables users to review information in a self-directed fashion. Theoretically, both of these features should facilitate informed decision making by increasing user engagement with and understanding of the decision at hand. We sought to determine if the interactive decision dashboard format can be successfully adapted to create a clinically realistic prototype patient decision aid suitable for further evaluation and refinement. Methods We created a computerized, interactive clinical decision dashboard and performed a pilot test of its clinical feasibility and acceptability using a multi-method analysis. The dashboard summarized information about the effectiveness, risks of side effects and drug-drug interactions, out-of-pocket costs, and ease of use of nine analgesic treatment options for knee osteoarthritis. Outcome evaluations included observations of how study participants utilized the dashboard, questionnaires to assess usability, acceptability, and decisional conflict, and an open-ended qualitative analysis. Results The study sample consisted of 25 volunteers - 7 men and 18 women - with an average age of 51 years. The mean time spent interacting with the dashboard was 4.6 minutes. Mean evaluation scores on scales ranging from 1 (low) to 7 (high) were: mechanical ease of use 6.1, cognitive ease of use 6.2, emotional difficulty 2.7, decision-aiding effectiveness 5.9, clarification of values 6.5, reduction in decisional uncertainty 6.1, and provision of decision-related information 6.0. Qualitative findings were similarly positive. Conclusions Interactive decision dashboards can be adapted for clinical use and have the potential to foster informed decision making. Additional research is warranted to more rigorously test the effectiveness and efficiency of patient decision dashboards for supporting informed decision making and other aspects of patient-centered care, including shared decision making. PMID:23601912

Basic physiological systems indicator's informative assessment for children and adolescents obesity diagnosis tasks

NASA Astrophysics Data System (ADS)

Marukhina, O. V.; Berestneva, O. G.; Emelyanova, Yu A.; Romanchukov, S. V.; Petrova, L.; Lombardo, C.; Kozlova, N. V.

2018-05-01

The healthcare computerization creates opportunities to the clinical decision support system development. In the course of diagnosis, doctor manipulates a considerable amount of data and makes a decision in the context of uncertainty basing upon the first-hand experience and knowledge. The situation is exacerbated by the fact that the knowledge scope in medicine is incrementally growing, but the decision-making time does not increase. The amount of medical malpractice is growing and it leads to various negative effects, even the mortality rate increase. IT-solution's development for clinical purposes is one of the most promising and efficient ways to prevent these effects. That is why the efforts of many IT specialists are directed to the doctor's heuristics simulating software or expert-based medical decision-making algorithms development. Thus, the objective of this study is to develop techniques and approaches for the body physiological system's informative value assessment index for the obesity degree evaluation based on the diagnostic findings.

Improving the cost-effectiveness of IRS with climate informed health surveillance systems

PubMed Central

Worrall, Eve; Connor, Stephen J; Thomson, Madeleine C

2008-01-01

Background This paper examines how the cost-effectiveness of IRS varies depending on the severity of transmission and level of programme coverage and how efficiency could be improved by incorporating climate information into decision making for malaria control programmes as part of an integrated Malaria Early Warning and Response System (MEWS). Methods A climate driven model of malaria transmission was used to simulate cost-effectiveness of alternative IRS coverage levels over six epidemic and non-epidemic years. Decision rules for a potential MEWS system that triggers different IRS coverage are described. The average and marginal cost per case averted with baseline IRS coverage (24%) and under varying IRS coverage levels (50%, 75% and 100%) were calculated. Results Average cost-effectiveness of 24% coverage varies dramatically between years, from US$108 per case prevented in low transmission to US$0.42 in epidemic years. Similarly for higher coverage (24–100%) cost per case prevented is far higher in low than high transmission years ($108–$267 to $0.88–$2.26). Discussion Efficiency and health benefit gains could be achieved by implementing MEWS that provides timely, accurate information. Evidence from southern Africa, (especially Botswana) supports this. Conclusion Advance knowledge of transmission severity can help managers make coverage decisions which optimise resource use and exploit efficiency gains if a fully integrated MEWS is in place alongside a health system with sufficient flexibility to modify control plans in response to information. More countries and programmes should be supported to use the best available evidence and science to integrate climate informed MEWS into decision making within malaria control programmes. PMID:19108723

Agent-based Decision Support System for the Third Generation Distributed Dynamic Decision-making (DDD-III) Simulator

DTIC Science & Technology

2004-06-01

suitable form of organizational adaptation is effective organizational diagnosis and analysis. The organizational diagnosis and analysis involve...related to the mission environment, organizational structure, and strategy is imperative for an effective and efficient organizational diagnosis . The...not easily articulated nor expressed otherwise. These displays are crucial to facilitate effective organizational diagnosis and analysis, and

Operating room managerial decision-making on the day of surgery with and without computer recommendations and status displays.

PubMed

Dexter, Franklin; Willemsen-Dunlap, Ann; Lee, John D

2007-08-01

There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text recommendations about what to do). Anesthesiologists, OR nurses, and housekeepers were given nine simulated scenarios (vignettes) involving multiple ORs to study their decision-making. Participants were randomized to one of four groups, all with an updated paper OR schedule: with/without command display and with/without passive status display. Participants making decisions without command displays performed no better than random chance in terms of increasing the predictability of work hours, reducing over-utilized OR time, and increasing OR efficiency. Status displays had no effect on these end-points, whereas command displays improved the quality of decisions. In the scenarios for which the command displays provided recommendations that adversely affected safety, participants appropriately ignored advice. Anesthesia providers and nursing staff made decisions that increased clinical work per unit time in each OR, even when doing so resulted in an increase in over-utilized OR time, higher staffing costs, unpredictable work hours, and/or mandatory overtime. Organizational culture and socialization during clinical training may be a cause. Command displays showed promise in mitigating this tendency. Additional investigations are in our companion paper.

Integrating land cover modeling and adaptive management to conserve endangered species and reduce catastrophic fire risk

USGS Publications Warehouse

Breininger, David; Duncan, Brean; Eaton, Mitchell J.; Johnson, Fred; Nichols, James

2014-01-01

Land cover modeling is used to inform land management, but most often via a two-step process, where science informs how management alternatives can influence resources, and then, decision makers can use this information to make decisions. A more efficient process is to directly integrate science and decision-making, where science allows us to learn in order to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by the specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuel monitoring with decision-making focused on the dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy; other conditions require tradeoffs between objectives. Knowledge about system responses to actions can be informed by developing hypotheses based on ideas about fire behavior and then applying competing management actions to different land units in the same system state. Monitoring and management integration is important to optimize state-specific management decisions and to increase knowledge about system responses. We believe this approach has broad utility and identifies a clear role for land cover modeling programs intended to inform decision-making.

Evidence-based health policy-making, hospital funding and health insurance.

PubMed

Palmer, G R

2000-02-07

An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-based approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various disciplines involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political assessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of evidence on the impact of policy options for improving the health status of the community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiatives shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by initiatives such as greater exposure of health professionals to educational inputs with a policy focus; increased contribution of doctors to health services research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.

Shapley value-based multi-objective data envelopment analysis application for assessing academic efficiency of university departments

NASA Astrophysics Data System (ADS)

Abing, Stephen Lloyd N.; Barton, Mercie Grace L.; Dumdum, Michael Gerard M.; Bongo, Miriam F.; Ocampo, Lanndon A.

2018-02-01

This paper adopts a modified approach of data envelopment analysis (DEA) to measure the academic efficiency of university departments. In real-world case studies, conventional DEA models often identify too many decision-making units (DMUs) as efficient. This occurs when the number of DMUs under evaluation is not large enough compared to the total number of decision variables. To overcome this limitation and reduce the number of decision variables, multi-objective data envelopment analysis (MODEA) approach previously presented in the literature is applied. The MODEA approach applies Shapley value as a cooperative game to determine the appropriate weights and efficiency score of each category of inputs. To illustrate the performance of the adopted approach, a case study is conducted in a university in the Philippines. The input variables are academic staff, non-academic staff, classrooms, laboratories, research grants, and department expenditures, while the output variables are the number of graduates and publications. The results of the case study revealed that all DMUs are inefficient. DMUs with efficiency scores close to the ideal efficiency score may be emulated by other DMUs with least efficiency scores.

Performance measures for metropolitan planning organizations.

DOT National Transportation Integrated Search

2012-04-01

Performance measurement is a topic of increasing importance to transportation agencies, as issues with : funding shortfalls and concerns about transportation system efficiency lead to a shift in how transportation : decision making is carried out. In...

Note on Professor Sizer's Paper.

ERIC Educational Resources Information Center

Balderston, Frederick E.

1979-01-01

Issues suggested by John Sizer's paper, an overview of the assessment of institutional performance, include: the efficient-frontier approach, multiple-criterion decision-making models, performance analysis approached as path analysis, and assessment of academic quality. (JMD)

e-Government for Development Information Exchange (DIE): Zambia

NASA Astrophysics Data System (ADS)

Joseph, Bwalya Kelvin

In most parts of the world, political systems which utilize authoritative rule and mostly employ top-down decision-making processes are slowly transcending towards democratic norms. Information Technology Systems have been identified and adopted as one of the most efficient vehicles for appropriate, transparent and inclusive / participatory decision making. Zambia has shown a higher propensity to indigenous knowledge systems which are full of inefficiencies, a lot of red tape in public service delivery, and prone to corrupt practices. Despite that being the case, it is slowly trying to implement e-government. The adoption of e-government promises a sharp paradigm shift where public institutions will be more responsive and transparent, promote efficient PPP (Public Private Partnerships), and empower citizens by making knowledge and other resources more directly accessible. This paper examines three cases from Zambia where ICT in support of e-government has been implemented for Development Information Exchange (DIE) - knowledge-based decision making. The paper also assesses the challenges, opportunities, and issues together with e-government adoption criteria regarding successful encapsulation of e-government into the Zambian contextual environment. I propose a conceptual model which offers balanced e-government adoption criteria involving a combination of electronic and participatory services. This conceptual e-government adoption model can later be replicated to be used at the Southern African Development Community (SADC) level given the similarity in the contextual environment.

Neuroethology of Decision-making

PubMed Central

Adams, Geoffrey K.; Watson, Karli K.; Pearson, John; Platt, Michael L.

2012-01-01

A neuroethological approach to decision-making considers the effect of evolutionary pressures on neural circuits mediating choice. In this view, decision systems are expected to enhance fitness with respect to the local environment, and particularly efficient solutions to specific problems should be conserved, expanded, and repurposed to solve other problems. Here, we discuss basic prerequisites for a variety of decision systems from this viewpoint. We focus on two of the best-studied and most widely represented decision problems. First, we examine patch leaving, a prototype of environmentally based switching between action patterns. Second, we consider social information seeking, a process resembling foraging with search costs. We argue that while the specific neural solutions to these problems sometimes differ across species, both the problems themselves and the algorithms instantiated by biological hardware are repeated widely throughout nature. The behavioral and mathematical study of ubiquitous decision processes like patch leaving and social information seeking thus provides a powerful new approach to uncovering the fundamental design structure of nervous systems. PMID:22902613

Least reliable bits coding (LRBC) for high data rate satellite communications

NASA Technical Reports Server (NTRS)

Vanderaar, Mark; Budinger, James; Wagner, Paul

1992-01-01

LRBC, a bandwidth efficient multilevel/multistage block-coded modulation technique, is analyzed. LRBC uses simple multilevel component codes that provide increased error protection on increasingly unreliable modulated bits in order to maintain an overall high code rate that increases spectral efficiency. Soft-decision multistage decoding is used to make decisions on unprotected bits through corrections made on more protected bits. Analytical expressions and tight performance bounds are used to show that LRBC can achieve increased spectral efficiency and maintain equivalent or better power efficiency compared to that of BPSK. The relative simplicity of Galois field algebra vs the Viterbi algorithm and the availability of high-speed commercial VLSI for block codes indicates that LRBC using block codes is a desirable method for high data rate implementations.

The missing link: Creating science policies that facilitate the use of research in environmental and water-related decision-making

NASA Astrophysics Data System (ADS)

Dilling, L.; Pielke, R.; Sarewitz, D.

2005-12-01

Despite all good intentions, it is clear that science intended to serve decision making needs often fails to achieve that purpose. The aftermath of Hurricane Katrina provides a recent, tragic example. The reasons for failures of science to support decision making are varied. Researchers studying forecasts of climate variability have found, for example, cases where information provided is not needed; information is needed but not provided; information lacks regional specificity; information is provided in an inaccessible form; poor communication exists between potential users and providers; there is a lack of trust in information or deliverers; institutional constraints prevent use of new information; and so on. Traditional science policies have institutionalized the separation of the conduct of science from its application and use. It is clear that as long as such a separation, reinforced by tradition, institution and culture, is the dominant paradigm of science policies, the efficient and effective use of science in environmental and water-related decision making will be hampered. We introduce here a research methodology for examining the decision making involved in setting science policies for research aimed at being useful. Based on the economic concept, the notion of "reconciling supply and demand" for information offers a framework for identifying missed opportunities where science policies can be adjusted to improve the usefulness of a given research portfolio. We present results from a case study focused on internal science policies and decision making within the Regional Integrated Sciences and Assessments (RISA) projects. The RISA program aims to "expand the range of choices available to private and public communities in a region, by...enabling practical decisions...using research-based knowledge" and so provides an excellent opportunity for harvesting lessons for creating usable science.

An information processing/associative learning account of behavioral disinhibition in externalizing psychopathology.

PubMed

Endres, Michael J; Donkin, Chris; Finn, Peter R

2014-04-01

Externalizing psychopathology (EXT) is associated with low executive working memory (EWM) capacity and problems with inhibitory control and decision-making; however, the specific cognitive processes underlying these problems are not well known. This study used a linear ballistic accumulator computational model of go/no-go associative-incentive learning conducted with and without a working memory (WM) load to investigate these cognitive processes in 510 young adults varying in EXT (lifetime problems with substance use, conduct disorder, ADHD, adult antisocial behavior). High scores on an EXT factor were associated with low EWM capacity and higher scores on a latent variable reflecting the cognitive processes underlying disinhibited decision-making (more false alarms, faster evidence accumulation rates for false alarms [vFA], and lower scores on a Response Precision Index [RPI] measure of information processing efficiency). The WM load increased disinhibited decision-making, decisional uncertainty, and response caution for all subjects. Higher EWM capacity was associated with lower scores on the latent disinhibited decision-making variable (lower false alarms, lower vFAs and RPI scores) in both WM load conditions. EWM capacity partially mediated the association between EXT and disinhibited decision-making under no-WM load, and completely mediated this association under WM load. The results underline the role that EWM has in associative-incentive go/no-go learning and indicate that common to numerous types of EXT are impairments in the cognitive processes associated with the evidence accumulation-evaluation-decision process. PsycINFO Database Record (c) 2014 APA, all rights reserved.

An information processing/associative learning account of behavioral disinhibition in externalizing psychopathology

PubMed Central

Endres, Michael J.; Donkin, Chris; Finn, Peter R.

2014-01-01

Externalizing psychopathology (EXT) is associated with low executive working memory (EWM) capacity and problems with inhibitory control and decision-making; however, the specific cognitive processes underlying these problems are not well known. This study used a linear ballistic accumulator computational model of go/no-go associative-incentive learning conducted with and without a working memory (WM) load to investigate these cognitive processes in 510 young adults varying in EXT (lifetime problems with substance use, conduct disorder, ADHD, adult antisocial behavior). High scores on an EXT factor were associated with low EWM capacity and higher scores on a latent variable reflecting the cognitive processes underlying disinhibited decision making (more false alarms, faster evidence accumulation rates for false alarms (vFA), and lower scores on a Response Precision Index (RPI) measure of information processing efficiency). The WM load increased disinhibited decision making, decisional uncertainty, and response caution for all subjects. Higher EWM capacity was associated with lower scores on the latent disinhibited decision making variable (lower false alarms, lower vFAs and RPI scores) in both WM load conditions. EWM capacity partially mediated the association between EXT and disinhibited decision making under no-WM load, and completely mediated this association under WM load. The results underline the role that EWM has in associative – incentive go/no-go learning and indicate that common to numerous types of EXT are impairments in the cognitive processes associated with the evidence accumulation – evaluation – decision process. PMID:24611834

Higher Trait Psychopathy Is Associated with Increased Risky Decision-Making and Less Coincident Insula and Striatal Activity

PubMed Central

Sutherland, Matthew T.; Fishbein, Diana H.

2017-01-01

Higher trait levels of psychopathy have been associated with both a tendency to maintain disadvantageous decision-making strategies and aberrant cortico-limbic neural activity. To explore the neural mechanisms associated with the psychopathy-related propensity to continue selecting risky choices, a non-forensic sample of participants completed a self-report psychopathy questionnaire and two runs of a risky decision-making task during H215O positron emission tomography (PET) scanning. In this secondary data analysis study, we leveraged data previously collected to examine the impact of previous drug use on risky decision-making to explore the relations between self-reported psychopathy and behavioral and brain metrics during performance of the Cambridge Decision-Making Task (CDMT), in which volunteers chose between small/likely or large/unlikely potential reward outcomes. Behaviorally, we observed that psychopathy scores were differentially correlated with the percent of risky decisions made in run 1 vs. run 2 of the task. Specifically, higher levels of psychopathy, above and beyond that attributable to drug use or sex, were associated with greater tendencies to make risky selections only in the second half (run 2) of the task. In parallel, psychopathy scores negatively correlated with regional cerebral blood flow (rCBF) in the right insula and right ventral striatum during run 2 of the CDMT. These exploratory outcomes suggest that greater levels of psychopathy may be associated with an inability to translate experience with negative outcomes into behavioral adaptations possibly due to decreased neural efficiency in regions related to somatic and/or reward feedback processes. PMID:29311863

Health technology assessment and primary data collection for reducing uncertainty in decision making.

PubMed

Goeree, Ron; Levin, Les; Chandra, Kiran; Bowen, James M; Blackhouse, Gord; Tarride, Jean-Eric; Burke, Natasha; Bischof, Matthias; Xie, Feng; O'Reilly, Daria

2009-05-01

Health care expenditures continue to escalate, and pressures for increased spending will continue. Health care decision makers from publicly financed systems, private insurance companies, or even from individual health care institutions, will continue to be faced with making difficult purchasing, access, and reimbursement decisions. As a result, decision makers are increasingly turning to evidence-based platforms to help control costs and make the most efficient use of existing resources. Most tools used to assist with evidence-based decision making focus on clinical outcomes. Health technology assessment (HTA) is increasing in popularity because it also considers other factors important for decision making, such as cost, social and ethical values, legal issues, and factors such as the feasibility of implementation. In some jurisdictions, HTAs have also been supplemented with primary data collection to help address uncertainty that may still exist after conducting a traditional HTA. The HTA process adopted in Ontario, Canada, is unique in that assessments are also made to determine what primary data research should be conducted and what should be collected in these studies. In this article, concerns with the traditional HTA process are discussed, followed by a description of the HTA process that has been established in Ontario, with a particular focus on the data collection program followed by the Programs for Assessment of Technology in Health Research Institute. An illustrative example is used to show how the Ontario HTA process works and the role value of information analyses plays in addressing decision uncertainty, determining research feasibility, and determining study data collection needs.

Nurse Managers' Decisions: Fast and Favoring Remediation

PubMed Central

Effken, Judith A.; Verran, Joyce A.; Logue, Melanie D.; Hsu, Ya-Chuan

2010-01-01

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically, systematically and efficiently, while encouraging consideration of more alternatives to reach targeted goals. PMID:20305465

Leveraging business intelligence to make better decisions: Part I.

PubMed

Reimers, Mona

2014-01-01

Data is the new currency. Business intelligence tools will provide better performing practices with a competitive intelligence advantage that will separate the high performers from the rest of the pack. Given the investments of time and money into our data systems, practice leaders must work to take every advantage and look at the datasets as a potential goldmine of business intelligence decision tools. A fresh look at decision tools created from practice data will create efficiencies and improve effectiveness for end-users and managers.

[Ethical principles and approaches to health systems governance research: conceptual and methodological implications].

PubMed

Flores, Walter

2010-01-01

Governance refers to decision-making processes in which power relationships and actors and institutions' particular interests converge. Situations of consensus and conflict are inherent to such processes. Furthermore, decision-making happens within a framework of ethical principles, motivations and incentives which could be explicit or implicit. Health systems in most Latin-American and Caribbean countries take the principles of equity, solidarity, social participation and the right to health as their guiding principles; such principles must thus rule governance processes. However, this is not always the case and this is where the importance of investigating governance in health systems lies. Making advances in investigating governance involves conceptual and methodological implications. Clarifying and integrating normative and analytical approaches is relevant at conceptual level as both are necessary for an approach seeking to investigate and understand social phenomena's complexity. In relation to methodological level, there is a need to expand the range of variables, sources of information and indicators for studying decision-making aimed to greater equity, health citizenship and public policy efficiency.

Logics of pre-merger decision-making processes: the case of Karolinska University Hospital.

PubMed

Choi, Soki; Brommels, Mats

2009-01-01

The purpose of this paper is to examine how and why a decision to merge two university hospitals in a public context might occur by using an in-depth case study of the pre-merger process of Karolinska University Hospital. Based on extensive document analysis and 35 key informant interviews the paper reconstructed the pre-merger process, searched for empirical patterns, and interpreted those by applying neo-institutional theory. Spanning nearly a decade, the pre-merger process goes from idea generation through transition to decision, and took place on two arenas, political, and scientific. Both research excellence and economic efficiency are stated merger motives. By applying a neo-institutional perspective, the paper finds that the two initial phases are driven by decision rationality, which is typical for political organizations and that the final phase demonstrated action rationality, which is typical for private firms. Critical factors behind this radical change of decision logic are means convergence, uniting key stakeholder groups, and an economic and political crisis, triggering critical incidents, which ultimately legitimized the formal decision. It is evident from the paper that merger decisions in the public sector might not necessarily result from stated and/or economic drivers only. This paper suggests that a change of decision logic from decision to action rationality might promote effective decision making on large and complex issues in a public context. This is the first systematic in-depth study of a university hospital merger employing a decision-making perspective.

Abstraction of an Affective-Cognitive Decision Making Model Based on Simulated Behaviour and Perception Chains

NASA Astrophysics Data System (ADS)

Sharpanskykh, Alexei; Treur, Jan

Employing rich internal agent models of actors in large-scale socio-technical systems often results in scalability issues. The problem addressed in this paper is how to improve computational properties of a complex internal agent model, while preserving its behavioral properties. The problem is addressed for the case of an existing affective-cognitive decision making model instantiated for an emergency scenario. For this internal decision model an abstracted behavioral agent model is obtained, which ensures a substantial increase of the computational efficiency at the cost of approximately 1% behavioural error. The abstraction technique used can be applied to a wide range of internal agent models with loops, for example, involving mutual affective-cognitive interactions.

[Basic principles and methodological considerations of health economic evaluations].

PubMed

Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

2011-01-01

Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

Presenting Germany's drug pricing rule as a cost-per-QALY rule.

PubMed

Gandjour, Afschin

2012-06-01

In Germany, the Institute for Quality and Efficiency in Health Care (IQWiG) makes recommendations for ceiling prices of drugs based on an evaluation of the relationship between costs and effectiveness. To set ceiling prices, IQWiG uses the following decision rule: the incremental cost-effectiveness ratio of a new drug compared with the next effective intervention should not be higher than that of the next effective intervention compared to its comparator. The purpose of this paper is to show that IQWiG's decision rule can be presented as a cost-per-QALY rule by using equity-weighted QALYs. This transformation shows where both rules share commonalities. Furthermore, it makes the underlying ethical implications of IQWiG's decision rule transparent and open to debate.

Ecological models supporting environmental decision making: a strategy for the future

USGS Publications Warehouse

Schmolke, Amelie; Thorbek, Pernille; DeAngelis, Donald L.; Grimm, Volker

2010-01-01

Ecological models are important for environmental decision support because they allow the consequences of alternative policies and management scenarios to be explored. However, current modeling practice is unsatisfactory. A literature review shows that the elements of good modeling practice have long been identified but are widely ignored. The reasons for this might include lack of involvement of decision makers, lack of incentives for modelers to follow good practice, and the use of inconsistent terminologies. As a strategy for the future, we propose a standard format for documenting models and their analyses: transparent and comprehensive ecological modeling (TRACE) documentation. This standard format will disclose all parts of the modeling process to scrutiny and make modeling itself more efficient and coherent.

Clinical decision rules, spinal pain classification and prediction of treatment outcome: A discussion of recent reports in the rehabilitation literature

PubMed Central

2012-01-01

Clinical decision rules are an increasingly common presence in the biomedical literature and represent one strategy of enhancing clinical-decision making with the goal of improving the efficiency and effectiveness of healthcare delivery. In the context of rehabilitation research, clinical decision rules have been predominantly aimed at classifying patients by predicting their treatment response to specific therapies. Traditionally, recommendations for developing clinical decision rules propose a multistep process (derivation, validation, impact analysis) using defined methodology. Research efforts aimed at developing a “diagnosis-based clinical decision rule” have departed from this convention. Recent publications in this line of research have used the modified terminology “diagnosis-based clinical decision guide.” Modifications to terminology and methodology surrounding clinical decision rules can make it more difficult for clinicians to recognize the level of evidence associated with a decision rule and understand how this evidence should be implemented to inform patient care. We provide a brief overview of clinical decision rule development in the context of the rehabilitation literature and two specific papers recently published in Chiropractic and Manual Therapies. PMID:22726639

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

NASA Technical Reports Server (NTRS)

Sankararaman, Shankar; Teubert, Christopher

2017-01-01

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

From Data to Improved Decisions: Operations Research in Healthcare Delivery.

PubMed

Capan, Muge; Khojandi, Anahita; Denton, Brian T; Williams, Kimberly D; Ayer, Turgay; Chhatwal, Jagpreet; Kurt, Murat; Lobo, Jennifer Mason; Roberts, Mark S; Zaric, Greg; Zhang, Shengfan; Schwartz, J Sanford

2017-11-01

The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems. Decision making is the process of choosing between possible solutions to a problem with respect to certain metrics. OR concepts can help systematically improve decision making through efficient modeling techniques while accounting for relevant constraints. Depending on the problem, methods that are part of OR (e.g., linear programming, Markov Decision Processes) or methods that are derived from related fields (e.g., regression from statistics) can be incorporated into the solution approach. This paper highlights the characteristics of different OR methods that have been applied to healthcare decision making and provides examples of emerging research opportunities. We illustrate OR applications in healthcare using previous studies, including diagnosis and treatment of diseases, organ transplants, and patient flow decisions. Further, we provide a selection of emerging areas for utilizing OR. There is a timely need to inform practitioners and policy makers of the benefits of using OR techniques in solving healthcare problems. OR methods can support the development of sustainable long-term solutions across disease management, service delivery, and health policies by optimizing the performance of system elements and analyzing their interaction while considering relevant constraints.

Making the Best Use of Student Trustees

ERIC Educational Resources Information Center

Alvarez-Breckenridge, Christopher

2010-01-01

Campuses with student trustees often see them as both an efficient way to get a student perspective on issues the board is dealing with and a way to use student trustees' active engagement with student organizations to explain board and administrative decisions to the student body. To maximize the contributions a student member can make on the…

75 FR 47269 - Pilot Program for Waiver of Patent Owner's Statement in Ex Parte Reexamination Proceedings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-05

... expected to form a portion of the data used in the decision making processes in phases II and III. Dated... likely to improve efficiency. Such changes may include internal procedural changes, rule making that... notice will take effect on August 5, 2010. FOR FURTHER INFORMATION CONTACT: Robert A. Clarke, Kenneth M...

Surrogate biochemical markers: precise measurement for strategic drug and biologics development.

PubMed

Lee, J W; Hulse, J D; Colburn, W A

1995-05-01

More efficient drug and biologics development is necessary for future success of pharmaceutical and biotechnology companies. One way to achieve this objective is to use rationally selected surrogate markers to improve the early decision-making process. Using typical clinical chemistry methods to measure biochemical markers may not ensure adequate precision and reproducibility. In contrast, using analytical methods that meet good laboratory practices along with rational selection and validation of biochemical markers can give those who use them a competitive advantage over those who do not by providing meaningful data for earlier decision making.

Mobility Data Analytics Center.

DOT National Transportation Integrated Search

2016-01-01

Mobility Data Analytics Center aims at building a centralized data engine to efficiently manipulate : large-scale data for smart decision making. Integrating and learning the massive data are the key to : the data engine. The ultimate goal of underst...

Getting What You Don't Pay For.

ERIC Educational Resources Information Center

Edds, Daniel B.

1997-01-01

Describes the use of the charge-back system to foster better financial decision making, organizational efficiency, and waste prevention. Discusses an example of the charge-back system in reducing copying costs, including charging criteria. (GR)

Multimodal Logistics Network Design over Planning Horizon through a Hybrid Meta-Heuristic Approach

NASA Astrophysics Data System (ADS)

Shimizu, Yoshiaki; Yamazaki, Yoshihiro; Wada, Takeshi

Logistics has been acknowledged increasingly as a key issue of supply chain management to improve business efficiency under global competition and diversified customer demands. This study aims at improving a quality of strategic decision making associated with dynamic natures in logistics network optimization. Especially, noticing an importance to concern with a multimodal logistics under multiterms, we have extended a previous approach termed hybrid tabu search (HybTS). The attempt intends to deploy a strategic planning more concretely so that the strategic plan can link to an operational decision making. The idea refers to a smart extension of the HybTS to solve a dynamic mixed integer programming problem. It is a two-level iterative method composed of a sophisticated tabu search for the location problem at the upper level and a graph algorithm for the route selection at the lower level. To keep efficiency while coping with the resulting extremely large-scale problem, we invented a systematic procedure to transform the original linear program at the lower-level into a minimum cost flow problem solvable by the graph algorithm. Through numerical experiments, we verified the proposed method outperformed the commercial software. The results indicate the proposed approach can make the conventional strategic decision much more practical and is promising for real world applications.

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach.

PubMed

Si, Sheng-Li; You, Xiao-Yue; Liu, Hu-Chen; Huang, Jia

2017-08-19

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that "accidents/adverse events", "nosocomial infection", ''incidents/errors", "number of operations/procedures" are significant influential indicators. Also, the indicators of "length of stay", "bed occupancy" and "financial measures" play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions.

Quantifying Energy and Water Savings in the U.S. Residential Sector.

PubMed

Chini, Christopher M; Schreiber, Kelsey L; Barker, Zachary A; Stillwell, Ashlynn S

2016-09-06

Stress on water and energy utilities, including natural resource depletion, infrastructure deterioration, and growing populations, threatens the ability to provide reliable and sustainable service. This study presents a demand-side management decision-making tool to evaluate energy and water efficiency opportunities at the residential level, including both direct and indirect consumption. The energy-water nexus accounts for indirect resource consumption, including water-for-energy and energy-for-water. We examine the relationship between water and energy in common household appliances and fixtures, comparing baseline appliances to ENERGY STAR or WaterSense appliances, using a cost abatement analysis for the average U.S. household, yielding a potential annual per household savings of 7600 kWh and 39 600 gallons, with most upgrades having negative abatement cost. We refine the national average cost abatement curves to understand regional relationships, specifically for the urban environments of Los Angeles, Chicago, and New York. Cost abatement curves display per unit cost savings related to overall direct and indirect energy and water efficiency, allowing utilities, policy makers, and homeowners to consider the relationship between energy and water when making decisions. Our research fills an important gap of the energy-water nexus in a residential unit and provides a decision making tool for policy initiatives.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

Rational decision making in a wide scenario of different minimally invasive lumbar interbody fusion approaches and devices.

PubMed

Pimenta, Luiz; Tohmeh, Antoine; Jones, David; Amaral, Rodrigo; Marchi, Luis; Oliveira, Leonardo; Pittman, Bruce C; Bae, Hyun

2018-03-01

With the proliferation of a variety of modern MIS spine surgery procedures, it is mandatory that the surgeon dominate all aspects involved in surgical indication. The information related to the decision making in patient selection for specific procedures is mandatory for surgical success. The objective of this study is to present decision-making criteria in minimally invasive surgery (MIS) selection for a variety of patients and pathologies. In this article, practicing surgeons who specialize in various MIS approaches for spinal fusion were engaged to provide expert opinion and literature review on decision making criteria for several MIS procedures. Pros, cons, relative limitations, and case examples are provided for patient selection in treatment with MIS posterolateral fusion (MIS-PLF), mini anterior lumbar interbody fusion (mini-ALIF), lateral interbody fusion (LLIF), MIS posterior lumbar interbody fusion (MIS-PLIF) and MIS transforaminal lumbar interbody fusion (MIS-TLIF). There is a variety of aspects to consider when deciding which modern MIS surgical approach is most appropriate to use based on patient and pathologic characteristics. The surgeon must adapt them to the characteristic of each type of patients, helping them to choose the most effective and efficient therapeutic option for each case.

Apply creative thinking of decision support in electrical nursing record.

PubMed

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

2006-01-01

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

Decentralized Opportunistic Spectrum Resources Access Model and Algorithm toward Cooperative Ad-Hoc Networks.

PubMed

Liu, Ming; Xu, Yang; Mohammed, Abdul-Wahid

2016-01-01

Limited communication resources have gradually become a critical factor toward efficiency of decentralized large scale multi-agent coordination when both system scales up and tasks become more complex. In current researches, due to the agent's limited communication and observational capability, an agent in a decentralized setting can only choose a part of channels to access, but cannot perceive or share global information. Each agent's cooperative decision is based on the partial observation of the system state, and as such, uncertainty in the communication network is unavoidable. In this situation, it is a major challenge working out cooperative decision-making under uncertainty with only a partial observation of the environment. In this paper, we propose a decentralized approach that allows agents cooperatively search and independently choose channels. The key to our design is to build an up-to-date observation for each agent's view so that a local decision model is achievable in a large scale team coordination. We simplify the Dec-POMDP model problem, and each agent can jointly work out its communication policy in order to improve its local decision utilities for the choice of communication resources. Finally, we discuss an implicate resource competition game, and show that, there exists an approximate resources access tradeoff balance between agents. Based on this discovery, the tradeoff between real-time decision-making and the efficiency of cooperation using these channels can be well improved.

Buying and Using Tomorrow's Computers in Today's Tertiary Institutions.

ERIC Educational Resources Information Center

Sungalia, Helen

1980-01-01

Higher-education administrators are alerted to the advent of the microprocessor and the capabilities of desk computers. The potential use of the microcomputer in administrative decision making, efficiency, and resource allocation are reviewed briefly. (MSE)

Clinic Workflow Simulations using Secondary EHR Data

PubMed Central

Hribar, Michelle R.; Biermann, David; Read-Brown, Sarah; Reznick, Leah; Lombardi, Lorinna; Parikh, Mansi; Chamberlain, Winston; Yackel, Thomas R.; Chiang, Michael F.

2016-01-01

Clinicians today face increased patient loads, decreased reimbursements and potential negative productivity impacts of using electronic health records (EHR), but have little guidance on how to improve clinic efficiency. Discrete event simulation models are powerful tools for evaluating clinical workflow and improving efficiency, particularly when they are built from secondary EHR timing data. The purpose of this study is to demonstrate that these simulation models can be used for resource allocation decision making as well as for evaluating novel scheduling strategies in outpatient ophthalmology clinics. Key findings from this study are that: 1) secondary use of EHR timestamp data in simulation models represents clinic workflow, 2) simulations provide insight into the best allocation of resources in a clinic, 3) simulations provide critical information for schedule creation and decision making by clinic managers, and 4) simulation models built from EHR data are potentially generalizable. PMID:28269861

Leadership as an Emergent Feature in Social Organizations: Insights from A Laboratory Simulation Experiment.

PubMed

Curral, Luis; Marques-Quinteiro, Pedro; Gomes, Catarina; Lind, Pedro G

2016-01-01

Recent theoretical contributions have suggested a theory of leadership that is grounded in complexity theory, hence regarding leadership as a complex process (i.e., nonlinear; emergent). This article tests if complexity leadership theory promotes efficiency in work groups. 40 groups of five participants each had to complete four decision making tasks using the city simulation game SimCity4. Before engaging in the four decision making tasks, participants received information regarding what sort of leadership behaviors were more adequate to help them perform better. Results suggest that if complexity leadership theory is applied, groups can achieve higher efficiency over time, when compared with other groups where complexity leadership is not applied. This study goes beyond traditional views of leadership as a centralized form of control, and presents new evidence suggesting that leadership is a collective and emergent phenomenon, anchored in simple rules of behavior.

Leadership as an Emergent Feature in Social Organizations: Insights from A Laboratory Simulation Experiment

PubMed Central

Marques-Quinteiro, Pedro; Gomes, Catarina; Lind, Pedro G.

2016-01-01

Recent theoretical contributions have suggested a theory of leadership that is grounded in complexity theory, hence regarding leadership as a complex process (i.e., nonlinear; emergent). This article tests if complexity leadership theory promotes efficiency in work groups. 40 groups of five participants each had to complete four decision making tasks using the city simulation game SimCity4. Before engaging in the four decision making tasks, participants received information regarding what sort of leadership behaviors were more adequate to help them perform better. Results suggest that if complexity leadership theory is applied, groups can achieve higher efficiency over time, when compared with other groups where complexity leadership is not applied. This study goes beyond traditional views of leadership as a centralized form of control, and presents new evidence suggesting that leadership is a collective and emergent phenomenon, anchored in simple rules of behavior. PMID:27973596

An integrative multi-criteria decision making techniques for supplier evaluation problem with its application

NASA Astrophysics Data System (ADS)

Fatrias, D.; Kamil, I.; Meilani, D.

2018-03-01

Coordinating business operation with suppliers becomes increasingly important to survive and prosper under the dynamic business environment. A good partnership with suppliers not only increase efficiency, but also strengthen corporate competitiveness. Associated with such concern, this study aims to develop a practical approach of multi-criteria supplier evaluation using combined methods of Taguchi loss function (TLF), best-worst method (BWM) and VIse Kriterijumska Optimizacija kompromisno Resenje (VIKOR). A new framework of integrative approach adopting these methods is our main contribution for supplier evaluation in literature. In this integrated approach, a compromised supplier ranking list based on the loss score of suppliers is obtained using efficient steps of a pairwise comparison based decision making process. Implemetation to the case problem with real data from crumb rubber industry shows the usefulness of the proposed approach. Finally, a suitable managerial implication is presented.

Automation Bias: Decision Making and Performance in High-Tech Cockpits

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.; Skitka, Linda J.; Heers, Susan; Burdick, Mark; Rosekind, Mark R. (Technical Monitor)

1997-01-01

Automated aids and decision support tools are rapidly becoming indispensible tools in high-technology cockpits, and are assuming increasing control of "cognitive" flight tasks, such as calculating fuel-efficient routes, navigating, or detecting and diagnosing system malfunctions and abnormalities. This study was designed to investigate "automation bias," a recently documented factor in the use of automated aids and decision support systems. The term refers to omission and commission errors resulting from the use of automated cues as a heuristic replacement for vigilant information seeking and processing. Glass-cockpit pilots flew flight scenarios involving automation "events," or opportunities for automation-related omission and commission errors. Pilots who perceived themselves as "accountable" for their performance and strategies of interaction with the automation were more likely to double-check automated functioning against other cues, and less likely to commit errors. Pilots were also likely to erroneously "remember" the presence of expected cues when describing their decision-making processes.

The holy grail of soil metal contamination site assessment: reducing risk and increasing confidence of decision making using infield portable X-ray Fluorescence (pXRF) technology

NASA Astrophysics Data System (ADS)

Rouillon, M.; Taylor, M. P.; Dong, C.

2016-12-01

This research assesses the advantages of integrating field portable X-ray Fluorescence (pXRF) technology for reducing the risk and increase confidence of decision making for metal-contaminated site assessments. Metal-contaminated sites are often highly heterogeneous and require a high sampling density to accurately characterize the distribution and concentration of contaminants. The current regulatory assessment approaches rely on a small number of samples processed using standard wet-chemistry methods. In New South Wales (NSW), Australia, the current notification trigger for characterizing metal-contaminated sites require the upper 95% confidence interval of the site mean to equal or exceed the relevant guidelines. The method's low `minimum' sampling requirements can misclassify sites due to the heterogeneous nature of soil contamination, leading to inaccurate decision making. To address this issue, we propose integrating infield pXRF analysis with the established sampling method to overcome sampling limitations. This approach increases the minimum sampling resolution and reduces the 95% CI of the site mean. Infield pXRF analysis at contamination hotspots enhances sample resolution efficiently and without the need to return to the site. In this study, the current and proposed pXRF site assessment methods are compared at five heterogeneous metal-contaminated sites by analysing the spatial distribution of contaminants, 95% confidence intervals of site means, and the sampling and analysis uncertainty associated with each method. Finally, an analysis of costs associated with both the current and proposed methods is presented to demonstrate the advantages of incorporating pXRF into metal-contaminated site assessments. The data shows that pXRF integrated site assessments allows for faster, cost-efficient, characterisation of metal-contaminated sites with greater confidence for decision making.

Getting Started with Data Warehousing: The First in a Series on How to Manage Data Efficiently

ERIC Educational Resources Information Center

Mills, Lane B.

2008-01-01

These days, "data-driven decision making" is on every school district's buzzword bingo game board. Accountability pressures and lean budgets make translating data into information a major focus of school systems that are trying to improve district outcomes in all areas. As such, data warehousing has become an essential district tool. Historically…

Quality evaluation of portal sites in health system, as a tool for education and learning.

PubMed

Hejazi, Sayed Mehdi; Sarmadi, Sima

2013-01-01

The main objective of creating a portal is to make information service available for users who need them for performance of duties and responsibilities regardless of the sources. This article is attempted to consider the parameters that can evaluate these sites since these criteria can be effective in designing and implementing such portals. On the other hand, portal sites in health systems of every country make it possible for leaders, policy makers, and directors to system education as a tool for new learning technologies. One of the main decisions each manager has to make is precise selection of appropriate portal sites. This is a descriptive and qualitative study. The research sample was 53 computer professional working in the area of computer programming and design. In the first part of the study a questionnaire was send to the participants and in the second part of the study based on their response to the questionnaire the participant was interviewed and the main themes of the studies were formulated. The validity and the reliability of the questionnaire were confirmed. The study results were summarized in 10 themes and 50 sub-categories. The main themes included were portal requirements, security, management, and efficiency, user friendliness, built-in applications, portal flexibility, interoperability, and support systems. Portal sites in any education systems make it possible for health system leaders and policy makers to manage their organization information system efficiently and effectively. One of the major decisions each manager has to make is precise selection of an appropriate portal sites design and development. The themes and sub-categories of this study could help health system managers and policy makers and information technology professionals to make appropriate decisions regarding portal design and development.

Healthy eating decisions require efficient dietary self-control in children: A mouse-tracking food decision study.

PubMed

Ha, Oh-Ryeong; Bruce, Amanda S; Pruitt, Stephen W; Cherry, J Bradley C; Smith, T Ryan; Burkart, Dominic; Bruce, Jared M; Lim, Seung-Lark

2016-10-01

Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions. Published by Elsevier Ltd.

Environmental change challenges decision-making during post-market environmental monitoring of transgenic crops.

PubMed

Sanvido, Olivier; Romeis, Jörg; Bigler, Franz

2011-12-01

The ability to decide what kind of environmental changes observed during post-market environmental monitoring of genetically modified (GM) crops represent environmental harm is an essential part of most legal frameworks regulating the commercial release of GM crops into the environment. Among others, such decisions are necessary to initiate remedial measures or to sustain claims of redress linked to environmental liability. Given that consensus on criteria to evaluate 'environmental harm' has not yet been found, there are a number of challenges for risk managers when interpreting GM crop monitoring data for environmental decision-making. In the present paper, we argue that the challenges in decision-making have four main causes. The first three causes relate to scientific data collection and analysis, which have methodological limits. The forth cause concerns scientific data evaluation, which is controversial among the different stakeholders involved in the debate on potential impacts of GM crops on the environment. This results in controversy how the effects of GM crops should be valued and what constitutes environmental harm. This controversy may influence decision-making about triggering corrective actions by regulators. We analyse all four challenges and propose potential strategies for addressing them. We conclude that environmental monitoring has its limits in reducing uncertainties remaining from the environmental risk assessment prior to market approval. We argue that remaining uncertainties related to adverse environmental effects of GM crops would probably be assessed in a more efficient and rigorous way during pre-market risk assessment. Risk managers should acknowledge the limits of environmental monitoring programmes as a tool for decision-making.

An integrated theory of attention and decision making in visual signal detection.

PubMed

Smith, Philip L; Ratcliff, Roger

2009-04-01

The simplest attentional task, detecting a cued stimulus in an otherwise empty visual field, produces complex patterns of performance. Attentional cues interact with backward masks and with spatial uncertainty, and there is a dissociation in the effects of these variables on accuracy and on response time. A computational theory of performance in this task is described. The theory links visual encoding, masking, spatial attention, visual short-term memory (VSTM), and perceptual decision making in an integrated dynamic framework. The theory assumes that decisions are made by a diffusion process driven by a neurally plausible, shunting VSTM. The VSTM trace encodes the transient outputs of early visual filters in a durable form that is preserved for the time needed to make a decision. Attention increases the efficiency of VSTM encoding, either by increasing the rate of trace formation or by reducing the delay before trace formation begins. The theory provides a detailed, quantitative account of attentional effects in spatial cuing tasks at the level of response accuracy and the response time distributions. (c) 2009 APA, all rights reserved

Implementing shared decision-making: consider all the consequences.

PubMed

Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah

2016-08-08

The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences. To date, many more studies have evaluated patient decision aids rather than other approaches to shared decision-making, and the outcomes measured have typically been focused on short-term cognitive and affective outcomes, for example knowledge and decisional conflict. From a clinicians perspective, the shared decision-making process could be viewed as either intrinsically rewarding and protective, or burdensome and impractical, yet studies have not focused on the impact on professionals, either positive or negative. At interactional levels, group, team, and microsystem, the potential long-term consequences could include the development of a culture where deliberation and collaboration are regarded as guiding principles, where patients are coached to assess the value of interventions, to trade-off benefits versus harms, and assess their burdens-in short, to new social norms in the clinical workplace. At organizational levels, consistent shared decision-making might boost patient experience evaluations and lead to fewer complaints and legal challenges. In the long-term, shared decision-making might lead to changes in resource utilization, perhaps to reductions in cost, and to modification of workforce composition. Despite the gradual shift to value-based payment, some organizations, motivated by continued income derived from achieving high volumes of procedures and contacts, will see this as a negative consequence. We suggest that a broader conceptualization and measurement of shared decision-making would provide a more substantive evidence base to guide implementation. We outline a framework which illustrates a hypothesized set of proximal, distal, and distant consequences that might occur if collaboration and deliberation could be achieved routinely, proposing that well-informed preference-based patient decisions might lead to safer, more cost-effective healthcare, which in turn might result in reduced utilization rates and improved health outcomes.

Reexamining our bias against heuristics.

PubMed

McLaughlin, Kevin; Eva, Kevin W; Norman, Geoff R

2014-08-01

Using heuristics offers several cognitive advantages, such as increased speed and reduced effort when making decisions, in addition to allowing us to make decision in situations where missing data do not allow for formal reasoning. But the traditional view of heuristics is that they trade accuracy for efficiency. Here the authors discuss sources of bias in the literature implicating the use of heuristics in diagnostic error and highlight the fact that there are also data suggesting that under certain circumstances using heuristics may lead to better decisions that formal analysis. They suggest that diagnostic error is frequently misattributed to the use of heuristics and propose an alternative view whereby content knowledge is the root cause of diagnostic performance and heuristics lie on the causal pathway between knowledge and diagnostic error or success.

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

NASA Astrophysics Data System (ADS)

Andreu, J.; Capilla, J.; Sanchís, E.

1996-04-01

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

Asset management inventory and data collection.

DOT National Transportation Integrated Search

2009-10-01

An efficient and accurate inventory of a state highway agencys assets, along with the means to assess the condition : of those assets and model their performance, is critical to enabling an agency to make informed investment decisions : in a Trans...

Decision-making tools for distribution networks in disaster relief.

DOT National Transportation Integrated Search

2011-08-05

The devastation caused by the 2010 earthquake in Haiti was compounded by the significant logistical : challenges of distributing relief to those in need. Unfortunately this is the case with many disasters. : Rapid and efficient distribution of water,...

Freight Matters: Trucking Industry Guide to Freight and Intermodal Planning Under ISTEA

DOT National Transportation Integrated Search

1993-11-01

The Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA) has changed the rules of the transportation decision-making game. Previously narrow, restrictive funding categories have been collapsed into a few broad, flexible programs, and stat...

Benchmarking--Measuring and Comparing for Continuous Improvement.

ERIC Educational Resources Information Center

Henczel, Sue

2002-01-01

Discussion of benchmarking focuses on the use of internal and external benchmarking by special librarians. Highlights include defining types of benchmarking; historical development; benefits, including efficiency, improved performance, increased competitiveness, and better decision making; problems, including inappropriate adaptation; developing a…

Fronting Integrated Scientific Web Applications: Design Features and Benefits for Regulatory Environments

EPA Science Inventory

Integrated decision support systems for regulatory applications benefit from standardindustry practices such as code reuse, test-driven development, and modularization. Theseapproaches make meeting the federal government’s goals of transparency, efficiency, and quality assurance ...

Barriers to electric energy efficiency in Ghana

NASA Astrophysics Data System (ADS)

Berko, Joseph Kofi, Jr.

Development advocates argue that sustainable development strategies are the best means to permanently improve living standards in developing countries. Advocates' arguments are based on the technical, financial, and environmental advantages of sustainable development. However, they have not addressed the organizational and administrative decision-making issues which are key to successful implementation of sustainable development in developing countries. Using the Ghanaian electricity industry as a case study, this dissertation identifies and analyzes organizational structures, administrative mechanisms, and decision-maker viewpoints that critically affect the success of adoption and implementation of energy efficiency within a sustainable development framework. Utilizing semi-structured interviews in field research, decision-makers' perceptions of the pattern of the industry's development, causes of the electricity supply shortfall, and barriers to electricity-use efficiency were identified. Based on the initial findings, the study formulated a set of policy initiatives to establish support for energy use efficiency. In a second set of interviews, these policy suggestions were presented to some of the top decision-makers to elicit their reactions. According to the decision-makers, the electricity supply shortfall is due to rapid urbanization and increased industrial consumption as a result of the structural adjustment program, rural electrification, and the sudden release of suppressed loads. The study found a lack of initiative and collaboration among industry decision-makers, and a related divergence in decision-makers' concerns and viewpoints. Also, lacking are institutional support systems and knowledge of proven energy efficiency strategies and technologies. As a result, planning, and even the range of perceived solutions to choose from are supply-side oriented. The final chapter of the study presents implications of its findings and proposes that any implementation strategy will have to address the different decision-makers' concerns and viewpoints. These include the need for national policies to promote electric energy efficiency and institutional development to provide support, guidance and direction to an energy efficiency effort. It also proposes structural changes within the industry to reduce government influence by creating an independent regulatory board. Finally, it proposes the adoption of integrated resource planning strategies and changes in the supply-side dominated culture within the electric utilities.

Modeling Energy Efficiency As A Green Logistics Component In Vehicle Assembly Line

NASA Astrophysics Data System (ADS)

Oumer, Abduaziz; Mekbib Atnaw, Samson; Kie Cheng, Jack; Singh, Lakveer

2016-11-01

This paper uses System Dynamics (SD) simulation to investigate the concept green logistics in terms of energy efficiency in automotive industry. The car manufacturing industry is considered to be one of the highest energy consuming industries. An efficient decision making model is proposed that capture the impacts of strategic decisions on energy consumption and environmental sustainability. The sources of energy considered in this research are electricity and fuel; which are the two main types of energy sources used in a typical vehicle assembly plant. The model depicts the performance measurement for process- specific energy measures of painting, welding, and assembling processes. SD is the chosen simulation method and the main green logistics issues considered are Carbon Dioxide (CO2) emission and energy utilization. The model will assist decision makers acquire an in-depth understanding of relationship between high level planning and low level operation activities on production, environmental impacts and costs associated. The results of the SD model signify the existence of positive trade-offs between green practices of energy efficiency and the reduction of CO2 emission.

Incapacitated Surrogates: A New and Increasing Dilemma in Hospital Care.

PubMed

Smith, Karen L; Fedel, Patrice; Heitman, Jay

2017-01-01

A power of attorney for healthcare (POAHC) form gives designated individuals legal status to make healthcare decisions when patients are unable to convey their decisions to medical staff. Completion of a POAHC form is crucial in the provision of comprehensive healthcare, since it helps to ensure that patients' interests, values, and preferences are represented in decisions about their medical treatment. Because increasing numbers of people suffer from debilitating illness and cognitive deficits, healthcare systems may be called upon to navigate the complexities of patients' care without clear directives from the patients themselves. Hence, the healthcare industry encourages all individuals to complete a POAHC form to ensure that persons who have the patients' trust are able to act as their surrogate decision makers. However, sometimes POAHC agents, even when they are patients' trusted agents, lack the capacity to make fully informed decisions that are in the patients' best interests. We describe designated surrogate decision makers who have impaired or diminished judgment capacity as incapacitated surrogates. Decision making that is obviously flawed or questionable is a significant impediment to providing timely and appropriate care to patients. Moreover, failure to redress these issues in a timely and efficient manner can result in significant costs to an institution and a diminished quality of patient care. The authors offer a legal, ethical, and interdisciplinary framework to help navigate cases of incapacitated surrogates. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

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

Ethics and rationality in information-enriched decisions: A model for technical communication

NASA Astrophysics Data System (ADS)

Dressel, S. B.; Carlson, P.; Killingsworth, M. J.

1993-12-01

In a technological culture, information has a crucial impact upon decisions, but exactly how information plays into decisions is not always clear. Decisions that are effective, efficient, and ethical must be rational. That is, we must be able to determine and present good reasons for our actions. The topic in this paper is how information relates to good reasons and thereby affects the best decisions. A brief sketch of a model for decision-making, is presented which offers a synthesis of theoretical approaches to argument and to information analysis. Then the model is applied to a brief hypothetical case. The main purpose is to put the model before an interested audience in hopes of stimulating discussion and further research.

The determinants of efficiency in the Canadian health care system.

PubMed

Allin, Sara; Grignon, Michel; Wang, Li

2016-01-01

In spite of the vast number of studies measuring economic efficiency in health care, there has been little take-up of this evidence by policy-makers to date. This study provides an illustration of how a system-level study drawing on best practice in empirical measurement of efficiency may be of practical use to health system decision makers and managers. We make use of the rich data available in Canada to undertake a robust two-stage data envelopment analysis to calculate efficiency at the regional (sub-provincial) level. Decisions about what the health system produces (the outcome to measure efficiency against) and what are the resources it has to produce that outcome were based on interviews and consultation with health system decision makers. Overall, we find large inefficiencies in the Canadian health care system, which could improve outcomes (here, measured as a reduction in treatable causes of death) by between 18 and 35% across our analyses. Also, we find that inefficiencies are the result of three main sets of factors that policy makers could pay attention to: management factors, such as hospital re-admissions; public health factors, such as obesity and smoking rates; and environmental factors such as the population's average income.

[Influenza A from the rational choice theory: proposals for decision making in prevention policies].

PubMed

Peña, Francisco Garrido; Fernández, Luís Andrés López; García, Eugenia Gil

2009-01-01

This article is a reflection on the social uncertainty caused by Influenza A and on the consequences that it can have on decision making in health promotion policies. We use concepts and metaphors of the Rational Choice Theory, among them, the "in gratitude effect" or the "distrust effect", as we analyse how these can become obstacles for the efficiency of prevention policies. Then, we focus on the information asymmetry of the principal-agent relationship, and we propose measures to diminish the "moral risk" that they cause. We finish by advancing some proposals for designing lines and strategies of action in health promotion policies.

Assessing the speed--accuracy trade-off effect on the capacity of information processing.

PubMed

Donkin, Chris; Little, Daniel R; Houpt, Joseph W

2014-06-01

The ability to trade accuracy for speed is fundamental to human decision making. The speed-accuracy trade-off (SAT) effect has received decades of study, and is well understood in relatively simple decisions: collecting more evidence before making a decision allows one to be more accurate but also slower. The SAT in more complex paradigms has been given less attention, largely due to limits in the models and statistics that can be applied to such tasks. Here, we have conducted the first analysis of the SAT in multiple signal processing, using recently developed technologies for measuring capacity that take into account both response time and choice probability. We show that the primary influence of caution in our redundant-target experiments is on the threshold amount of evidence required to trigger a response. However, in a departure from the usual SAT effect, we found that participants strategically ignored redundant information when they were forced to respond quickly, but only when the additional stimulus was reliably redundant. Interestingly, because the capacity of the system was severely limited on redundant-target trials, ignoring additional targets meant that processing was more efficient when making fast decisions than when making slow and accurate decisions, where participants' limited resources had to be divided between the 2 stimuli. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Modeling the value for money of changing clinical practice change: a stochastic application in diabetes care.

PubMed

Hoomans, Ties; Abrams, Keith R; Ament, Andre J H A; Evers, Silvia M A A; Severens, Johan L

2009-10-01

Decision making about resource allocation for guideline implementation to change clinical practice is inevitably undertaken in a context of uncertainty surrounding the cost-effectiveness of both clinical guidelines and implementation strategies. Adopting a total net benefit approach, a model was recently developed to overcome problems with the use of combined ratio statistics when analyzing decision uncertainty. To demonstrate the stochastic application of the model for informing decision making about the adoption of an audit and feedback strategy for implementing a guideline recommending intensive blood glucose control in type 2 diabetes in primary care in the Netherlands. An integrated Bayesian approach to decision modeling and evidence synthesis is adopted, using Markov Chain Monte Carlo simulation in WinBUGs. Data on model parameters is gathered from various sources, with effectiveness of implementation being estimated using pooled, random-effects meta-analysis. Decision uncertainty is illustrated using cost-effectiveness acceptability curves and frontier. Decisions about whether to adopt intensified glycemic control and whether to adopt audit and feedback alter for the maximum values that decision makers are willing to pay for health gain. Through simultaneously incorporating uncertain economic evidence on both guidance and implementation strategy, the cost-effectiveness acceptability curves and cost-effectiveness acceptability frontier show an increase in decision uncertainty concerning guideline implementation. The stochastic application in diabetes care demonstrates that the model provides a simple and useful tool for quantifying and exploring the (combined) uncertainty associated with decision making about adopting guidelines and implementation strategies and, therefore, for informing decisions about efficient resource allocation to change clinical practice.

Barriers to Building Energy Efficiency (BEE) promotion: A transaction costs perspective

NASA Astrophysics Data System (ADS)

Qian Kun, Queena

Worldwide, buildings account for a surprisingly high 40% of global energy consumption, and the resulting carbon footprint significantly exceeds that of all forms of transportation combined. Large and attractive opportunities exist to reduce buildings' energy use at lower costs and higher returns than in other sectors. This thesis analyzes the concerns of the market stakeholders, mainly real estate developers and end-users, in terms of transaction costs as they make decisions about investing in Building Energy Efficiency (BEE). It provides a detailed analysis of the current situation and future prospects for BEE adoption by the market's stakeholders. It delineates the market and lays out the economic and institutional barriers to the large-scale deployment of energy-efficient building techniques. The aim of this research is to investigate the barriers raised by transaction costs that hinder market stakeholders from investing in BEES. It explains interactions among stakeholders in general and in the specific case of Hong Kong as they consider transaction costs. It focuses on the influence of transaction costs on the decision-making of the stakeholders during the entire process of real estate development. The objectives are: 1) To establish an analytical framework for understanding the barriers to BEE investment with consideration of transaction costs; 2) To build a theoretical game model of decision making among the BEE market stakeholders; 3) To study the empirical data from questionnaire surveys of building designers and from focused interviews with real estate developers in Hong Kong; 4) To triangulate the study's empirical findings with those of the theoretical model and analytical framework. The study shows that a coherent institutional framework needs to be established to ensure that the design and implementation of BEE policies acknowledge the concerns of market stakeholders by taking transaction costs into consideration. Regulatory and incentive options should be integrated into BEE policies to minimize efficiency gaps and to realize a sizeable increase in the number of energy-efficient buildings in the next decades. Specifically, the analysis shows that a thorough understanding of the transaction costs borne by particular stakeholders could improve the energy efficiency of buildings, even without improvements in currently available technology.

77 FR 47800 - Adoption of Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... recommendations designed to ensure that agencies satisfy the existing requirements in the most efficient and... make decisions on their implementation. The Conference based these recommendations on research reports... sweeping measures designed to ensure that agencies' regulations advance legitimate goals, such as Executive...

Information needs to support state and local transportation decision making into the 21st century

DOT National Transportation Integrated Search

1997-03-01

The Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA) established new requirements for data development and dissemination that have had an impact on federal, state, and local transportation planning processes across the United States. ...

Moves in Hypertext: The Resource of Negotiation as a Means to Describe the Way Students Navigate a Pathway through Hypertext

ERIC Educational Resources Information Center

Zammit, Katina

2011-01-01

With the increased use of hypertexts to locate information, students need to make informed decisions about their pathway so they build knowledge efficiently. The moves they make need to contribute to understanding the topic more than detracting them. This paper explores the use of Systemic Functional Linguistics (SFL) to describe the construction…

Impact of a decision-support tool on decision making at the district level in Kenya

PubMed Central

2013-01-01

Background In many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions. Methods Thirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts. Results Findings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement. Conclusions This paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems. PMID:24011028

Categorization and decision-making in a neurobiologically plausible spiking network using a STDP-like learning rule.

PubMed

Beyeler, Michael; Dutt, Nikil D; Krichmar, Jeffrey L

2013-12-01

Understanding how the human brain is able to efficiently perceive and understand a visual scene is still a field of ongoing research. Although many studies have focused on the design and optimization of neural networks to solve visual recognition tasks, most of them either lack neurobiologically plausible learning rules or decision-making processes. Here we present a large-scale model of a hierarchical spiking neural network (SNN) that integrates a low-level memory encoding mechanism with a higher-level decision process to perform a visual classification task in real-time. The model consists of Izhikevich neurons and conductance-based synapses for realistic approximation of neuronal dynamics, a spike-timing-dependent plasticity (STDP) synaptic learning rule with additional synaptic dynamics for memory encoding, and an accumulator model for memory retrieval and categorization. The full network, which comprised 71,026 neurons and approximately 133 million synapses, ran in real-time on a single off-the-shelf graphics processing unit (GPU). The network was constructed on a publicly available SNN simulator that supports general-purpose neuromorphic computer chips. The network achieved 92% correct classifications on MNIST in 100 rounds of random sub-sampling, which is comparable to other SNN approaches and provides a conservative and reliable performance metric. Additionally, the model correctly predicted reaction times from psychophysical experiments. Because of the scalability of the approach and its neurobiological fidelity, the current model can be extended to an efficient neuromorphic implementation that supports more generalized object recognition and decision-making architectures found in the brain. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach

PubMed Central

Si, Sheng-Li; You, Xiao-Yue; Huang, Jia

2017-01-01

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that “accidents/adverse events”, “nosocomial infection”, ‘‘incidents/errors”, “number of operations/procedures” are significant influential indicators. Also, the indicators of “length of stay”, “bed occupancy” and “financial measures” play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions. PMID:28825613

Accounting for tastes: a German perspective on the inclusion of patient preferences in healthcare.

PubMed

Vogt, Florian; Schwappach, David L B; Bridges, John F P

2006-01-01

Internationally, there has been a movement in medicine to better involve patients in decision making, whether it be at the individual or aggregate level. However, the German health sector has been slow to understand and accommodate the preferences of patients. This paper discusses the reasons why and attempts to highlight some of the consequences of not involving patients in healthcare decision making within the German context. We argue that a fundamental paradigm shift at all levels of the German health system, including better doctor/patient communication, is necessary for more choices to be available to patients and to better reflect patient preferences in centralised healthcare decision making. The newly created German health technology assessment agency (IQWiG; Institute for Quality and Economic Efficiency in the Health Care Sector) has indicated that they are interested in focusing on patient preferences, but there is a need for them to clarify what methods they deem suitable for doing so.

Collaborative mining and interpretation of large-scale data for biomedical research insights.

PubMed

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence.

Collaborative Mining and Interpretation of Large-Scale Data for Biomedical Research Insights

PubMed Central

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence. PMID:25268270

NASA Applied Sciences Program Rapid Prototyping Results and Conclusions

NASA Astrophysics Data System (ADS)

Cox, E. L.

2007-12-01

NASA's Applied Sciences Program seeks to expand the use of Earth science research results to benefit current and future operational systems tasked with making policy and management decisions. The Earth Science Division within the Science Mission Directorate sponsors over 1000 research projects annually to answer the fundamental research question: How is the Earth changing and what are the consequences for life on Earth? As research results become available, largely from satellite observations and Earth system model outputs, the Applied Sciences Program works diligently with scientists and researchers (internal and external to NASA) , and other government agency officials (USDA, EPA, CDC, DOE, US Forest Service, US Fish and Wildlife Service, DHS, USAID) to determine useful applications for these results in decision-making, ultimately benefiting society. The complexity of Earth science research results and the breadth of the Applied Sciences Program national priority areas dictate a broad scope and multiple approaches available to implement their use in decision-making. Over the past five years, the Applied Sciences Program has examined scientific and engineering practices and solicited the community for methods and steps that can lead to the enhancement of operational systems (Decision Support Systems - DSS) required for decision-making. In November 2006, the Applied Sciences Program launched an initiative aimed at demonstrating the applicability of NASA data (satellite observations, models, geophysical parameters from data archive centers) being incorporated into decision support systems and their related environments at a low cost and quick turnaround of results., i.e. designed rapid prototyping. Conceptually, an understanding of Earth science research (and results) coupled with decision-making requirements and needs leads to a demonstration (experiment) depicting enhancements or improvements to an operational decisions process through the use of NASA data. Five NASA centers (GSFC, LaRC, SSC, MSFC, ARC) participated and are currently conducting fifteen prototyping experiments covering eight of the twelve national priority applications - Energy, Coastal, Carbon, and Disaster Management; Agricultural Efficiency, Aviation, Air Quality, and Ecological Forecasting. Results from six experiments will be discussed highlighting purpose, expected results, enhancement to the decision-making process achieved, and the potential plans for future collaboration and sustainable projects.

Evolution Of USDOE Performance Assessments Over 20 Years

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

Seitz, Roger R.; Suttora, Linda C.

2013-02-26

Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (USDOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role. Overmore » the past 20+ years, the USDOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of USDOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept represents the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient implementation of the graded and iterative approach. Rather than attempt to exactly predict the migration of radionuclides in a disposal unit, the best PAs have evolved into tools that provide a range of results to guide decision-makers in planning the most efficient, cost effective, and safe disposal of radionuclides.« less

Inhibition of Pre-Supplementary Motor Area by Continuous Theta Burst Stimulation Leads to More Cautious Decision-making and More Efficient Sensory Evidence Integration.

PubMed

Tosun, Tuğçe; Berkay, Dilara; Sack, Alexander T; Çakmak, Yusuf Ö; Balcı, Fuat

2017-08-01

Decisions are made based on the integration of available evidence. The noise in evidence accumulation leads to a particular speed-accuracy tradeoff in decision-making, which can be modulated and optimized by adaptive decision threshold setting. Given the effect of pre-SMA activity on striatal excitability, we hypothesized that the inhibition of pre-SMA would lead to higher decision thresholds and an increased accuracy bias. We used offline continuous theta burst stimulation to assess the effect of transient inhibition of the right pre-SMA on the decision processes in a free-response two-alternative forced-choice task within the drift diffusion model framework. Participants became more cautious and set higher decision thresholds following right pre-SMA inhibition compared with inhibition of the control site (vertex). Increased decision thresholds were accompanied by an accuracy bias with no effects on post-error choice behavior. Participants also exhibited higher drift rates as a result of pre-SMA inhibition compared with the vertex inhibition. These results, in line with the striatal theory of speed-accuracy tradeoff, provide evidence for the functional role of pre-SMA activity in decision threshold modulation. Our results also suggest that pre-SMA might be a part of the brain network associated with the sensory evidence integration.

Increased decision thresholds enhance information gathering performance in juvenile Obsessive-Compulsive Disorder (OCD)

PubMed Central

Iannaccone, Reto; Brem, Silvia; Walitza, Susanne

2017-01-01

Patients with obsessive-compulsive disorder (OCD) can be described as cautious and hesitant, manifesting an excessive indecisiveness that hinders efficient decision making. However, excess caution in decision making may also lead to better performance in specific situations where the cost of extended deliberation is small. We compared 16 juvenile OCD patients with 16 matched healthy controls whilst they performed a sequential information gathering task under different external cost conditions. We found that patients with OCD outperformed healthy controls, winning significantly more points. The groups also differed in the number of draws required prior to committing to a decision, but not in decision accuracy. A novel Bayesian computational model revealed that subjective sampling costs arose as a non-linear function of sampling, closely resembling an escalating urgency signal. Group difference in performance was best explained by a later emergence of these subjective costs in the OCD group, also evident in an increased decision threshold. Our findings present a novel computational model and suggest that enhanced information gathering in OCD can be accounted for by a higher decision threshold arising out of an altered perception of costs that, in some specific contexts, may be advantageous. PMID:28403139

A Conceptual Framework for Decision-making Support in Uncertainty- and Risk-based Diagnosis of Rare Clinical Cases by Specialist Physicians.

PubMed

Santos, Adriano A; Moura, J Antão B; de Araújo, Joseana Macêdo Fechine Régis

2015-01-01

Mitigating uncertainty and risks faced by specialist physicians in analysis of rare clinical cases is something desired by anyone who needs health services. The number of clinical cases never seen by these experts, with little documentation, may introduce errors in decision-making. Such errors negatively affect well-being of patients, increase procedure costs, rework, health insurance premiums, and impair the reputation of specialists and medical systems involved. In this context, IT and Clinical Decision Support Systems (CDSS) play a fundamental role, supporting decision-making process, making it more efficient and effective, reducing a number of avoidable medical errors and enhancing quality of treatment given to patients. An investigation has been initiated to look into characteristics and solution requirements of this problem, model it, propose a general solution in terms of a conceptual risk-based, automated framework to support rare-case medical diagnostics and validate it by means of case studies. A preliminary validation study of the proposed framework has been carried out by interviews conducted with experts who are practicing professionals, academics, and researchers in health care. This paper summarizes the investigation and its positive results. These results motivate continuation of research towards development of the conceptual framework and of a software tool that implements the proposed model.

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence. PMID:20181270

Social network and decision-making in primates: a report on Franco-Japanese research collaborations.

PubMed

Sueur, Cédric; Pelé, Marie

2016-07-01

Sociality is suggested to evolve as a strategy for animals to cope with challenges in their environment. Within a population, each individual can be seen as part of a network of social interactions that vary in strength, type and dynamics (Sueur et al. 2011a). The structure of this social network can strongly impact upon not only on the fitness of individuals and their decision-making, but also on the ecology of populations and the evolution of a species. Our Franco-Japanese collaboration allowed us to study social networks in several species (Japanese macaques, chimpanzees, colobines, etc.) and on different topics (social epidemiology, social evolution, information transmission). Individual attributes such as stress, rank or age can affect how individuals take decisions and the structure of the social network. This heterogeneity is linked to the assortativity of individuals and to the efficiency of the flow within a network. It is important, therefore, that this heterogeneity is integrated in the process or pattern under study in order to provide a better resolution of investigation and, ultimately, a better understanding of behavioural strategies, social dynamics and social evolution. How social information affects decision-making could be important to understand how social groups make collective decisions and how information may spread throughout the social group. In human beings, road-crossing behaviours in the presence of other individuals is a good way to study the influence of social information on individual behaviour and decision-making, for instance. Culture directly affects which information - personal vs social - individuals prefer to follow. Our collaboration contributed to the understanding of the relative influence of different factors, cultural and ecological, on primate, including human, sociality.

The politics of large infrastructure investment decision-making : the case of the second avenue subway case study.

DOT National Transportation Integrated Search

2013-11-01

Over the past few decades, urbanization and economic growth have intensified the need for more efficient urban and : regional transportation, including the expansion and reorganization of existing transportation networks. Given such : huge investment...

Examining the value of travel time reliability for freight transportation to support freight planning and decision-Making [summary].

DOT National Transportation Integrated Search

2016-12-01

As consumers demand greater choice and availability of products, suppliers have responded with more just-in-time delivery and less centralized inventories. Keeping this supply chain working efficiently requires reliable freight transportation. Delays...

Conference Proceedings for the Advanced Multimodal Transportation Weather Services Partnership Initiatives

DOT National Transportation Integrated Search

1999-01-01

A symposium was held at the Volpe National Transportation Systems Center on September 28, 1998 to continue an active dialogue on issues related to the use of weather informaiton to support transportation decision making, safety, and efficiency. The o...

A synthesis of the "state-of-the-practice for advancing planning and operations integration opportunities within transportation agencies".

DOT National Transportation Integrated Search

2014-12-01

Linking Planning and Operations is vital to improving transportation decision-making and overall : efficiency of transportation systems management. This synthesis summarizes current state of : knowledge and practices in Planning and Operations Integr...

Federal roles to realize national energy-efficiency opportunities in the 1990s

NASA Astrophysics Data System (ADS)

Hirst, Eric

1989-10-01

Improving energy efficiency throughout the U.S. economy is a vital component of our nation's energy future, with many benefits. Improving efficiency can: save money consumers, increase economic productivity and international competitiveness, reduce oil and gas prices by reducing the demand for foreign oil, enhance national security by lowering oil imports, reduce the adverse environmental consequences of fuel cycles, especially acid rain and global warming, add diversity and flexibility to the nation's portfolio of energy resources, respond to public interest in, and support of, energy efficiency. The primary purpose of this report is to suggest expanded roles for the U.S. Department of Energy (DOE) in improving energy efficiency during the 1990s. In an ideal world, the normal workings of the market place would yield optimal energy-efficiency purchase and operating decisions. Unfortunately, distortions in fuel prices, limited access to capital, misplaced incentives, lack of information, and difficulty in processing information complicate energy-related decision making. Thus, consumers in all sectors of the economy underinvest in energy-efficient systems. These market barriers, coupled with growing concern about environmental quality, justify a larger Federal role.

Finding stability regions for preserving efficiency classification of variable returns to scale technology in data envelopment analysis

NASA Astrophysics Data System (ADS)

Zamani, P.; Borzouei, M.

2016-12-01

This paper addresses issue of sensitivity of efficiency classification of variable returns to scale (VRS) technology for enhancing the credibility of data envelopment analysis (DEA) results in practical applications when an additional decision making unit (DMU) needs to be added to the set being considered. It also develops a structured approach to assisting practitioners in making an appropriate selection of variation range for inputs and outputs of additional DMU so that this DMU be efficient and the efficiency classification of VRS technology remains unchanged. This stability region is simply specified by the concept of defining hyperplanes of production possibility set of VRS technology and the corresponding halfspaces. Furthermore, this study determines a stability region for the additional DMU within which, in addition to efficiency classification, the efficiency score of a specific inefficient DMU is preserved and also using a simulation method, a region in which some specific efficient DMUs become inefficient is provided.

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.

From science to action: Principles for undertaking environmental research that enables knowledge exchange and evidence-based decision-making.

PubMed

Cvitanovic, C; McDonald, J; Hobday, A J

2016-12-01

Effective conservation requires knowledge exchange among scientists and decision-makers to enable learning and support evidence-based decision-making. Efforts to improve knowledge exchange have been hindered by a paucity of empirically-grounded guidance to help scientists and practitioners design and implement research programs that actively facilitate knowledge exchange. To address this, we evaluated the Ningaloo Research Program (NRP), which was designed to generate new scientific knowledge to support evidence-based decisions about the management of the Ningaloo Marine Park in north-western Australia. Specifically, we evaluated (1) outcomes of the NRP, including the extent to which new knowledge informed management decisions; (2) the barriers that prevented knowledge exchange among scientists and managers; (3) the key requirements for improving knowledge exchange processes in the future; and (4) the core capacities that are required to support knowledge exchange processes. While the NRP generated expansive and multidisciplinary science outputs directly relevant to the management of the Ningaloo Marine Park, decision-makers are largely unaware of this knowledge and little has been integrated into decision-making processes. A range of barriers prevented efficient and effective knowledge exchange among scientists and decision-makers including cultural differences among the groups, institutional barriers within decision-making agencies, scientific outputs that were not translated for decision-makers and poor alignment between research design and actual knowledge needs. We identify a set of principles to be implemented routinely as part of any applied research program, including; (i) stakeholder mapping prior to the commencement of research programs to identify all stakeholders, (ii) research questions to be co-developed with stakeholders, (iii) implementation of participatory research approaches, (iv) use of a knowledge broker, and (v) tailored knowledge management systems. Finally, we articulate the individual, institutional and financial capacities that must be developed to underpin successful knowledge exchange strategies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Use of a web-based survey to facilitate shared decision making for patients eligible for cancer screening.

PubMed

Brackett, Charles D; Kearing, Stephen

2015-04-01

Our aim was to facilitate shared decision making (SDM) during preventive visits by utilizing a web-based survey system to offer colorectal cancer (CRC) and prostate cancer screening decision aids (DAs) to appropriately identified patients prior to the visit. Patients completed a web-based questionnaire before their preventive medicine appointment. Age- and gender-appropriate patients completed additional questions to determine eligibility for CRC or prostate-specific antigen (PSA) screening. Eligible patients were offered a choice of video or print DA, and completed questions assessing their knowledge, values, and preferences regarding the screening decision. Responses were summarized and fed forward to clinician and patient reports. Overall, 11,493 CRC and 4,384 PSA questionnaires were completed. Patient responses were used to identify those eligible for cancer-screening DAs: 2,187 (19 %) for CRC and 2,962 (68 %) for PSA; 15 % of eligible patients requested a DA. Many patients declined a DA because they indicated they "already know enough to make their decision" (34 % for CRC, 46 % for PSA). A web-based questionnaire provides an efficient means to identify patients eligible for cancer screening decisions and to offer them DAs before an appointment. Pre-visit use of DAs along with reports giving feedback to patients and clinicians provides an opportunity for SDM to occur at the visit.

CEOS Contributions to Informing Energy Management and Policy Decision Making Using Space-Based Earth Observations

NASA Technical Reports Server (NTRS)

Eckman, Richard S.

2009-01-01

Earth observations are playing an increasingly significant role in informing decision making in the energy sector. In renewable energy applications, space-based observations now routinely augment sparse ground-based observations used as input for renewable energy resource assessment applications. As one of the nine Group on Earth Observations (GEO) societal benefit areas, the enhancement of management and policy decision making in the energy sector is receiving attention in activities conducted by the Committee on Earth Observation Satellites (CEOS). CEOS has become the "space arm" for the implementation of the Global Earth Observation System of Systems (GEOSS) vision. It is directly supporting the space-based, near-term tasks articulated in the GEO three-year work plan. This paper describes a coordinated program of demonstration projects conducted by CEOS member agencies and partners to utilize Earth observations to enhance energy management end-user decision support systems. I discuss the importance of engagement with stakeholders and understanding their decision support needs in successfully increasing the uptake of Earth observation products for societal benefit. Several case studies are presented, demonstrating the importance of providing data sets in formats and units familiar and immediately usable by decision makers. These projects show the utility of Earth observations to enhance renewable energy resource assessment in the developing world, forecast space-weather impacts on the power grid, and improve energy efficiency in the built environment.

Interdependence in decision-making by medical consultants: implications for improving the efficiency of inpatient physician services.

PubMed

Wilk, Adam S; Chen, Lena M

2017-12-01

Hospital administrators are seeking to improve efficiency in medical consultation services, yet whether consultants make decisions to provide more or less care is unknown. We examined how medical consultants account for prior consultants' care when determining whether to provide intensive consulting care or sign off in the treatment of complex surgical inpatients. We applied three distinct theoretical frameworks in the interpretation of our results. We performed a retrospective cohort study of consultants' care intensity, measured alternately using a dummy variable for providing two or more days consulting (versus one) and a continuous measure of total days consulting, with 100% Medicare claims data from 2007-2010. Our analytic samples included consults for beneficiaries undergoing coronary artery bypass grafting (n = 61,785) or colectomy (n = 33,460) in general acute care hospitals. We compared the care intensity of consultants who observed different patterns of consulting care before their initial consults using ordinary least squares regression models at the patient-physician dyad level, controlling for patient comorbidity and many other patient- and physician-level factors as well as hospital region and year fixed effects. Consultants were less likely to provide intensive consulting care with each additional prior consultant on the case (1.2-1.7 percent) or if a prior consultant rendered intensive consulting care (20.6-21.5 percent) but more likely when prior consults were more concentrated across consultants (2.9-3.1 percent). Effects on consultants' total days consulting were similar. On average, consultants appeared to calibrate their care intensity for individual patients to maximize their value to all patients. Interventions for improving consulting care efficiency should seek to facilitate (not constrain) consultants' decision-making processes.

The use of predictive models to optimize risk of decisions.

PubMed

Baranyi, József; Buss da Silva, Nathália

2017-01-02

The purpose of this paper is to set up a mathematical framework that risk assessors and regulators could use to quantify the "riskiness" of a particular recommendation (choice/decision). The mathematical theory introduced here can be used for decision support systems. We point out that efficient use of predictive models in decision making for food microbiology needs to consider three major points: (1) the uncertainty and variability of the used information based on which the decision is to be made; (2) the validity of the predictive models aiding the assessor; and (3) the cost generated by the difference between the a-priory choice and the a-posteriori outcome. Copyright © 2016 Elsevier B.V. All rights reserved.

Individual differences in voluntary alcohol intake in rats: relationship with impulsivity, decision making and Pavlovian conditioned approach.

PubMed

Spoelder, Marcia; Flores Dourojeanni, Jacques P; de Git, Kathy C G; Baars, Annemarie M; Lesscher, Heidi M B; Vanderschuren, Louk J M J

2017-07-01

Alcohol use disorder (AUD) has been associated with suboptimal decision making, exaggerated impulsivity, and aberrant responses to reward-paired cues, but the relationship between AUD and these behaviors is incompletely understood. This study aims to assess decision making, impulsivity, and Pavlovian-conditioned approach in rats that voluntarily consume low (LD) or high (HD) amounts of alcohol. LD and HD were tested in the rat gambling task (rGT) or the delayed reward task (DRT). Next, the effect of alcohol (0-1.0 g/kg) was tested in these tasks. Pavlovian-conditioned approach (PCA) was assessed both prior to and after intermittent alcohol access (IAA). Principal component analyses were performed to identify relationships between the most important behavioral parameters. HD showed more optimal decision making in the rGT. In the DRT, HD transiently showed reduced impulsive choice. In both LD and HD, alcohol treatment increased optimal decision making in the rGT and increased impulsive choice in the DRT. PCA prior to and after IAA was comparable for LD and HD. When PCA was tested after IAA only, HD showed a more sign-tracking behavior. The principal component analyses indicated dimensional relationships between alcohol intake, impulsivity, and sign-tracking behavior in the PCA task after IAA. HD showed a more efficient performance in the rGT and DRT. Moreover, alcohol consumption enhanced approach behavior to reward-predictive cues, but sign-tracking did not predict the level of alcohol consumption. Taken together, these findings suggest that high levels of voluntary alcohol intake are associated with enhanced cue- and reward-driven behavior.

Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

PubMed

Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

2017-01-26

The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of economic evaluations include, amongst others, educating decision-makers and the general population about economic evaluations and presenting economic evaluation results in a clearer and more understandable way. This study demonstrated that the current use and impact of economic evaluations in Dutch healthcare decision-making is limited at best. Therefore, strategies are needed to overcome the barriers that currently prevent economic evaluations from being used extensively.

Voting systems for environmental decisions.

PubMed

Burgman, Mark A; Regan, Helen M; Maguire, Lynn A; Colyvan, Mark; Justus, James; Martin, Tara G; Rothley, Kris

2014-04-01

Voting systems aggregate preferences efficiently and are often used for deciding conservation priorities. Desirable characteristics of voting systems include transitivity, completeness, and Pareto optimality, among others. Voting systems that are common and potentially useful for environmental decision making include simple majority, approval, and preferential voting. Unfortunately, no voting system can guarantee an outcome, while also satisfying a range of very reasonable performance criteria. Furthermore, voting methods may be manipulated by decision makers and strategic voters if they have knowledge of the voting patterns and alliances of others in the voting populations. The difficult properties of voting systems arise in routine decision making when there are multiple criteria and management alternatives. Because each method has flaws, we do not endorse one method. Instead, we urge organizers to be transparent about the properties of proposed voting systems and to offer participants the opportunity to approve the voting system as part of the ground rules for operation of a group. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Decision analysis of emergency ventilation and evacuation strategies against suddenly released contaminant indoors by considering the uncertainty of source locations.

PubMed

Cai, Hao; Long, Weiding; Li, Xianting; Kong, Lingjuan; Xiong, Shuang

2010-06-15

In case hazardous contaminants are suddenly released indoors, the prompt and proper emergency responses are critical to protect occupants. This paper aims to provide a framework for determining the optimal combination of ventilation and evacuation strategies by considering the uncertainty of source locations. The certainty of source locations is classified as complete certainty, incomplete certainty, and complete uncertainty to cover all the possible situations. According to this classification, three types of decision analysis models are presented. A new concept, efficiency factor of contaminant source (EFCS), is incorporated in these models to evaluate the payoffs of the ventilation and evacuation strategies. A procedure of decision-making based on these models is proposed and demonstrated by numerical studies of one hundred scenarios with ten ventilation modes, two evacuation modes, and five source locations. The results show that the models can be useful to direct the decision analysis of both the ventilation and evacuation strategies. In addition, the certainty of the source locations has an important effect on the outcomes of the decision-making. Copyright 2010 Elsevier B.V. All rights reserved.

Uncertainty quantification in downscaling procedures for effective decisions in energy systems

NASA Astrophysics Data System (ADS)

Constantinescu, E. M.

2010-12-01

Weather is a major driver both of energy supply and demand, and with the massive adoption of renewable energy sources and changing economic and producer-consumer paradigms, the management of the next-generation energy systems is becoming ever more challenging. The operational and planning decisions in energy systems are guided by efficiency and reliability, and therefore a central role in these decisions will be played by the ability to obtain weather condition forecasts with accurate uncertainty estimates. The appropriate temporal and spatial resolutions needed for effective decision-making, be it operational or planning, is not clear. It is arguably certain however, that such temporal scales as hourly variations of temperature or wind conditions and ramp events are essential in this process. Planning activities involve decade or decades-long projections of weather. One sensible way to achieve this is to embed regional weather models in a global climate system. This strategy acts as a downscaling procedure. Uncertainty modeling techniques must be developed in order to quantify and minimize forecast errors as well as target variables that impact the decision-making process the most. We discuss the challenges of obtaining a realistic uncertainty quantification estimate using mathematical algorithms based on scalable matrix-free computations and physics-based statistical models. The process of making decisions for energy management systems based on future weather scenarios is a very complex problem. We shall focus on the challenges in generating wind power predictions based on regional weather predictions, and discuss the implications of making the common assumptions about the uncertainty models.

Applying Behavioral Economics to Public Health Policy

PubMed Central

Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

2016-01-01

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

An efficient representation of spatial information for expert reasoning in robotic vehicles

NASA Technical Reports Server (NTRS)

Scott, Steven; Interrante, Mark

1987-01-01

The previous generation of robotic vehicles and drones was designed for a specific task, with limited flexibility in executing their mission. This limited flexibility arises because the robotic vehicles do not possess the intelligence and knowledge upon which to make significant tactical decisions. Current development of robotic vehicles is toward increased intelligence and capabilities, adapting to a changing environment and altering mission objectives. The latest techniques in artificial intelligence (AI) are being employed to increase the robotic vehicle's intelligent decision-making capabilities. This document describes the design of the SARA spatial database tool, which is composed of request parser, reasoning, computations, and database modules that collectively manage and derive information useful for robotic vehicles.

An automatic iterative decision-making method for intuitionistic fuzzy linguistic preference relations

NASA Astrophysics Data System (ADS)

Pei, Lidan; Jin, Feifei; Ni, Zhiwei; Chen, Huayou; Tao, Zhifu

2017-10-01

As a new preference structure, the intuitionistic fuzzy linguistic preference relation (IFLPR) was recently introduced to efficiently deal with situations in which the membership and non-membership are represented as linguistic terms. In this paper, we study the issues of additive consistency and the derivation of the intuitionistic fuzzy weight vector of an IFLPR. First, the new concepts of order consistency, additive consistency and weak transitivity for IFLPRs are introduced, and followed by a discussion of the characterisation about additive consistent IFLPRs. Then, a parameterised transformation approach is investigated to convert the normalised intuitionistic fuzzy weight vector into additive consistent IFLPRs. After that, a linear optimisation model is established to derive the normalised intuitionistic fuzzy weights for IFLPRs, and a consistency index is defined to measure the deviation degree between an IFLPR and its additive consistent IFLPR. Furthermore, we develop an automatic iterative decision-making method to improve the IFLPRs with unacceptable additive consistency until the adjusted IFLPRs are acceptable additive consistent, and it helps the decision-maker to obtain the reasonable and reliable decision-making results. Finally, an illustrative example is provided to demonstrate the validity and applicability of the proposed method.

Successful School Board Meetings.

ERIC Educational Resources Information Center

Anderson, Stuart A.

This handbook is intended to help school boards become more effective governing bodies by becoming more efficient in conducting routine business, improving their abilities to reach constructive decisions and to solve problems, making their meetings sources of good will among members, students, and the community, and developing and following…

Strategic Alignment: Recruiting Students in a Highly Decentralized Environment

ERIC Educational Resources Information Center

Levin, Richard

2016-01-01

All enrollment managers face some level of challenge related to decentralized decision making and operations. Policies and practices can vary considerably by academic area, creating administrative complexity, restricting the scope and speed of institutional initiatives, and limiting potential efficiencies. Central attempts to standardize or…

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy

PubMed Central

Seixas, Brayan V.

2018-01-01

In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation. PMID:29626402

A Reward-Maximizing Spiking Neuron as a Bounded Rational Decision Maker.

PubMed

Leibfried, Felix; Braun, Daniel A

2015-08-01

Rate distortion theory describes how to communicate relevant information most efficiently over a channel with limited capacity. One of the many applications of rate distortion theory is bounded rational decision making, where decision makers are modeled as information channels that transform sensory input into motor output under the constraint that their channel capacity is limited. Such a bounded rational decision maker can be thought to optimize an objective function that trades off the decision maker's utility or cumulative reward against the information processing cost measured by the mutual information between sensory input and motor output. In this study, we interpret a spiking neuron as a bounded rational decision maker that aims to maximize its expected reward under the computational constraint that the mutual information between the neuron's input and output is upper bounded. This abstract computational constraint translates into a penalization of the deviation between the neuron's instantaneous and average firing behavior. We derive a synaptic weight update rule for such a rate distortion optimizing neuron and show in simulations that the neuron efficiently extracts reward-relevant information from the input by trading off its synaptic strengths against the collected reward.

Value-based attentional capture influences context-dependent decision-making

PubMed Central

Cha, Kexin; Rangsipat, Napat; Serences, John T.

2015-01-01

Normative theories posit that value-based decision-making is context independent. However, decisions between two high-value options can be suboptimally biased by the introduction of a third low-value option. This context-dependent modulation is consistent with the divisive normalization of the value of each stimulus by the total value of all stimuli. In addition, an independent line of research demonstrates that pairing a stimulus with a high-value outcome can lead to attentional capture that can mediate the efficiency of visual information processing. Here we tested the hypothesis that value-based attentional capture interacts with value-based normalization to influence the optimality of decision-making. We used a binary-choice paradigm in which observers selected between two targets and the color of each target indicated the magnitude of their reward potential. Observers also had to simultaneously ignore a task-irrelevant distractor rendered in a color that was previously associated with a specific reward magnitude. When the color of the task-irrelevant distractor was previously associated with a high reward, observers responded more slowly and less optimally. Moreover, as the learned value of the distractor increased, electrophysiological data revealed an attenuation of the lateralized N1 and N2Pc responses evoked by the relevant choice stimuli and an attenuation of the late positive deflection (LPD). Collectively, these behavioral and electrophysiological data suggest that value-based attentional capture and value-based normalization jointly mediate the influence of context on free-choice decision-making. PMID:25995350

Value-based attentional capture influences context-dependent decision-making.

PubMed

Itthipuripat, Sirawaj; Cha, Kexin; Rangsipat, Napat; Serences, John T

2015-07-01

Normative theories posit that value-based decision-making is context independent. However, decisions between two high-value options can be suboptimally biased by the introduction of a third low-value option. This context-dependent modulation is consistent with the divisive normalization of the value of each stimulus by the total value of all stimuli. In addition, an independent line of research demonstrates that pairing a stimulus with a high-value outcome can lead to attentional capture that can mediate the efficiency of visual information processing. Here we tested the hypothesis that value-based attentional capture interacts with value-based normalization to influence the optimality of decision-making. We used a binary-choice paradigm in which observers selected between two targets and the color of each target indicated the magnitude of their reward potential. Observers also had to simultaneously ignore a task-irrelevant distractor rendered in a color that was previously associated with a specific reward magnitude. When the color of the task-irrelevant distractor was previously associated with a high reward, observers responded more slowly and less optimally. Moreover, as the learned value of the distractor increased, electrophysiological data revealed an attenuation of the lateralized N1 and N2Pc responses evoked by the relevant choice stimuli and an attenuation of the late positive deflection (LPD). Collectively, these behavioral and electrophysiological data suggest that value-based attentional capture and value-based normalization jointly mediate the influence of context on free-choice decision-making. Copyright © 2015 the American Physiological Society.

The neural basis of social risky decision making in females with major depressive disorder.

PubMed

Shao, Robin; Zhang, Hui-jun; Lee, Tatia M C

2015-01-01

Recent evidence indicates that Major Depressive Disorder (MDD) may be associated with reduced tendency of committing noncompliant actions during social decision-making even when the risk of being punished is low. The neural underpinnings of this behavioral pattern are unknown, although it likely relates to compromised functioning of the lateral prefrontal-striatal/limbic networks implicated in executive control, emotion regulation and risk/value-based instrumental behaviors. We employed a modified trust game (TG) that provided explicit information on the risk levels of cheating behaviors being detected and punished. Behavioral and neuro-image data were acquired and analyzed from 14 first-episode female MDD patients and 15 age- and gender-matched controls performing the role of trustee in the TG. Relative to controls, MDD patients exhibited less behavioral switching to making cheating choices under low risk, and reduced activity in the dorsal putamen, anterior insula and dorsolateral prefrontal cortex (DLPFC) during making low-risk cheating versus benevolent choices, with limited evidence indicating abnormal bilateral inferior frontal gyrus activities of patients when making high-risk cheating versus benevolent choices. Patients' left dorsal putamen/anterior insular signals correlated positively with their frequency of low-risk cheating. MDD patients' symptom severity correlated positively with their signals in the lateral prefrontal networks during decision-making. A psycho-physiological interaction analysis provided tentative evidence for the recruitment of IFG-striatal/limbic circuitry among the control participants, but greater frontopolar-striatal/limbic connectivity among the MDD patients, during low-risk decision-making. We propose that making risky social decisions based on the balancing of self-gain and other's welfare relies on the functioning of the integrated lateral prefrontal-striatal/limbic networks, which are less efficient and dysregulated among MDD patients compared with controls, impacting negatively on the patients' social capacity and highlighting a key therapeutic target for MDD. Copyright © 2014 Elsevier Ltd. All rights reserved.

A public health decision support system model using reasoning methods.

PubMed

Mera, Maritza; González, Carolina; Blobel, Bernd

2015-01-01

Public health programs must be based on the real health needs of the population. However, the design of efficient and effective public health programs is subject to availability of information that can allow users to identify, at the right time, the health issues that require special attention. The objective of this paper is to propose a case-based reasoning model for the support of decision-making in public health. The model integrates a decision-making process and case-based reasoning, reusing past experiences for promptly identifying new population health priorities. A prototype implementation of the model was performed, deploying the case-based reasoning framework jColibri. The proposed model contributes to solve problems found today when designing public health programs in Colombia. Current programs are developed under uncertain environments, as the underlying analyses are carried out on the basis of outdated and unreliable data.

Self-Organized Service Negotiation for Collaborative Decision Making

PubMed Central

Zhang, Bo; Zheng, Ziming

2014-01-01

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

Self-organized service negotiation for collaborative decision making.

PubMed

Zhang, Bo; Huang, Zhenhua; Zheng, Ziming

2014-01-01

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

Building a SEM Analytics Reporting Portfolio

ERIC Educational Resources Information Center

Goff, Jay W.; Williams, Brian G.; Kilgore, Wendy

2016-01-01

Effective strategic enrollment management (SEM) efforts require vast amounts of internal and external data to ensure that meaningful reporting and analysis systems can assist managers in decision making. A wide range of information is integral for leading effective and efficient student recruitment and retention programs. This article is designed…

Budgeting-Based Organization of Internal Control

ERIC Educational Resources Information Center

Rogulenko, Tatiana; Ponomareva, Svetlana; Bodiaco, Anna; Mironenko, Valentina; Zelenov, Vladimir

2016-01-01

The article suggests methodical approaches to the budgeting-based organization of internal control, determines the tasks and subtasks of control that consist in the construction of an efficient system for the making, implementation, control, and analysis of managerial decisions. The organization of responsibility centers by means of implementing…

Towards efficient multi-scale methods for monitoring sugarcane aphid infestations in sorghum

USDA-ARS?s Scientific Manuscript database

We discuss approaches and issues involved with developing optimal monitoring methods for sugarcane aphid infestations (SCA) in grain sorghum. We discuss development of sequential sampling methods that allow for estimation of the number of aphids per sample unit, and statistical decision making rela...

Resisting Consumerist Rationalities in Higher Vocational Education

ERIC Educational Resources Information Center

Puaca, Goran; Theandersson, Christer; Carlén, Margareta

2017-01-01

Swedish higher education policy is currently moving toward consumption ideals that focus on promoting the efficiency and economic viability of student choices. This paper scrutinizes students' practical considerations when making decisions regarding their education and future occupations and the choice rationalities and motives that these reflect.…

An Instructional Theory for Learner Control: Revisited.

ERIC Educational Resources Information Center

Chung, Jaesam; Davies, Ivor K.

This study develops a prescriptive theory of learner control for educators to support the learner's decision making in the learning process and to manage more efficiently their instructional processes. The theoretical framework of learner control in conjunction with the self-regulation of learning, learner characteristics, and learner motivation…

Plug-In Electric Vehicle Handbook for Consumers (Spanish Version); Clean Cities, Energy Efficiency & Renewable Energy (EERE)

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

None

This is a Spanish-language handbook designed to answer a consumer's basic questions, as well as point them to additional information they need, to make the best decision about whether an electric-drive vehicle is right for them.

An Employee Assistance Curriculum: The Ultimate Collaborative Function.

ERIC Educational Resources Information Center

Epstein, Howard V.; Perryman, William J.

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

The recognition heuristic: a review of theory and tests.

PubMed

Pachur, Thorsten; Todd, Peter M; Gigerenzer, Gerd; Schooler, Lael J; Goldstein, Daniel G

2011-01-01

The recognition heuristic is a prime example of how, by exploiting a match between mind and environment, a simple mental strategy can lead to efficient decision making. The proposal of the heuristic initiated a debate about the processes underlying the use of recognition in decision making. We review research addressing four key aspects of the recognition heuristic: (a) that recognition is often an ecologically valid cue; (b) that people often follow recognition when making inferences; (c) that recognition supersedes further cue knowledge; (d) that its use can produce the less-is-more effect - the phenomenon that lesser states of recognition knowledge can lead to more accurate inferences than more complete states. After we contrast the recognition heuristic to other related concepts, including availability and fluency, we carve out, from the existing findings, some boundary conditions of the use of the recognition heuristic as well as key questions for future research. Moreover, we summarize developments concerning the connection of the recognition heuristic with memory models. We suggest that the recognition heuristic is used adaptively and that, compared to other cues, recognition seems to have a special status in decision making. Finally, we discuss how systematic ignorance is exploited in other cognitive mechanisms (e.g., estimation and preference).

Uncalculating cooperation is used to signal trustworthiness.

PubMed

Jordan, Jillian J; Hoffman, Moshe; Nowak, Martin A; Rand, David G

2016-07-20

Humans frequently cooperate without carefully weighing the costs and benefits. As a result, people may wind up cooperating when it is not worthwhile to do so. Why risk making costly mistakes? Here, we present experimental evidence that reputation concerns provide an answer: people cooperate in an uncalculating way to signal their trustworthiness to observers. We present two economic game experiments in which uncalculating versus calculating decision-making is operationalized by either a subject's choice of whether to reveal the precise costs of cooperating (Exp. 1) or the time a subject spends considering these costs (Exp. 2). In both experiments, we find that participants are more likely to engage in uncalculating cooperation when their decision-making process is observable to others. Furthermore, we confirm that people who engage in uncalculating cooperation are perceived as, and actually are, more trustworthy than people who cooperate in a calculating way. Taken together, these data provide the first empirical evidence, to our knowledge, that uncalculating cooperation is used to signal trustworthiness, and is not merely an efficient decision-making strategy that reduces cognitive costs. Our results thus help to explain a range of puzzling behaviors, such as extreme altruism, the use of ethical principles, and romantic love.

Uncalculating cooperation is used to signal trustworthiness

PubMed Central

Jordan, Jillian J.; Hoffman, Moshe; Nowak, Martin A.; Rand, David G.

2016-01-01

Humans frequently cooperate without carefully weighing the costs and benefits. As a result, people may wind up cooperating when it is not worthwhile to do so. Why risk making costly mistakes? Here, we present experimental evidence that reputation concerns provide an answer: people cooperate in an uncalculating way to signal their trustworthiness to observers. We present two economic game experiments in which uncalculating versus calculating decision-making is operationalized by either a subject’s choice of whether to reveal the precise costs of cooperating (Exp. 1) or the time a subject spends considering these costs (Exp. 2). In both experiments, we find that participants are more likely to engage in uncalculating cooperation when their decision-making process is observable to others. Furthermore, we confirm that people who engage in uncalculating cooperation are perceived as, and actually are, more trustworthy than people who cooperate in a calculating way. Taken together, these data provide the first empirical evidence, to our knowledge, that uncalculating cooperation is used to signal trustworthiness, and is not merely an efficient decision-making strategy that reduces cognitive costs. Our results thus help to explain a range of puzzling behaviors, such as extreme altruism, the use of ethical principles, and romantic love. PMID:27439873

Performance indicators for the efficiency analysis of urban drainage systems.

PubMed

Artina, S; Becciu, G; Maglionico, M; Paoletti, A; Sanfilippo, U

2005-01-01

Performance indicators implemented in a decision support system (DSS) for the technical, managerial and economic evaluation of urban drainage systems (UDS), called MOMA FD, are presented. Several kinds of information are collected and processed by MOMA FD to evaluate both present situation and future scenarios of development and enhancement. Particular interest is focused on the evaluation of the environmental impact, which is considered a very relevant factor in the decision making process to identify the priorities for UDS improvements.

Analysis of Ordinary Public Fund and Its Impact on the Quality of Academic Programs in the Higher Education in the Subsystem of the Polytechnic Universities in Mexico

ERIC Educational Resources Information Center

Monroy, Pedro Salazar; Arcos-Vega, José L.; Garcia, Juan J. Sevilla

2017-01-01

In 2015, there was the need of making this study to determine the efficient and effectiveness management for making decisions in respect to the ordinary fund allocations and their impact on the quality of the academic programs into the Polytechnic engineering universities in Mexico. This analysis is very important for providing essential evidence…

Ten Principles to Guide Health Reform.

PubMed

Gerald, Joe K

2017-03-01

Americans face inevitable trade-offs between health care affordability, accessibility, and innovation. Although numerous reforms have been proposed, universal principles to guide decision-making are lacking. Solving the challenges that confront us will be difficult, owing to intense partisan divisions and a dysfunctional political process. Nevertheless, we must engage in reasoned debate that respects deeply held differences of opinion regarding our individual and collective obligations to promote healthy living and ensure affordable access to health care. Otherwise, our decisions will be expressed through political processes that reflect the preferences of narrow interests rather than the general public. Our health care system can be made more efficient and equitable by incentivizing consumers and providers to utilize high-value care and avoid low-value care. To accomplish this, we must understand the determinants of consumer and provider behavior and implement policies that encourage, but do not force, optimal decision-making. Although distinguishing between low- and high-value treatments will invariably threaten established interests, we must expand our capacity to make such judgements. Throughout this process, consumers, taxpayers, and policy makers must maintain realistic expectations. Although realigning incentives to promote high-value care will improve efficiency, it is unlikely to control increasing medical expenditures because they are not primarily caused by inefficiency. Rather, rising medical expenditures are driven by medical innovation made possible by increasing incomes and expanding health insurance coverage. Failure to recognize these linkages risks adopting indiscriminate policies that will reduce spending but slow innovation and impair access to needed care.

Game Theory and Risk-Based Levee System Design

NASA Astrophysics Data System (ADS)

Hui, R.; Lund, J. R.; Madani, K.

2014-12-01

Risk-based analysis has been developed for optimal levee design for economic efficiency. Along many rivers, two levees on opposite riverbanks act as a simple levee system. Being rational and self-interested, land owners on each river bank would tend to independently optimize their levees with risk-based analysis, resulting in a Pareto-inefficient levee system design from the social planner's perspective. Game theory is applied in this study to analyze decision making process in a simple levee system in which the land owners on each river bank develop their design strategies using risk-based economic optimization. For each land owner, the annual expected total cost includes expected annual damage cost and annualized construction cost. The non-cooperative Nash equilibrium is identified and compared to the social planner's optimal distribution of flood risk and damage cost throughout the system which results in the minimum total flood cost for the system. The social planner's optimal solution is not feasible without appropriate level of compensation for the transferred flood risk to guarantee and improve conditions for all parties. Therefore, cooperative game theory is then employed to develop an economically optimal design that can be implemented in practice. By examining the game in the reversible and irreversible decision making modes, the cost of decision making myopia is calculated to underline the significance of considering the externalities and evolution path of dynamic water resource problems for optimal decision making.

Analysis on Inclusion of Social Studies Economy Concepts in Coursebooks

ERIC Educational Resources Information Center

Seker, Mustafa; Osmanoglu, Ahmet Emin

2015-01-01

Having an efficient and satisfactory economy education may enable an individual to actively participate in decision making process about economy-related issues. This is very important for democratic societies. This research aims to search methods and levels of teaching "economy" concepts prepared for Turkey 2005 Social Studies Program in…

36 CFR 905.735-201 - General standards of conduct.

Code of Federal Regulations, 2010 CFR

2010-07-01

... economy; (4) Losing complete independence or impartiality; (5) Making a Government decision outside... CORPORATION STANDARDS OF CONDUCT Conduct and Responsibilities of Employees § 905.735-201 General standards of conduct. (a) All employees shall conduct themselves on the job so as to efficiently discharge the work of...

Constructing Sample Space with Combinatorial Reasoning: A Mixed Methods Study

ERIC Educational Resources Information Center

McGalliard, William A., III.

2012-01-01

Recent curricular developments suggest that students at all levels need to be statistically literate and able to efficiently and accurately make probabilistic decisions. Furthermore, statistical literacy is a requirement to being a well-informed citizen of society. Research also recognizes that the ability to reason probabilistically is supported…

Construction alternatives for free-standing facilities.

PubMed

Brown, G

1990-01-01

Many hospitals are exploring free-standing facilities as an option for providing more efficient imaging services. Mr. Brown discusses the pros and cons of an emerging building technology, manufactured construction, in which building and site preparation are done simultaneously. He presents the criteria managers should use to make a knowledgeable decision.

Get a Grip on Demographics with Geospatial Technology

ERIC Educational Resources Information Center

Raymond, Randall E.

2009-01-01

Aging school infrastructure, changing population dynamics, decreased funding, and increased accountability for reporting school success all require today's school business officials to combine a variety of disparate data sets into a coherent system that enables effective and efficient decision making. School business officials are required to: (1)…

Predicting honey bee sensitivity based on the conservation of the pesticide molecular initiating event

EPA Science Inventory

Concern surrounding the potential adverse impacts of pesticides to honey bee colonies has led to the need for rapid/cost efficient methods for aiding decision making relative to the protection of this important pollinator species. Neonicotinoids represent a class of pesticides th...

A Three-Question Framework to Facilitate Clinical Decision Making

ERIC Educational Resources Information Center

Sibold, Jeremy

2012-01-01

Context: Highly developed critical thinking and the ability to discriminate among many possible therapeutic interventions is a core behavior for the practicing athletic trainer. However, while athletic training students receive a great deal of clinically applicable information, many are not explicitly trained in efficient methods for channeling…

Conflict Monitoring in Dual Process Theories of Thinking

ERIC Educational Resources Information Center

De Neys, Wim; Glumicic, Tamara

2008-01-01

Popular dual process theories have characterized human thinking as an interplay between an intuitive-heuristic and demanding-analytic reasoning process. Although monitoring the output of the two systems for conflict is crucial to avoid decision making errors there are some widely different views on the efficiency of the process. Kahneman…

Experience- and egg-mediated oviposition behaviour in the yellow fever mosquito Stegomyia aegypti (=Aedes aegypti)

USDA-ARS?s Scientific Manuscript database

Animals may adapt foraging behavior in variable environments using environmental information. For repeated behaviors such as feeding or reproduction, past experiences can provide this information to guide future decision-making. By changing behavior to be more efficient in an animal’s specific env...

Leadership Motivation and Mentoring Can Improve Efficiency of a Classroom Teacher and Workers in Institutions

ERIC Educational Resources Information Center

Onjoro, Veronica; Arogo, Rebecca Bwari; Embeywa, Henry Etende

2015-01-01

Motivational strategies guarantee quality assurance in the educational system. Motivational strategies like staff training and development, promotion, salary, remuneration, working conditions, status and participatory decision making, acted as a barrier towards achieving quality assurance in the educational system. The study adopted the…

Transportability of Equivalence-Based Programmed Instruction: Efficacy and Efficiency in a College Classroom

ERIC Educational Resources Information Center

Fienup, Daniel M.; Critchfield, Thomas S.

2011-01-01

College students in a psychology research-methods course learned concepts related to inferential statistics and hypothesis decision making. One group received equivalence-based instruction on conditional discriminations that were expected to promote the emergence of many untaught, academically useful abilities (i.e., stimulus equivalence group). A…

Comparing District Achievement to Improve Decision Making in Clark County, Nevada. Vignette

ERIC Educational Resources Information Center

American Institutes for Research, 2012

2012-01-01

In response to changing demographics, a tightening budget, and drastic achievement gaps (white students outperform Latino students on standardized tests) the Clark County School District in Nevada (the fifth largest district in the country) commissioned, in 2011, an educational and operational efficiency review. The district commissioned the…

A data envelopment analysis approach to compare the environmental efficiency of energy technologies and countries

USDA-ARS?s Scientific Manuscript database

Due to increasing financial and environmental concerns, governmental rules, regulations and incentives alternative energy sources are soon expected to grow at a much faster pace than conventional sources of energy. However, the current body of research providing comparative decision making models fo...

77 FR 2514 - National Ocean Council-National Ocean Policy Draft Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

... for users, more efficient and coordinated decision-making, and improved sharing of data and technology... the preparation of the final plan. We welcome your general input, and also pose the following...: Strengthen and integrate Federal and non-Federal ocean observing systems, sensors, data collection platforms...

On the Efficient Allocation of Resources for Hypothesis Evaluation in Machine Learning: A Statistical Approach

NASA Technical Reports Server (NTRS)

Chien, S.; Gratch, J.; Burl, M.

1994-01-01

In this report we consider a decision-making problem of selecting a strategy from a set of alternatives on the basis of incomplete information (e.g., a finite number of observations): the system can, however, gather additional information at some cost.

Key factors that influence government policies and decision making about healthcare priorities: Lessons for the field of eating disorders.

PubMed

Whiteford, Harvey; Weissman, Ruth Striegel

2017-03-01

Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies. Beyond setting priorities for resource allocation, governments also become involved where there is a need for regulation to maintain quality in the delivery of healthcare. By providing field-specific examples for each factor, we illustrate how advocates in the eating disorder field may use evidence to inform government policy about resource allocation and regulation in support of individuals with an eating disorder. © 2017 Wiley Periodicals, Inc.

The prescribing of specialist medicines: what factors influence GPs' decision making?

PubMed

Crowe, Sarah; Tully, Mary P; Cantrill, Judith A

2009-08-01

As Governments worldwide strive to integrate efficient health care delivery across the primary-secondary care divide, particular significance has been placed on the need to understand GPs' prescribing of specialist drugs. To explore the factors which influence GPs' decision-making process when requested to prescribe specialist drugs. A qualitative approach was used to explore the perspectives of a wide range of practice-, primary care trust-, strategic health authority-level staff and other relevant stakeholders in the North-West of England. All semi-structured interviews (n = 47) were analysed comprehensively using the five-stage 'framework' approach. Six diverse factors were identified as having a crucial bearing on how GPs evaluate initial requests and subsequently decide whether or not to prescribe. These include GPs' lack of knowledge and expertise in using specialist drugs, the shared care arrangement, the influence of a locally agreed advisory list, financial and resource considerations, patient convenience and understanding and GPs' specific areas of interest. This exploration of GPs' decision-making process is needed to support future integrated health care delivery.

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Decision making based on data analysis and optimization algorithm applied for cogeneration systems integration into a grid

NASA Astrophysics Data System (ADS)

Asmar, Joseph Al; Lahoud, Chawki; Brouche, Marwan

2018-05-01

Cogeneration and trigeneration systems can contribute to the reduction of primary energy consumption and greenhouse gas emissions in residential and tertiary sectors, by reducing fossil fuels demand and grid losses with respect to conventional systems. The cogeneration systems are characterized by a very high energy efficiency (80 to 90%) as well as a less polluting aspect compared to the conventional energy production. The integration of these systems into the energy network must simultaneously take into account their economic and environmental challenges. In this paper, a decision-making strategy will be introduced and is divided into two parts. The first one is a strategy based on a multi-objective optimization tool with data analysis and the second part is based on an optimization algorithm. The power dispatching of the Lebanese electricity grid is then simulated and considered as a case study in order to prove the compatibility of the cogeneration power calculated by our decision-making technique. In addition, the thermal energy produced by the cogeneration systems which capacity is selected by our technique shows compatibility with the thermal demand for district heating.

Stop wasting valuable time.

PubMed

Mankins, Michael C

2004-09-01

Companies routinely squander their most precious resource--the time of their top executives. In the typical company, senior executives meet to discuss strategy for only three hours a month. And that time is poorly spent in diffuse discussions never even meant to result in any decision. The price of misused executive time is high. Delayed strategic decisions lead to overlooked waste and high costs, harmful cost reductions, missed new product and business development opportunities, and poor long-term investments. But a few deceptively simple changes in the way top management teams set agendas and structure team meetings can make an enormous difference in their effectiveness. Efficient companies use seven techniques to make the most of the time their top executives spend together. They keep strategy meetings separate from meetings focused on operations. They explore issues through written communications before they meet, so that meeting time is used solely for reaching decisions. In setting agendas, they rank the importance of each item according to its potential to create value for the company. They seek to get issues not only on, but also off, the agenda quickly, keeping to a clear implementation timetable. They make sure they have considered all viable alternatives before deciding a course of action. They use a common language and methodology for reaching decisions. And they insist that, once a decision is made, they stick to it--that there be no more debate or mere grudging compliance. Once leadership teams get the basics right, they can make more fundamental changes in the way they work together. Strategy making can be transformed from a series of fragmented and unproductive events into a streamlined, effective, and continuing management dialogue. In companies that have done this, management meetings aren't a necessary evil; they're a source of real competitive advantage.

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

Mundaca, Luis; Neij, Lena; Worrell, Ernst

The growing complexities of energy systems, environmental problems and technology markets are driving and testing most energy-economy models to their limits. To further advance bottom-up models from a multidisciplinary energy efficiency policy evaluation perspective, we review and critically analyse bottom-up energy-economy models and corresponding evaluation studies on energy efficiency policies to induce technological change. We use the household sector as a case study. Our analysis focuses on decision frameworks for technology choice, type of evaluation being carried out, treatment of market and behavioural failures, evaluated policy instruments, and key determinants used to mimic policy instruments. Although the review confirms criticismmore » related to energy-economy models (e.g. unrealistic representation of decision-making by consumers when choosing technologies), they provide valuable guidance for policy evaluation related to energy efficiency. Different areas to further advance models remain open, particularly related to modelling issues, techno-economic and environmental aspects, behavioural determinants, and policy considerations.« less

Evaluating the impact of HIA on urban reconstruction decision-making. Who manages whose risks?

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

Bekker, Marleen P.M.; Putters, Kim; Grinten, Tom E.D. van der

2005-10-15

Practitioners and academic researchers increasingly look to evaluation of health impact assessment (HIA) to improve its practice, its efficiency and its legitimacy. Evaluation is also used to account to policy-makers, who express doubts that the benefits of HIA justify its costs. Until recently evaluation of HIA focused on instrument design and procedures but now the focus needs to shift to analysis of the interaction of HIA and decision-making. Multiple case studies have been applied to identify the conditions in which HIA produces the desired benefits. These studies used analytical concepts derived from the literature on evaluation, knowledge utilization, science ofmore » sociology and knowledge management. This paper describes a case study in which the strategic motives of the decision-makers affected the impact of an HIA. This HIA comprised of a quantitative environmental model 'City and Environment' that was used to assess environmental health impacts of an urban reconstruction plan in a Dutch city. The evaluation of the HIA shows that the decision to follow the recommendations of the HIA was part of a damage control strategy. The more HIA goals deviate from the policy problem and the less HIA is embedded in institutional procedures, then the more HIA impact will be subject to strategic decision-making behaviour. Appropriate cognitive and social strategies are needed to avoid 'negative learning' in those the HIA seeks to influence.« less

Integrated catchment modelling within a strategic planning and decision making process: Werra case study

NASA Astrophysics Data System (ADS)

Dietrich, Jörg; Funke, Markus

Integrated water resources management (IWRM) redefines conventional water management approaches through a closer cross-linkage between environment and society. The role of public participation and socio-economic considerations becomes more important within the planning and decision making process. In this paper we address aspects of the integration of catchment models into such a process taking the implementation of the European Water Framework Directive (WFD) as an example. Within a case study situated in the Werra river basin (Central Germany), a systems analytic decision process model was developed. This model uses the semantics of the Unified Modeling Language (UML) activity model. As an example application, the catchment model SWAT and the water quality model RWQM1 were applied to simulate the effect of phosphorus emissions from non-point and point sources on water quality. The decision process model was able to guide the participants of the case study through the interdisciplinary planning and negotiation of actions. Further improvements of the integration framework include tools for quantitative uncertainty analyses, which are crucial for real life application of models within an IWRM decision making toolbox. For the case study, the multi-criteria assessment of actions indicates that the polluter pays principle can be met at larger scales (sub-catchment or river basin) without significantly compromising cost efficiency for the local situation.

Consideration of reference points for the management of renewable resources under an adaptive management paradigm

USGS Publications Warehouse

Irwin, Brian J.; Conroy, Michael J.

2013-01-01

The success of natural resource management depends on monitoring, assessment and enforcement. In support of these efforts, reference points (RPs) are often viewed as critical values of management-relevant indicators. This paper considers RPs from the standpoint of objective-driven decision making in dynamic resource systems, guided by principles of structured decision making (SDM) and adaptive resource management (AM). During the development of natural resource policy, RPs have been variously treated as either ‘targets’ or ‘triggers’. Under a SDM/AM paradigm, target RPs correspond approximately to value-based objectives, which may in turn be either of fundamental interest to stakeholders or intermediaries to other central objectives. By contrast, trigger RPs correspond to decision rules that are presumed to lead to desirable outcomes (such as the programme targets). Casting RPs as triggers or targets within a SDM framework is helpful towards clarifying why (or whether) a particular metric is appropriate. Further, the benefits of a SDM/AM process include elucidation of underlying untested assumptions that may reveal alternative metrics for use as RPs. Likewise, a structured decision-analytic framework may also reveal that failure to achieve management goals is not because the metrics are wrong, but because the decision-making process in which they are embedded is insufficiently robust to uncertainty, is not efficiently directed at producing a resource objective, or is incapable of adaptation to new knowledge.

International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines.

PubMed

Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W; Vondeling, Hindrik

2017-01-01

Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor. New economic evaluation checklists, Multi-Criteria Decision Analyses (MCDA) and other decision criteria enable health economists to impact on decision making world-wide. We analyse the methodologies for integrating economic evidence into CPG agencies globally, including the Agency of Health Research and Quality (AHRQ) in the USA, National Health and Medical Research Council (NHMRC) and Australian political reforms. The Guidelines and Economists Network International (GENI) Board members from Australia, UK, Canada and Denmark presented the findings at the conference of the International Health Economists Association (IHEA) and we report conclusions and developments since. The Consolidated Guidelines for the Reporting of Economic Evaluations (CHEERS) 24 item check list can be used by AHRQ, NHMRC, other CPG and health organisations, in conjunction with the Drummond ten-point check list and a questionnaire that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability in checklists can be addressed by including more than one assessor to reach a consensus, especially when impacting on treatment decisions. We identify priority areas to generate economic evidence for CPGs by NHMRC, AHRQ, and other agencies. The evidence may cover demand for care issues such as involved time, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning.

Flood Resilient Systems and their Application for Flood Resilient Planning

NASA Astrophysics Data System (ADS)

Manojlovic, N.; Gabalda, V.; Antanaskovic, D.; Gershovich, I.; Pasche, E.

2012-04-01

Following the paradigm shift in flood management from traditional to more integrated approaches, and considering the uncertainties of future development due to drivers such as climate change, one of the main emerging tasks of flood managers becomes the development of (flood) resilient cities. It can be achieved by application of non-structural - flood resilience measures, summarised in the 4As: assistance, alleviation, awareness and avoidance (FIAC, 2007). As a part of this strategy, the key aspect of development of resilient cities - resilient built environment can be reached by efficient application of Flood Resilience Technology (FReT) and its meaningful combination into flood resilient systems (FRS). FRS are given as [an interconnecting network of FReT which facilitates resilience (including both restorative and adaptive capacity) to flooding, addressing physical and social systems and considering different flood typologies] (SMARTeST, http://www.floodresilience.eu/). Applying the system approach (e.g. Zevenbergen, 2008), FRS can be developed at different scales from the building to the city level. Still, a matter of research is a method to define and systematise different FRS crossing those scales. Further, the decision on which resilient system is to be applied for the given conditions and given scale is a complex task, calling for utilisation of decision support tools. This process of decision-making should follow the steps of flood risk assessment (1) and development of a flood resilience plan (2) (Manojlovic et al, 2009). The key problem in (2) is how to match the input parameters that describe physical&social system and flood typology to the appropriate flood resilient system. Additionally, an open issue is how to integrate the advances in FReT and findings on its efficiency into decision support tools. This paper presents a way to define, systematise and make decisions on FRS at different scales of an urban system developed within the 7th FP Project SMARTeST. A web based three tier advisory system FLORETO-KALYPSO (http://floreto.wb.tu-harburg.de/, Manojlovic et al, 2009) devoted to support decision-making process at the building level has been further developed to support multi-scale decision making on resilient systems, improving the existing data mining algorithms of the Business Logic tier. Further tuning of the algorithms is to be performed based on the new developments and findings in applicability and efficiency of different FRe Technology for different flood typologies. The first results obtained at the case studies in Greater Hamburg, Germany indicate the potential of this approach to contribute to the multiscale resilient planning on the road to flood resilient cities. FIAC (2007): "Final report form the Awareness and Assistance Sub-committee", FIAC, Scottish Government Zevenbergen C. et al (2008) "Challenges in urban flood management: travelling across spatial and temporal scales", Journal of FRM Volume 1 Issue 2, p 81-88 Manojlovic N., et al (2009): "Capacity Building in FRM through a DSS Utilising Data Mining Approach", Proceed. 8th HIC, Concepcion, Chile, January, 2009

Likelihood ratio decisions in memory: three implied regularities.

PubMed

Glanzer, Murray; Hilford, Andrew; Maloney, Laurence T

2009-06-01

We analyze four general signal detection models for recognition memory that differ in their distributional assumptions. Our analyses show that a basic assumption of signal detection theory, the likelihood ratio decision axis, implies three regularities in recognition memory: (1) the mirror effect, (2) the variance effect, and (3) the z-ROC length effect. For each model, we present the equations that produce the three regularities and show, in computed examples, how they do so. We then show that the regularities appear in data from a range of recognition studies. The analyses and data in our study support the following generalization: Individuals make efficient recognition decisions on the basis of likelihood ratios.

Economic evaluation of preventive dental programs: what can they tell us?

PubMed

Morgan, Mike; Mariño, Rodrigo; Wright, Clive; Bailey, Denise; Hopcraft, Matthew

2012-10-01

The role of public health program planners is to determine the effectiveness of public health programs, what recommendations should be made, what future initiatives should be taken, and what policies should be developed. At a basic level, to choose between competing alternatives, two characteristics of an intervention must be considered; these are its outcome and its cost. Based on cost and outcome, planners must select the option that offers the most advantages. Economic evaluation is commonly adopted by decision makers in the health sector to investigate the effectiveness of public health programs and to help plan future initiatives. Economic evaluation assists decision makers who must weigh the information it provides in the context of many and often competing options. In this way, an economic evaluation is an aid to decision making rather than the decision itself. Economic evaluation is becoming essential for informed decision making, with potential implications for public health policy and practice and for clinical practice too. While economic evaluations are commonly used in decision-making processes about health programs, few examples exist in the oral health literature. In the case of preventive oral health programs, economic analysis is often difficult, largely because it makes demands on epidemiological and demographic data that are hard to meet. This study will address the concepts and tools required to conduct economic evaluations of prevention programs. The emphasis will be on oral health and preventive dental programs, although the concepts presented could be useful for other public health programs by practitioners and managers with the aim of producing effective and efficient oral health programs. © 2012 John Wiley & Sons A/S.

[How much business management does a surgeon need?].

PubMed

Bork, U; Koch, M; Büchler, M W; Weitz, J

2010-08-01

The present day healthcare system in Germany is rapidly changing, even more so after the introduction of diagnosis-related groups. The basic requirements for every surgeon remain manual skills, a profound clinical knowledge and the ability for clinical decision-making even in difficult situations. However, these key elements of surgical education no longer fulfill the requirements for today's leaders in surgery. New requirements, consisting of administrative duties, strategic decision-making and department management are too complex to be made only intuitively. Nowadays surgeons also need a profound education in management skills and knowledge of economic mechanisms in order to run an efficient, profitable, patient-oriented surgical department. Every surgeon who aims at obtaining a leadership position should acquire the necessary knowledge and skills.

A moral compass for management decision making: a healthcare CEO's reflections.

PubMed

Donnellan, John J

2013-01-01

Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.

[Application of pharmacoeconomics in clinical management].

PubMed

Amat Díaz, M; Poveda Andrés, J L; Carrera-Hueso, F J

2011-05-01

The present article discusses the importance of clinical management in the transformation of organizations and its role in the daily activities of health professionals and, in particular, of hospital pharmacists. Because of social changes, healthcare models must make the shift from more rigid management models toward new organizational models based on clinical management. From this perspective, pharmacoeconomics is viewed as a useful tool to introduce the criteria of efficiency in all decisions subject to clinical management, including those on pharmacotherapeutics. Subsequently, the application of this discipline is discussed in real decision-making scenarios and settings for its use within the context of the work of hospital pharmacy are proposed. Copyright © 2011 Sociedad Española de Farmacia Hospitalaria. Published by Elsevier Espana. All rights reserved.

Focus group positioning and analysis: a commentary on adjuncts for enhancing the design of health care research.

PubMed

Johnson, B C

1990-01-01

As health care competition increases, and as the penalties for making poor decisions become potentially more devastating, market research continues to play an increasingly important role in the decision-making process for hospitals. Concern over the appropriate use of market research and the costs related to it remains high. As such, efficiency in research design and clarity in research outcome are clearly the goals. This paper examines the focus group process and its adjunctive role in enhancing the overall design of health care market research. Specifically, the function and placement of focus groups within the research plan as well as several methods of creative focus group analysis are considered within the context of an effective research design.

Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

2014-01-01

The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

A decision support system using combined-classifier for high-speed data stream in smart grid

NASA Astrophysics Data System (ADS)

Yang, Hang; Li, Peng; He, Zhian; Guo, Xiaobin; Fong, Simon; Chen, Huajun

2016-11-01

Large volume of high-speed streaming data is generated by big power grids continuously. In order to detect and avoid power grid failure, decision support systems (DSSs) are commonly adopted in power grid enterprises. Among all the decision-making algorithms, incremental decision tree is the most widely used one. In this paper, we propose a combined classifier that is a composite of a cache-based classifier (CBC) and a main tree classifier (MTC). We integrate this classifier into a stream processing engine on top of the DSS such that high-speed steaming data can be transformed into operational intelligence efficiently. Experimental results show that our proposed classifier can return more accurate answers than other existing ones.

The importance of temporal inequality in quantifying vegetated filter strip removal efficiencies

NASA Astrophysics Data System (ADS)

Gall, H. E.; Schultz, D.; Mejia, A.; Harman, C. J.; Raj, C.; Goslee, S.; Veith, T.; Patterson, P. H.

2017-12-01

Vegetated filter strips (VFSs) are best management practices (BMPs) commonly implemented adjacent to row-cropped fields to trap overland transport of sediment and other constituents often present in agricultural runoff. VFSs are generally reported to have high sediment removal efficiencies (i.e., 70 - 95%); however, these values are typically calculated as an average of removal efficiencies observed or simulated for individual events. We argue that due to: (i) positively correlated sediment concentration-discharge relationships; (ii) strong temporal inequality exhibited by sediment transport; and (iii) decreasing VFS performance with increasing flow rates, VFS removal efficiencies over annual time scales may be significantly lower than the per-event values or averages typically reported in the literature and used in decision-making models. By applying a stochastic approach to a two-component VFS model, we investigated the extent of the disparity between two calculation methods: averaging efficiencies from each event over the course of one year, versus reporting the total annual load reduction. We examined the effects of soil texture, concentration-discharge relationship, and VFS slope to reveal the potential errors that may be incurred by ignoring the effects of temporal inequality in quantifying VFS performance. Simulation results suggest that errors can be as low as < 2% and as high as > 20%, with the differences between the two methods of removal efficiency calculations greatest for: (i) soils with high percentage of fine particulates; (ii) VFSs with higher slopes; and (iii) strongly positive concentration-discharge relationships. These results can aid in annual-scale decision making for achieving downstream water quality goals.

The manipulative skill: Cognitive devices and their neural correlates underlying Machiavellian's decision making.

PubMed

Bereczkei, Tamas

2015-10-01

Until now, Machiavellianism has mainly been studied in personality and social psychological framework, and little attention has been paid to the underlying cognitive and neural equipment. In light of recent findings, Machiavellian social skills are not limited to emotion regulation and "cold-mindedness" as many authors have recently stated, but linked to specific cognitive abilities. Although Machiavellians appear to have a relatively poor mindreading ability and emotional intelligence, they can efficiently exploit others which is likely to come from their flexible problem solving processes in changing environmental circumstances. The author proposed that Machiavellians have specialized cognitive domains of decision making, such as monitoring others' behavior, task orientation, reward seeking, inhibition of cooperative feelings, and choosing victims. He related the relevant aspects of cognitive functions to their neurological substrates, and argued why they make Machiavellians so successful in interpersonal relationships. Copyright © 2015 Elsevier Inc. All rights reserved.

Encouraging information sharing to boost the name-your-own-price auction

NASA Astrophysics Data System (ADS)

Chen, Yahong; Li, Jinlin; Huang, He; Ran, Lun; Hu, Yusheng

2017-08-01

During a name-your-own-price (NYOP) auction, buyers can learn a lot of knowledge from their socially connected peers. Such social learning process makes them become more active to attend the auction and also helps them make decisions on what price to submit. Combining an information diffusion model and a belief decision model, we explore three effects of bidders' information sharing on the buyers' behaviors and the seller profit. The results indicate that information sharing significantly increases the NYOP popularity and the seller profit. When enlarging the quality or quantity of information sharing, or increasing the spreading efficiency of the network topology, the number of attenders and the seller profit are increased significantly. However, the spread of information may make bidders be more likely to bid higher and consequently lose surplus. In addition, the different but interdependent influence of the successful information and failure information are discussed in this work.

A Fuzzy Rule Based Decision Support System for Identifying Location of Water Harvesting Technologies in Rainfed Agricultural Regions

NASA Astrophysics Data System (ADS)

Chaubey, I.; Vema, V. K.; Sudheer, K.

2016-12-01

Site suitability evaluation of water conservation structures in water scarce rainfed agricultural areas consist of assessment of various landscape characteristics and various criterion. Many of these landscape characteristic attributes are conveyed through linguistic terms rather than precise numeric values. Fuzzy rule based system are capable of incorporating uncertainty and vagueness, when various decision making criteria expressed in linguistic terms are expressed as fuzzy rules. In this study a fuzzy rule based decision support system is developed, for optimal site selection of water harvesting technologies. Water conservation technologies like farm ponds, Check dams, Rock filled dams and percolation ponds aid in conserving water for irrigation and recharging aquifers and development of such a system will aid in improving the efficiency of the structures. Attributes and criteria involved in decision making are classified into different groups to estimate the suitability of the particular technology. The developed model is applied and tested on an Indian watershed. The input attributes are prepared in raster format in ArcGIS software and suitability of each raster cell is calculated and output is generated in the form of a thematic map showing the suitability of the cells pertaining to different technologies. The output of the developed model is compared against the already existing structures and results are satisfactory. This developed model will aid in improving the sustainability and efficiency of the watershed management programs aimed at enhancing in situ moisture content.

Understanding what matters: An exploratory study to investigate the views of the general public for priority setting criteria in health care.

PubMed

Ratcliffe, Julie; Lancsar, Emily; Walker, Ruth; Gu, Yuanyuan

2017-06-01

Health care policy makers internationally are increasingly expressing commitment to consultation with, and incorporation of, the views of the general public into the formulation of health policy and the process of setting health care priorities. In practice, however, there are relatively few opportunities for the general public to be involved in health care decision-making. In making resource allocation decisions, funders, tasked with managing scarce health care resources, are often faced with difficult decisions in balancing efficiency with equity considerations. A mixed methods (qualitative and quantitative) approach incorporating focus group discussions and a ranking exercise was utilised to develop a comprehensive list of potential criteria for setting priorities in health care formulated from the perspective of members of the general public in Australia. A strong level of congruence was found in terms of the rankings of the key criteria with the size of the health gain, clinical effectiveness, and the ability to provide quality of life improvements identified consistently as the three most important criteria for prioritising the funding of an intervention. Findings from this study will be incorporated into a novel DCE framework to explore how decision makers and members of the general public prioritize and trade off different types of health gain and to quantify the weights attached to specific efficiency and equity criteria in the priority setting process. Copyright © 2017 Elsevier B.V. All rights reserved.

Evolution of US DOE Performance Assessments Over 20 Years - 13597

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

Suttora, Linda C.; Seitz, Roger R.

2013-07-01

Performance assessments (PAs) have been used for many years for the analysis of post-closure hazards associated with a radioactive waste disposal facility and to provide a reasonable expectation of the ability of the site and facility design to meet objectives for the protection of members of the public and the environment. The use of PA to support decision-making for LLW disposal facilities has been mandated in United States Department of Energy (US DOE) directives governing radioactive waste management since 1988 (currently DOE Order 435.1, Radioactive Waste Management). Prior to that time, PAs were also used in a less formal role.more » Over the past 20+ years, the US DOE approach to conduct, review and apply PAs has evolved into an efficient, rigorous and mature process that includes specific requirements for continuous improvement and independent reviews. The PA process has evolved through refinement of a graded and iterative approach designed to help focus efforts on those aspects of the problem expected to have the greatest influence on the decision being made. Many of the evolutionary changes to the PA process are linked to the refinement of the PA maintenance concept that has proven to be an important element of US DOE PA requirements in the context of supporting decision-making for safe disposal of LLW. The PA maintenance concept is central to the evolution of the graded and iterative philosophy and has helped to drive the evolution of PAs from a deterministic compliance calculation into a systematic approach that helps to focus on critical aspects of the disposal system in a manner designed to provide a more informed basis for decision-making throughout the life of a disposal facility (e.g., monitoring, research and testing, waste acceptance criteria, design improvements, data collection, model refinements). A significant evolution in PA modeling has been associated with improved use of uncertainty and sensitivity analysis techniques to support efficient implementation of the graded and iterative approach. Rather than attempt to exactly predict the migration of radionuclides in a disposal unit, the best PAs have evolved into tools that provide a range of results to guide decision-makers in planning the most efficient, cost effective, and safe disposal of radionuclides. (authors)« less

Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

PubMed

Dexter, Franklin; Epstein, Richard H

2015-12-01

As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement. Agreements assure that processes mutually beneficial to organizations, but not necessarily to individuals at each point in time, are performed as designed, especially in the setting of cognitive biases.

IS THE LINK BETWEEN HEALTH AND WEALTH CONSIDERED IN DECISION MAKING? RESULTS FROM A QUALITATIVE STUDY.

PubMed

Garau, Martina; Shah, Koonal Kirit; Sharma, Priya; Towse, Adrian

2015-01-01

The aim of this study was to explore whether wealth effects of health interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. To analyze reasons for including, or not including, wealth effects. Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom). There is evidence suggesting that health interventions can produce economic gains for patients and national economies. However, we found that the link between health and wealth does not influence decision making in any country with the exception of Sweden. This is due to a combination of factors, including system fragmentation, methodological issues, and the economic recession forcing national governments to focus on short-term measures. In countries with established HTA processes and methods allowing, in principle, the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and see a more systematic consideration of wealth effect in decision making. This would be consistent with principles of efficient priority setting. Barriers for the consideration of wealth effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, governments should consider all relevant effects from public investments, including healthcare, even when benefits can only be captured in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns.

Modular evaluation method for subsurface activities (MEMSA). A novel approach for integrating social acceptance in a permit decision-making process for subsurface activities

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

Os, Herman W.A. van, E-mail: h.w.a.van.os@rug.nl; Herber, Rien, E-mail: rien.herber@rug.nl; Scholtens, Bert, E-mail: l.j.r.scholtens@rug.nl

We investigate how the decision support system ‘Modular Evaluation Method Subsurface Activities’ (MEMSA) can help facilitate an informed decision-making process for permit applications of subsurface activities. To this end, we analyze the extent the MEMSA approach allows for a dialogue between stakeholders in a transparent manner. We use the exploration permit for the underground gas storage facility at the Pieterburen salt dome (Netherlands) as a case study. The results suggest that the MEMSA approach is flexible enough to adjust to changing conditions. Furthermore, MEMSA provides a novel way for identifying structural problems and possible solutions in permit decision-making processes formore » subsurface activities, on the basis of the sensitivity analysis of intermediate rankings. We suggest that the planned size of an activity should already be specified in the exploration phase, because this would allow for a more efficient use of the subsurface as a whole. We conclude that the host community should be involved to a greater extent and in an early phase of the permit decision-making process, for example, already during the initial analysis of the project area of a subsurface activity. We suggest that strategic national policy goals are to be re-evaluated on a regular basis, in the form of a strategic vision for the subsurface, to account for timing discrepancies between the realization of activities and policy deadlines, because this discrepancy can have a large impact on the necessity and therefore acceptance of a subsurface activity.« less

Clinical Decision Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents

PubMed Central

Danielson, Carla Kmett; Cohen, Joseph; Adams, Zachary; Youngstrom, Eric A.; Soltis, Kathryn; Amstadter, Ananda B.; Ruggiero, Kenneth J.

2016-01-01

The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2,000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC=.90), trauma history (AUC=.76), social support (AUC=.70), and family conflict (AUC=.72). Youth were 2–3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed. PMID:27103002

Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents.

PubMed

Danielson, Carla Kmett; Cohen, Joseph R; Adams, Zachary W; Youngstrom, Eric A; Soltis, Kathryn; Amstadter, Ananda B; Ruggiero, Kenneth J

2017-01-01

The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.

Procuring Stationary Fuel Cells For CHP: A Guide for Federal Facility Decision Makers

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

Stinton, David P; McGervey, Joseph; Curran, Scott

2011-11-01

Federal agency leaders are expressing growing interest in using innovative fuel cell combined heat and power (CHP) technology at their sites, motivated by both executive branch sustainability targets and a desire to lead by example in the transition to a clean energy economy. Fuel cell CHP can deliver reliable electricity and heat with 70% to 85% efficiency. Implementing this technology can be a high efficiency, clean energy solution for agencies striving to meet ambitious sustainability requirements with limited budgets. Fuel cell CHP systems can use natural gas or renewable fuels, such as biogas. Procuring Stationary Fuel Cells for CHP: Amore » Guide for Federal Facility Decision Makers presents an overview of the process for planning and implementing a fuel cell CHP project in a concise, step-by-step format. This guide is designed to help agency leaders turn their interest in fuel cell technology into successful installations. This guide concentrates on larger (100 kW and greater) fuel cell CHP systems and does not consider other fuel cell applications such as cars, forklifts, backup power supplies or small generators (<100 kW). Because fuel cell technologies are rapidly evolving and have high up front costs, their deployment poses unique challenges. The electrical and thermal output of the CHP system must be integrated with the building s energy systems. Innovative financing mechanisms allow agencies to make a make versus buy decision to maximize savings. This guide outlines methods that federal agencies may use to procure fuel cell CHP systems with little or no capital investment. Each agency and division, however, has its own set of procurement procedures. This guide was written as a starting point, and it defers to the reader s set of rules if differences exist. The fuel cell industry is maturing, and project developers are gaining experience in working with federal agencies. Technology improvements, cost reductions, and experienced project developers are making fuel cell projects easier to put into service. In this environment, federal decision makers can focus on being smart buyers of fuel cell energy instead of attempting to become experts in fuel cell technology. For agencies that want to pursue a fuel cell CHP this guide presents a four step process for a successful project. 1. Perform a preliminary screening of the energy needs energy costs and incentives. 2. Compare a detailed project plan. 3. Make a financing and contracting decision. 4. Execute the project plan including financing, installation, and operation. The simplest procurement method is designated funding for the outright purchase of the fuel cell CHP system, although this is usually not the most cost-effective option. This guide describes the following financing options: Power purchase agreement Energy savings performance contract Utility energy services contract Enhanced use lease Fuel cell CHP technology can help federal facility managers comply with agency objectives for reducing energy consumption and air pollution emissions. Fuel cells do not generate particulate pollutants, unburned hydrocarbons or the gases that produce acid rain. Fuel cells emit less carbon dioxide (CO2) than other, less efficient technologies and use of renewable fuels can make them carbon neutral. Fuel cell CHP technology can deliver reliable electricity and heat with high efficiency (70% to 85%) in a small physical footprint with little noise, making it a cost-effective option for federal facilities.« less

Impact of Probabilistic Weather on Flight Routing Decisions

NASA Technical Reports Server (NTRS)

Sheth, Kapil; Sridhar, Banavar; Mulfinger, Daniel

2006-01-01

Flight delays in the United States have been found to increase year after year, along with the increase in air traffic. During the four-month period from May through August of 2005, weather related delays accounted for roughly 70% of all reported delays, The current weather prediction in tactical (within 2 hours) timeframe is at manageable levels, however, the state of forecasting weather for strategic (2-6 hours) timeframe is still not dependable for long-term planning. In the absence of reliable severe weather forecasts, the decision-making for flights longer than two hours is challenging. This paper deals with an approach of using probabilistic weather prediction for Traffic Flow Management use, and a general method using this prediction for estimating expected values of flight length and delays in the National Airspace System (NAS). The current state-of-the-art convective weather forecasting is employed to aid the decision makers in arriving at decisions for traffic flow and flight planing. The six-agency effort working on the Next Generation Air Transportation System (NGATS) have considered weather-assimilated decision-making as one of the principal foci out of a list of eight. The weather Integrated Product Team has considered integrated weather information and improved aviation weather forecasts as two of the main efforts (Ref. 1, 2). Recently, research has focused on the concept of operations for strategic traffic flow management (Ref. 3) and how weather data can be integrated for improved decision-making for efficient traffic management initiatives (Ref. 4, 5). An overview of the weather data needs and benefits of various participants in the air traffic system along with available products can be found in Ref. 6. Previous work related to use of weather data in identifying and categorizing pilot intrusions into severe weather regions (Ref. 7, 8) has demonstrated a need for better forecasting in the strategic planning timeframes and moving towards a probabilistic description of weather (Ref. 9). This paper focuses on. specified probability in a local region for flight intrusion/deviation decision-making. The process uses a probabilistic weather description, implements that in a air traffic assessment system to study trajectories of aircraft crossing a cut-off probability contour. This value would be useful for meteorologists in creating optimum distribution profiles for severe weather, Once available, the expected values of flight path and aggregate delays are calculated for efficient operations. The current research, however, does not deal with the issue of multiple cell encounters, as well as echo tops, and will be a topic of future work.

Hurdling barriers through market uncertainty: Case studies ininnovative technology adoption

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

Payne, Christopher T.; Radspieler Jr., Anthony; Payne, Jack

The crisis atmosphere surrounding electricity availability in California during the summer of 2001 produced two distinct phenomena in commercial energy consumption decision-making: desires to guarantee energy availability while blackouts were still widely anticipated, and desires to avoid or mitigate significant price increases when higher commercial electricity tariffs took effect. The climate of increased consideration of these factors seems to have led, in some cases, to greater willingness on the part of business decision-makers to consider highly innovative technologies. This paper examines three case studies of innovative technology adoption: retrofit of time-and-temperature signs on an office building; installation of fuel cellsmore » to supply power, heating, and cooling to the same building; and installation of a gas-fired heat pump at a microbrewery. We examine the decision process that led to adoption of these technologies. In each case, specific constraints had made more conventional energy-efficient technologies inapplicable. We examine how these barriers to technology adoption developed over time, how the California energy decision-making climate combined with the characteristics of these innovative technologies to overcome the barriers, and what the implications of hurdling these barriers are for future energy decisions within the firms.« less

The impacts of racial group membership on people's distributive justice: an event-related potential study.

PubMed

Wang, Yan; Tang, Yi-Yuan; Deng, Yuqin

2014-04-16

How individuals and societies distribute benefits has long been studied by psychologists and sociologists. Previous work has highlighted the importance of social identity on people's justice concerns. However, it is not entirely clear how racial in-group/out-group relationship affects the brain activity in distributive justice. In this study, event-related potentials were recorded while participants made their decisions about donation allocation. Behavioral results showed that racial in-group factor affected participants' decisions on justice consideration. Participants were more likely to make relatively equity decisions when racial in-group factor was congruent with equity compared with the corresponding incongruent condition. Moreover, this incongruent condition took longer response times than congruent condition. Meanwhile, less equity decisions were made when efficiency was larger in the opposite side to equity than it was equal between the two options. Scalp event-related potential analyses revealed that greater P300 and late positive potential amplitudes were elicited by the incongruent condition compared with the congruent condition. These findings suggest that the decision-making of distributive justice could be modulated by racial group membership, and greater attentional resources or cognitive efforts are required when racial in-group factor and equity conflict with each other.

Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

PubMed

Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

2012-09-01

The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial opportunity to refine decision making and group dynamics. Making the best possible decisions concerning therapeutics selection for trial testing is a cornerstone of the Network's function.

Least Reliable Bits Coding (LRBC) for high data rate satellite communications

NASA Technical Reports Server (NTRS)

Vanderaar, Mark; Wagner, Paul; Budinger, James

1992-01-01

An analysis and discussion of a bandwidth efficient multi-level/multi-stage block coded modulation technique called Least Reliable Bits Coding (LRBC) is presented. LRBC uses simple multi-level component codes that provide increased error protection on increasingly unreliable modulated bits in order to maintain an overall high code rate that increases spectral efficiency. Further, soft-decision multi-stage decoding is used to make decisions on unprotected bits through corrections made on more protected bits. Using analytical expressions and tight performance bounds it is shown that LRBC can achieve increased spectral efficiency and maintain equivalent or better power efficiency compared to that of Binary Phase Shift Keying (BPSK). Bit error rates (BER) vs. channel bit energy with Additive White Gaussian Noise (AWGN) are given for a set of LRB Reed-Solomon (RS) encoded 8PSK modulation formats with an ensemble rate of 8/9. All formats exhibit a spectral efficiency of 2.67 = (log2(8))(8/9) information bps/Hz. Bit by bit coded and uncoded error probabilities with soft-decision information are determined. These are traded with with code rate to determine parameters that achieve good performance. The relative simplicity of Galois field algebra vs. the Viterbi algorithm and the availability of high speed commercial Very Large Scale Integration (VLSI) for block codes indicates that LRBC using block codes is a desirable method for high data rate implementations.

Automation bias: decision making and performance in high-tech cockpits.

PubMed

Mosier, K L; Skitka, L J; Heers, S; Burdick, M

1997-01-01

Automated aids and decision support tools are rapidly becoming indispensable tools in high-technology cockpits and are assuming increasing control of"cognitive" flight tasks, such as calculating fuel-efficient routes, navigating, or detecting and diagnosing system malfunctions and abnormalities. This study was designed to investigate automation bias, a recently documented factor in the use of automated aids and decision support systems. The term refers to omission and commission errors resulting from the use of automated cues as a heuristic replacement for vigilant information seeking and processing. Glass-cockpit pilots flew flight scenarios involving automation events or opportunities for automation-related omission and commission errors. Although experimentally manipulated accountability demands did not significantly impact performance, post hoc analyses revealed that those pilots who reported an internalized perception of "accountability" for their performance and strategies of interaction with the automation were significantly more likely to double-check automated functioning against other cues and less likely to commit errors than those who did not share this perception. Pilots were also lilkely to erroneously "remember" the presence of expected cues when describing their decision-making processes.

Enhancing stakeholder involvement in environmental decision making: Active Response Geographic Information System

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

Faber, B.G.; Thomas, V.L.; Thomas, M.R.

This paper describes a spatial decision support system that facilitates land-related negotiations and resolving conflicts. This system, called Active Response Geographic Information System (AR/GIS), uses a geographic information system to examine land resource management issues which involve multiple stakeholder groups. In this process, participants are given the opportunity and tools needed to share ideas in a facilitated land resource allocation negotiation session. Participants are able to assess current land status, develop objectives, propose alternative planning scenarios, and evaluate the effects or impacts of each alternative. AR/GIS is a unique tool that puts geographic information directly at the fingertips of non-technicalmore » policy analysts, decision makers, and representatives of stakeholder groups during the negotiation process. AR/GIS enhances individual comprehension and ownership of the decision making process and increasing the efficiency and effectiveness of group debate. It is most beneficial to planning tasks which are inherently geographic in nature, which require consideration of a large number of physical constraints and economic implications, and which involve publicly sensitive tradeoffs.« less

Decision based on big data research for non-small cell lung cancer in medical artificial system in developing country.

PubMed

Wu, Jia; Tan, Yanlin; Chen, Zhigang; Zhao, Ming

2018-06-01

Non-small cell lung cancer (NSCLC) is a high risk cancer and is usually scanned by PET-CT for testing, predicting and then give the treatment methods. However, in the actual hospital system, at least 640 images must be generated for each patient through PET-CT scanning. Especially in developing countries, a huge number of patients in NSCLC are attended by doctors. Artificial system can predict and make decision rapidly. According to explore and research artificial medical system, the selection of artificial observations also can result in low work efficiency for doctors. In this study, data information of 2,789,675 patients in three hospitals in China are collected, compiled, and used as the research basis; these data are obtained through image acquisition and diagnostic parameter machine decision-making method on the basis of the machine diagnosis and medical system design model of adjuvant therapy. By combining image and diagnostic parameters, the machine decision diagnosis auxiliary algorithm is established. Experimental result shows that the accuracy has reached 77% in NSCLC. Copyright © 2018 Elsevier B.V. All rights reserved.

Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

PubMed

Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

2017-03-01

The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

From Executive Desks to the Arctic Ocean and Back: A Dynamic Framework for Natural Resource Management

NASA Astrophysics Data System (ADS)

Auad, G.

2017-12-01

The translating of observational evidence for decision- and policy-making needs to be placed within the context of specific organizational structures to achieve efficient and effective natural resource management. To reach that stage, these structures would consistently integrate governance, decision-making, and legislative and policy elements that, as a whole, can be harmoniously coupled to the natural system under consideration, while being aligned toward a high level management goal. Examples will be highlighted where communication structures found in nature connect hierarchical and spatial scales and are the core of effective living and physical systems. Based on these concepts, a framework will be described while linkages and tradeoffs will be established among the different components of the socio-ecological system being addressed. The importance for decision- and policy-makers to define a continuous learning dynamics will be highlighted as a way to ensure enhanced (scientific and traditional) knowledge over time and therefore reduced uncertainty at decision moment. The need for an overarching management goal will be addressed while its underpinnings will be described and conceptually linked through different internal and external communication models.

Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.

PubMed

Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca

2017-12-01

Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

Can cooperative behaviors promote evacuation efficiency?

NASA Astrophysics Data System (ADS)

Cheng, Yuan; Zheng, Xiaoping

2018-02-01

This study aims to get insight into the question whether cooperative behaviors can promote the evacuation efficiency during an evacuation process. In this work, cooperative behaviors and evacuation efficiency have been examined in detail by using a cellular automata model with behavioral extension. The simulation results show that moderate cooperative behaviors can result in the highest evacuation efficiency. It is found that in a mixture of cooperative and competitive individuals, more cooperative people will lead to relatively high evacuation efficiency, and the larger subgroup will play a leading role. This work can also provide some new insights for the study of cooperative behaviors and evacuation efficiency which can be a scientific decision-making basis for emergency response involving large-scale crowd evacuation in emergencies.

The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

PubMed Central

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2009-01-01

Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes introduced by the participants. We will conduct within-case and cross-case analyses of the data. Discussion The question of the role of economic evaluation in FPs' decision-making is of great interest to scientists, health care practitioners, managers and policy-makers, as well as to consultants, industry, and society. It is believed that the proposed research approach will make an original contribution to the development of knowledge, both empirical and theoretical. PMID:19210787

Decentralisation of Health Services in Fiji: A Decision Space Analysis.

PubMed

Mohammed, Jalal; North, Nicola; Ashton, Toni

2015-11-15

Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Fiji's centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji's deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. © 2016 by Kerman University of Medical Sciences.

Improving decision making in crisis.

PubMed

Higgins, Guy; Freedman, Jennifer

2013-01-01

The most critical activity during emergencies or crises is making decisions about what to do next. This paper provides insights into the challenges that people face in making decisions at any time, but particularly during emergencies and crises. It also introduces the reader to the concept of different sense-making/decision-making domains, the human behaviours that can adversely affect decision making - decision derailers - and ways in which emergency responders can leverage this knowledge to make better decisions. While the literature on decision making is extensive, this paper is focused on those aspects that apply particularly to decision making in emergencies or times of crisis.

Making randomised trials more efficient: report of the first meeting to discuss the Trial Forge platform.

PubMed

Treweek, Shaun; Altman, Doug G; Bower, Peter; Campbell, Marion; Chalmers, Iain; Cotton, Seonaidh; Craig, Peter; Crosby, David; Davidson, Peter; Devane, Declan; Duley, Lelia; Dunn, Janet; Elbourne, Diana; Farrell, Barbara; Gamble, Carrol; Gillies, Katie; Hood, Kerry; Lang, Trudie; Littleford, Roberta; Loudon, Kirsty; McDonald, Alison; McPherson, Gladys; Nelson, Annmarie; Norrie, John; Ramsay, Craig; Sandercock, Peter; Shanahan, Daniel R; Summerskill, William; Sydes, Matt; Williamson, Paula; Clarke, Mike

2015-06-05

Randomised trials are at the heart of evidence-based healthcare, but the methods and infrastructure for conducting these sometimes complex studies are largely evidence free. Trial Forge ( www.trialforge.org ) is an initiative that aims to increase the evidence base for trial decision making and, in doing so, to improve trial efficiency.This paper summarises a one-day workshop held in Edinburgh on 10 July 2014 to discuss Trial Forge and how to advance this initiative. We first outline the problem of inefficiency in randomised trials and go on to describe Trial Forge. We present participants' views on the processes in the life of a randomised trial that should be covered by Trial Forge.General support existed at the workshop for the Trial Forge approach to increase the evidence base for making randomised trial decisions and for improving trial efficiency. Agreed upon key processes included choosing the right research question; logistical planning for delivery, training of staff, recruitment, and retention; data management and dissemination; and close down. The process of linking to existing initiatives where possible was considered crucial. Trial Forge will not be a guideline or a checklist but a 'go to' website for research on randomised trials methods, with a linked programme of applied methodology research, coupled to an effective evidence-dissemination process. Moreover, it will support an informal network of interested trialists who meet virtually (online) and occasionally in person to build capacity and knowledge in the design and conduct of efficient randomised trials.Some of the resources invested in randomised trials are wasted because of limited evidence upon which to base many aspects of design, conduct, analysis, and reporting of clinical trials. Trial Forge will help to address this lack of evidence.

Breaking down IT silos: a "connected" way to improve customer experience and the bottom line.

PubMed

Hallowell, Bruce; Turisco, Frances

2009-03-01

Hospitals can provide customer service like Amazon.com without purchasing new technology. Making technology interactive requires sharing patient data across applications and enhancing existing IT with decision support. Breaking down technology silos between hospital and outpatient care provider systems significantly improves efficiency, lowers costs, and speeds care delivery.

E-mail: Boon or Bane for School Leaders?

ERIC Educational Resources Information Center

Glendinning, Matt

2006-01-01

This article, by a principal who received over 17,000 e-mails in his first year on the job, explores ways in which email is reshaping education leadership. The main assets of e-mail--swift and efficient communication, more informed decision making through improved consultation with stakeholders, and automatic archiving of correspondence--come at a…

Teaching Thinking: The Forgotten Foundation of Education.

ERIC Educational Resources Information Center

Campbell, Tom; And Others

Descriptions are presented of three programs whose primary purpose is to teach students to think more efficiently, that is, to develop habits of critical thinking, and to improve decision-making and problem-solving skills. One of the three programs operates at Bowling Green State University and seeks to develop skill in critical analysis by…

Practical Considerations in Creating School-Wide Positive Behavior Support in Public Schools

ERIC Educational Resources Information Center

Handler, Marcie W.; Rey, Jannette; Connell, James; Thier, Kimberly; Feinberg, Adam; Putnam, Robert

2007-01-01

School-wide positive behavior support (SWPBS) has been identified as an effective and efficient method to teach students prosocial skills. It requires both effective behavior support practices and systems that will support these changes, including data-based decision making among the school leadership team. There are many practical and systemic…

Seriously Data-Driven Decision Making

ERIC Educational Resources Information Center

Casserly, Michael D.

2011-01-01

As states approach the funding cliff marking the end of federal stimulus help for education, school districts will be feeling more financial pain than they're experiencing now. But there's good news amid the bad: Big city districts are showing schools nationwide a way to save money and improve efficiency by working together. They've created the…

Organizational Culture at the University Level: A Study Using the OCAI Instrument

ERIC Educational Resources Information Center

Fralinger, Barbara; Olson, Valerie

2007-01-01

Organizational culture is a primary component of functional decision making in universities. In order for administrators, faculty, and staff to effectively coordinate an efficient academic environment for health education, continuing cultural assessment and change are necessary. The purpose of this study was to explore the concept of culture at…

Evaluation Methods Basis of Strategy Development Effectiveness of the Enterprise

ERIC Educational Resources Information Center

Zotova, Anna S.; Kandrashina, Elena A.; Ivliev, Andrey D.; Charaeva, Marina V.

2016-01-01

The urgency to study the problem is caused by the necessity to make management decisions in terms of reducing goods life cycle, reducing profitability of production, increasing speed of technological progress. In this context, this article aims to identify and elaborate the tools for integrated diagnostic of strategy efficiency, taking into…

Increasing the Efficiency of Program Status Reporting by Residential Direct Care Staff

ERIC Educational Resources Information Center

Bastien, James S.; Burns, William J.; Kelly, Francis D.; Schumm, Patricia A.; Allen, Theresa P.

2005-01-01

In large residential treatment centers for adolescent youth, program administrators and clinical staff rely on the information imparted to them by direct care staff to make appropriate decisions regarding administrative and clinical support functions so that the residents in care can receive the best treatment possible. This study was designed to…

Assessing soil erosion on trails: A comparison of techniques

Treesearch

Mark C. Jewell; William E. Hammitt

2000-01-01

Reports of trail degradation have been increasing in different wildernesses. This impact has become a common concern among managers. Deteriorating tread conditions of trails are increasing, as is concern at protected areas worldwide. In order to make objective and timely trail resource decisions, managers need to have effective and efficient methods of assessing trail...

Energy Conservation for the Home Builder: A Course for Residential Builders. Course Outline and Instructional Materials.

ERIC Educational Resources Information Center

Koenigshofer, Daniel R.

Background information, handouts and related instructional materials comprise this manual for conducting a course on energy conservation for home builders. Information presented in the five- and ten-hour course is intended to help residential contractors make appropriate and cost-effective decisions in constructing energy-efficient dwellings.…

An Integrated Decision-Making Framework for Sustainability Assessment: A Case Study of Memorial University

ERIC Educational Resources Information Center

Waheed, Bushra; Khan, Faisal; Veitch, Brian; Hawboldt, Kelly

2011-01-01

This article presents an overview of the sustainability initiatives at the St. John's campus of Memorial University in Newfoundland and Labrador (Canada). The key initiatives include setting a realistic goal for energy efficiency, becoming carbon neutral, and conducting various research and outreach projects related to sustainability. As…

Networks and games for precision medicine.

PubMed

Biane, Célia; Delaplace, Franck; Klaudel, Hanna

2016-12-01

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

Generalized railway tank car safety design optimization for hazardous materials transport: addressing the trade-off between transportation efficiency and safety.

PubMed

Saat, Mohd Rapik; Barkan, Christopher P L

2011-05-15

North America railways offer safe and generally the most economical means of long distance transport of hazardous materials. Nevertheless, in the event of a train accident releases of these materials can pose substantial risk to human health, property or the environment. The majority of railway shipments of hazardous materials are in tank cars. Improving the safety design of these cars to make them more robust in accidents generally increases their weight thereby reducing their capacity and consequent transportation efficiency. This paper presents a generalized tank car safety design optimization model that addresses this tradeoff. The optimization model enables evaluation of each element of tank car safety design, independently and in combination with one another. We present the optimization model by identifying a set of Pareto-optimal solutions for a baseline tank car design in a bicriteria decision problem. This model provides a quantitative framework for a rational decision-making process involving tank car safety design enhancements to reduce the risk of transporting hazardous materials. Copyright © 2011 Elsevier B.V. All rights reserved.

Multi-Objective, Auto-Optimization Modeling for Resource Allocation Decision Making in the Military Health System

DTIC Science & Technology

2014-01-22

FTEs would need to be reduced by 12.16, expenses reduced by $184.63K, and the number of interns adjusted by 7.67. The reference set for DMU D includes...efficiency: concept, measurement techniques and review of hospital efficiency studies. Malaysian Journal of Public Health Medicine, 10(2), 35-43...REPORT DOCUMENTATION PAGE Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 Form Approved OMB No. 0704-0188 The public reporting burden

Caring and professional practice settings: the impact of technology, change, and efficiency.

PubMed

Crow, G

2001-01-01

Technology, change, efficiency, and caring are not necessarily concepts that are used in the same sentence when describing motivational and professional practice settings. Caring within health care organizations can take many forms. One of the most significant and meaningful forms is through building networks for shared decision making and shared accountability. While caring can save the life of a patient and convey trust and commitment to patients, families, and staff, it can also save the life of your organization.

Planetary micro-rover operations on Mars using a Bayesian framework for inference and control

NASA Astrophysics Data System (ADS)

Post, Mark A.; Li, Junquan; Quine, Brendan M.

2016-03-01

With the recent progress toward the application of commercially-available hardware to small-scale space missions, it is now becoming feasible for groups of small, efficient robots based on low-power embedded hardware to perform simple tasks on other planets in the place of large-scale, heavy and expensive robots. In this paper, we describe design and programming of the Beaver micro-rover developed for Northern Light, a Canadian initiative to send a small lander and rover to Mars to study the Martian surface and subsurface. For a small, hardware-limited rover to handle an uncertain and mostly unknown environment without constant management by human operators, we use a Bayesian network of discrete random variables as an abstraction of expert knowledge about the rover and its environment, and inference operations for control. A framework for efficient construction and inference into a Bayesian network using only the C language and fixed-point mathematics on embedded hardware has been developed for the Beaver to make intelligent decisions with minimal sensor data. We study the performance of the Beaver as it probabilistically maps a simple outdoor environment with sensor models that include uncertainty. Results indicate that the Beaver and other small and simple robotic platforms can make use of a Bayesian network to make intelligent decisions in uncertain planetary environments.

Development of a real-time clinical decision support system upon the web mvc-based architecture for prostate cancer treatment

PubMed Central

2011-01-01

Background A real-time clinical decision support system (RTCDSS) with interactive diagrams enables clinicians to instantly and efficiently track patients' clinical records (PCRs) and improve their quality of clinical care. We propose a RTCDSS to process online clinical informatics from multiple databases for clinical decision making in the treatment of prostate cancer based on Web Model-View-Controller (MVC) architecture, by which the system can easily be adapted to different diseases and applications. Methods We designed a framework upon the Web MVC-based architecture in which the reusable and extractable models can be conveniently adapted to other hospital information systems and which allows for efficient database integration. Then, we determined the clinical variables of the prostate cancer treatment based on participating clinicians' opinions and developed a computational model to determine the pretreatment parameters. Furthermore, the components of the RTCDSS integrated PCRs and decision factors for real-time analysis to provide evidence-based diagrams upon the clinician-oriented interface for visualization of treatment guidance and health risk assessment. Results The resulting system can improve quality of clinical treatment by allowing clinicians to concurrently analyze and evaluate the clinical markers of prostate cancer patients with instantaneous clinical data and evidence-based diagrams which can automatically identify pretreatment parameters. Moreover, the proposed RTCDSS can aid interactions between patients and clinicians. Conclusions Our proposed framework supports online clinical informatics, evaluates treatment risks, offers interactive guidance, and provides real-time reference for decision making in the treatment of prostate cancer. The developed clinician-oriented interface can assist clinicians in conveniently presenting evidence-based information to patients and can be readily adapted to an existing hospital information system and be easily applied in other chronic diseases. PMID:21385459

Development of a real-time clinical decision support system upon the Web MVC-based architecture for prostate cancer treatment.

PubMed

Lin, Hsueh-Chun; Wu, Hsi-Chin; Chang, Chih-Hung; Li, Tsai-Chung; Liang, Wen-Miin; Wang, Jong-Yi Wang

2011-03-08

A real-time clinical decision support system (RTCDSS) with interactive diagrams enables clinicians to instantly and efficiently track patients' clinical records (PCRs) and improve their quality of clinical care. We propose a RTCDSS to process online clinical informatics from multiple databases for clinical decision making in the treatment of prostate cancer based on Web Model-View-Controller (MVC) architecture, by which the system can easily be adapted to different diseases and applications. We designed a framework upon the Web MVC-based architecture in which the reusable and extractable models can be conveniently adapted to other hospital information systems and which allows for efficient database integration. Then, we determined the clinical variables of the prostate cancer treatment based on participating clinicians' opinions and developed a computational model to determine the pretreatment parameters. Furthermore, the components of the RTCDSS integrated PCRs and decision factors for real-time analysis to provide evidence-based diagrams upon the clinician-oriented interface for visualization of treatment guidance and health risk assessment. The resulting system can improve quality of clinical treatment by allowing clinicians to concurrently analyze and evaluate the clinical markers of prostate cancer patients with instantaneous clinical data and evidence-based diagrams which can automatically identify pretreatment parameters. Moreover, the proposed RTCDSS can aid interactions between patients and clinicians. Our proposed framework supports online clinical informatics, evaluates treatment risks, offers interactive guidance, and provides real-time reference for decision making in the treatment of prostate cancer. The developed clinician-oriented interface can assist clinicians in conveniently presenting evidence-based information to patients and can be readily adapted to an existing hospital information system and be easily applied in other chronic diseases.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

REACT Real-Time Emergency Action Coordination Tool

NASA Technical Reports Server (NTRS)

2004-01-01

Recently the Emergency Management Operations Center (EMOC) of St. Tammany Parish turned to the Technology Development and Transfer Office (TDTO) of NASA's Stennis Space Center (SSC) for help in combating the problems associated with water inundation. Working through a Dual-Use Development Agreement the Technology Development and Transfer Office, EMOC and a small geospatial applications company named Nvision provided the parish with a new front-line defense. REACT, Real-time Emergency Action coordination Tool is a decision support system that integrates disparate information to enable more efficient decision making by emergency management personnel.

Shared Decision-Making in the Management of Congenital Vascular Malformations.

PubMed

Horbach, Sophie E R; Ubbink, Dirk T; Stubenrouch, Fabienne E; Koelemay, Mark J W; van der Vleuten, Carine J M; Verhoeven, Bas H; Reekers, Jim A; Schultze Kool, Leo J; van der Horst, Chantal M A M

2017-03-01

In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters. In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making). Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores. Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.

A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.

PubMed

Truglio-Londrigan, Marie; Slyer, Jason T; Singleton, Joanne K; Worral, Priscilla

The objective of this review is to identify and synthesize the best available evidence related to the meaningfulness of internal and external influences on shared-decision making for adult patients and health care providers in all health care settings.The specific questions to be answered are: BACKGROUND: Patient-centered care is emphasized in today's healthcare arena. This emphasis is seen in the works of the International Alliance of Patients' Organizations (IAOP) who describe patient-centered healthcare as care that is aimed at addressing the needs and preferences of patients. The IAOP presents five principles which are foundational to the achievement of patient-centered healthcare: respect, choice, policy, access and support, as well as information. These five principles are further described as:Within the description of these five principles the idea of shared decision-making is clearly evident.The concept of shared decision-making began to appear in the literature in the 1990s. It is defined as a "process jointly shared by patients and their health care provider. It aims at helping patients play an active role in decisions concerning their health, which is the ultimate goal of patient-centered care." The details of the shared decision-making process are complex and consist of a series of steps including:Three overall representative decision-making models are noted in contemporary literature. These three models include: paternalistic, informed decision-making, and shared decision-making. The paternalistic model is an autocratic style of decision-making where the healthcare provider carries out the care from the perspective of knowing what is best for the patient and therefore makes all decisions. The informed decision-making model takes place as the information needed to make decisions is conveyed to the patient and the patient makes the decisions without the healthcare provider involvement. Finally, the shared decision-making model is representative of a sharing and a negotiation towards treatment decisions. Thus, these models represent a range with patient non-participation at one end of the continuum to informed decision making or a high level of patient power at the other end. Several shared decision-making models focus on the process of shared decision-making previously noted. A discussion of several process models follows below.Charles et al. depicts a process model of shared decision-making that identifies key characteristics that must be in evidence. The patient shares in the responsibility with the healthcare provider in this model. The key characteristics included:This model illustrates that there must be at least two individuals participating, however, family and friends may be involved in a variety of roles such as the collector of information, the interpreter of this information, coach, advisor, negotiator, and caretaker. This model also depicts the need to take steps to participate in the shared decision-making process. To take steps means that there is an agreement between and among all involved that shared decision-making is necessary and preferred. Research about patient preferences, however, offers divergent views. The link between patient preferences for shared decision-making and the actuality of shared decision-making in practice is not strong. Research concerning patients and patient preferences on shared decision-making points to variations depending on age, education, socio-economic status, culture, and diagnosis. Healthcare providers may also hold preferences for shared decision-making; however, research in this area is not as comprehensive as is patient focused research. Elwyn et al. explored the views of general practice providers on involving patients in decisions. Both positive and negative views were identified ranging from receptive, noting potential benefits, to concern for the unrealistic nature of participation and sharing in the decision-making process. An example of this potential difficulty, from a healthcare provider perspective, is identifying the potential conflict that may develop when a patient's preference is different from clinical practice guidelines. This is further exemplified in healthcare encounters when a situation may not yield itself to a clear answer but rather lies in a grey area. These situations are challenging for healthcare providers.The notion of information sharing as a prerequisite to shared decision-making offers insight into another process. The healthcare provider must provide the patient the information that they need to know and understand in order to even consider and participate in the shared decision-making process. This information may include the disease, potential treatments, consequences of those treatments, and any alternatives, which may include the decision to do nothing. Without knowing this information the patient will not be able to participate in the shared decision-making process. The complexity of this step is realized if one considers what the healthcare provider needs to know in order to first assess what the patient knows and does not know, the readiness of the patient to participate in this educational process and learn the information, as well as, the individual learning styles of the patient taking into consideration the patient's ideas, values, beliefs, education, culture, literacy, and age. Depending on the results of this assessment the health care provider then must communicate the information to the patient. This is also a complex process that must take into consideration the relationship, comfort level, and trust between the healthcare provider and the patient.Finally, the treatment decision is reached between both the healthcare provider and the patient. Charles et al. portrays shared decision-making as a process with the end product, the shared decision, as the outcome. This outcome may be a decision as to the agreement of a treatment decision, no agreement reached as to a treatment decision, and disagreement as to a treatment decision. Negotiation is a part of the process as the "test of a shared decision (as distinct from the decision-making process) is if both parties agree on the treatment option."Towle and Godolphin developed a process model that further exemplifies the role of the healthcare provider and the patient in the shared decision-making process as mutual partners with mutual responsibilities. The capacity to engage in this shared decision-making rests, therefore, on competencies including knowledge, skills, and abilities for both the healthcare provider and the patient. This mutual partnership and the corresponding competencies are presented for both the healthcare provider and the patient in this model. The competencies noted for the healthcare provider for shared decision making include:Patient competencies include:This model illustrates the shared decision-making process with emphasis on the role of the healthcare provider and the patient very similar to the prior model. This model, however, gives greater emphasis to the process of the co-participation of the healthcare provider and the patient. The co-participation depicts a mutual partnership with mutual responsibilities that can be seen as "reciprocal relationships of dialogue." For this to take place the relationship between and among the participants of the shared decision-making process is important along with other internal and external influences such as communication, trust, mutual respect, honesty, time, continuity, and commitment. Cultural, social, and age group differences; evidence; and team and family are considered within this model.Elwyn et al. presents yet another model that depicts the shared decision-making process; however, this model offers a view where the healthcare provider holds greater responsibility in this process. In this particular model the process focuses on the healthcare provider and the essential skills needed to engage the patient in shard decisions. The competencies outlined in this model include:The healthcare provider must demonstrate knowledge, competencies, and skills as a communicator. The skills for communication competency require the healthcare provider to be able to elicit the patient's thoughts and input regarding treatment management throughout the consultation. The healthcare provider must also demonstrate competencies in assessment skills beyond physical assessment that includes the ability to assess the patient's perceptions and readiness to participate. In addition, the healthcare provider must be able to assess the patient's readiness to learn the information that the patient needs to know in order to fully engage in the shared decision-making process, assess what the patient already knows, what the patient does not know, and whether or not the information that the patient knows is accurate. Once this assessment is completed the healthcare provider then must draw on his/her knowledge, competencies, and skills necessary to teach the patient what the patient needs to know to be informed. This facilitates the notion of the tailor-made information noted previously. The healthcare provider also requires competencies in how to check and evaluate the entire process to ensure that the patient does understand and accept with comfort not only the plan being negotiated but the entire process of sharing in decision-making. In addition to the above, there are further competencies such as competence in working with groups and teams, competencies in terms of cultural knowledge, competencies with regard to negotiation skills, as well as, competencies when faced with ethical challenges.Shared decision-making has been associated with autonomy, empowerment, and effectiveness and efficiency. Both patients and health care providers have noted improvement in relationships and improved interactions when shared decision-making is in evidence. Along with this improved relationship and interaction enhanced compliance is noted. Additional research points to patient satisfaction and enhanced quality of life. There is some evidence to suggest that shared decision-making does facilitate positive health outcomes.In today's healthcare environment there is greater emphasis on patient-centered care that exemplifies patient engagement, participation, partnership, and shared decision-making. Given the shift from the more autocratic delivery of care to the shared approach there is a need to more fully understand the what of shared decision-making as well as how shared decision-making takes place along with what internal and external influences may encourage, support, and facilitate the shared decision-making process. These influences are intervening variables that may be of significance for the successful development of practice-based strategies that may foster shared decision-making in practice. The purpose of this qualitative systematic review is to identify internal and external influences on shared decision-making in all health care settings.A preliminary search of the Joanna Briggs Library of Systematic Reviews, MEDLINE, CINAHL, and PROSPERO did not identify any previously conducted qualitative systematic reviews on the meaningfulness of internal and external influences on shared decision-making.

Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.

PubMed

Gregory, Megan E; Sonesh, Shirley C; Feitosa, Jennifer; Benishek, Lauren E; Hughes, Ashley M; Salas, Eduardo

2017-09-01

Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.

The Recognition Heuristic: A Review of Theory and Tests

PubMed Central

Pachur, Thorsten; Todd, Peter M.; Gigerenzer, Gerd; Schooler, Lael J.; Goldstein, Daniel G.

2011-01-01

The recognition heuristic is a prime example of how, by exploiting a match between mind and environment, a simple mental strategy can lead to efficient decision making. The proposal of the heuristic initiated a debate about the processes underlying the use of recognition in decision making. We review research addressing four key aspects of the recognition heuristic: (a) that recognition is often an ecologically valid cue; (b) that people often follow recognition when making inferences; (c) that recognition supersedes further cue knowledge; (d) that its use can produce the less-is-more effect – the phenomenon that lesser states of recognition knowledge can lead to more accurate inferences than more complete states. After we contrast the recognition heuristic to other related concepts, including availability and fluency, we carve out, from the existing findings, some boundary conditions of the use of the recognition heuristic as well as key questions for future research. Moreover, we summarize developments concerning the connection of the recognition heuristic with memory models. We suggest that the recognition heuristic is used adaptively and that, compared to other cues, recognition seems to have a special status in decision making. Finally, we discuss how systematic ignorance is exploited in other cognitive mechanisms (e.g., estimation and preference). PMID:21779266

The effects of stress on nuclear power plant operational decision making and training approaches to reduce stress effects

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

Mumaw, R.J.

1994-08-01

Operational personnel may be exposed to significant levels of stress during unexpected changes in plant state an plant emergencies. The decision making that identifies operational actions, which is strongly determined by procedures, may be affected by stress, and performance may be impaired. ER report analyzes potential effects of stress in nuclear power plant (NPP) settings, especially in the context of severe accident management (SAM). First, potential sources of stress in the NPP setting are identified. This analysis is followed by a review of the ways in which stress is likely to affect performance, with an emphasis on performance of cognitivemore » skills that are linked to operational decision making. Finally, potential training approaches for reducing or eliminating stress effects are identified. Several training approaches have the potential to eliminate or mitigate stress effects on cognitive skill performance. First, the use of simulated events for training can reduce the novelty and uncertainty that can lead to stress and performance impairments. Second, training to make cognitive processing more efficient and less reliant on attention and memory resources can offset the reductions in these resources that occur under stressful conditions. Third, training that targets crew communications skills can reduce the likelihood that communications will fail under stress.« less

Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

PubMed

Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

2015-01-01

Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

PubMed Central

Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

2015-01-01

Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making. PMID:26664402

Role of pharmacoeconomic analysis in R&D decision making: when, where, how?

PubMed

Miller, Paul

2005-01-01

Pharmacoeconomics is vitally important to drug manufacturers in terms of communicating to external decision-makers (payers, prescribers, patients) the value of their products, achieving regulatory and reimbursement approval and contributing to commercial success. Since development of new drugs is long, costly and risky, and decisions must be made how to allocate considerable research and development (R&D) resources, pharmacoeconomics also has an essential role informing internal decision-making (within a company) during drug development. The use of pharmacoeconomics in early development phases is likely to enhance the efficiency of R&D resource use and also provide a solid foundation for communicating product value to external decision-makers further downstream, increasing the likelihood of regulatory (reimbursement) approval and commercial success. This paper puts the case for use of pharmacoeconomic analyses earlier in the development process and outlines five techniques (clinical trial simulation [CTS], option pricing [OP], investment appraisal [IA], threshold analysis [TA] and value of information [VOI] analysis) that can provide useful input into the design of clinical development programmes, portfolio management and optimal pricing strategy. CTS can estimate efficacy and tolerability profiles before clinical data are available. OP can show the value of different clinical programme designs, sequencing of studies and stop decisions. IA can compare expected net present value (NPV) of different product profiles or study designs. TA can be used to understand development drug profile requirements given partial data. VOI can assist risk management by quantifying uncertainty and assessing the economic viability of gathering further information on the development drug. No amount of pharmacoeconomic data can make a bad drug good; what it can do is enhance the drug developers understanding of the characteristics of that drug. Decision-making, in light of this information, is likely to be better than that without it, whether it leads to faster termination of uneconomic projects or the allocation of more appropriate resources to attractive projects.

Shared decision making in the safety net: where do we go from here?

PubMed

Bouma, Angelique B; Tiedje, Kristina; Poplau, Sara; Boehm, Deborah H; Shah, Nilay D; Commers, Matthew J; Linzer, Mark; Montori, Victor M

2014-01-01

Shared decision making (SDM) is an interactive process between clinicians and patients in which both share information, deliberate together, and make clinical decisions. Clinics serving safety net patients face special challenges, including fewer resources and more challenging work environments. The use of SDM within safety net institutions has not been well studied. We recruited a convenience sample of 15 safety net primary care clinicians (13 physicians, 2 nurse practitioners). Each answered a 9-item SDM questionnaire and participated in a semistructured interview. From the transcribed interviews and questionnaire data, we identified themes and suggestions for introducing SDM into a safety net environment. Clinicians reported only partially fulfilling the central components of SDM (sharing information, deliberating, and decision making). Most clinicians expressed interest in SDM by stating that they "selected a treatment option together" with patients (8 of 15 in strong or complete agreement), but only a minority (3 of 15) "thoroughly weighed the different treatment options" together with patients. Clinicians attributed this gap to many barriers, including time pressure, overwhelming visit content, patient preferences, and lack of available resources. All clinicians believed that lack of time made it difficult to practice SDM. To increase use of SDM in the safety net, efficient SDM interventions designed for this environment, team care, and patient engagement in SDM will need further development. Future studies should focus on adapting SDM to safety net settings and determine whether SDM can reduce health care disparities.

Towards sustainable infrastructure management: knowledge-based service-oriented computing framework for visual analytics

NASA Astrophysics Data System (ADS)

Vatcha, Rashna; Lee, Seok-Won; Murty, Ajeet; Tolone, William; Wang, Xiaoyu; Dou, Wenwen; Chang, Remco; Ribarsky, William; Liu, Wanqiu; Chen, Shen-en; Hauser, Edd

2009-05-01

Infrastructure management (and its associated processes) is complex to understand, perform and thus, hard to make efficient and effective informed decisions. The management involves a multi-faceted operation that requires the most robust data fusion, visualization and decision making. In order to protect and build sustainable critical assets, we present our on-going multi-disciplinary large-scale project that establishes the Integrated Remote Sensing and Visualization (IRSV) system with a focus on supporting bridge structure inspection and management. This project involves specific expertise from civil engineers, computer scientists, geographers, and real-world practitioners from industry, local and federal government agencies. IRSV is being designed to accommodate the essential needs from the following aspects: 1) Better understanding and enforcement of complex inspection process that can bridge the gap between evidence gathering and decision making through the implementation of ontological knowledge engineering system; 2) Aggregation, representation and fusion of complex multi-layered heterogeneous data (i.e. infrared imaging, aerial photos and ground-mounted LIDAR etc.) with domain application knowledge to support machine understandable recommendation system; 3) Robust visualization techniques with large-scale analytical and interactive visualizations that support users' decision making; and 4) Integration of these needs through the flexible Service-oriented Architecture (SOA) framework to compose and provide services on-demand. IRSV is expected to serve as a management and data visualization tool for construction deliverable assurance and infrastructure monitoring both periodically (annually, monthly, even daily if needed) as well as after extreme events.

Network meta-analysis of diagnostic test accuracy studies identifies and ranks the optimal diagnostic tests and thresholds for health care policy and decision-making.

PubMed

Owen, Rhiannon K; Cooper, Nicola J; Quinn, Terence J; Lees, Rosalind; Sutton, Alex J

2018-07-01

Network meta-analyses (NMA) have extensively been used to compare the effectiveness of multiple interventions for health care policy and decision-making. However, methods for evaluating the performance of multiple diagnostic tests are less established. In a decision-making context, we are often interested in comparing and ranking the performance of multiple diagnostic tests, at varying levels of test thresholds, in one simultaneous analysis. Motivated by an example of cognitive impairment diagnosis following stroke, we synthesized data from 13 studies assessing the efficiency of two diagnostic tests: Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), at two test thresholds: MMSE <25/30 and <27/30, and MoCA <22/30 and <26/30. Using Markov chain Monte Carlo (MCMC) methods, we fitted a bivariate network meta-analysis model incorporating constraints on increasing test threshold, and accounting for the correlations between multiple test accuracy measures from the same study. We developed and successfully fitted a model comparing multiple tests/threshold combinations while imposing threshold constraints. Using this model, we found that MoCA at threshold <26/30 appeared to have the best true positive rate, whereas MMSE at threshold <25/30 appeared to have the best true negative rate. The combined analysis of multiple tests at multiple thresholds allowed for more rigorous comparisons between competing diagnostics tests for decision making. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Risk Assessment Overview

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

Decision-making on shared sanitation in the informal settlements of Kisumu, Kenya.

PubMed

Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy

2017-10-01

Unlike most quantitative studies that investigate decision-making on investing in sanitation, this study adopted a qualitative approach to investigate decision-making on shared sanitation in the informal settlements of Kisumu city, in Kenya. Using a grounded theory approach, landlords and tenants were interviewed to identify sanitation decisions, individuals involved in decision-making and factors influencing decision-making. The results indicate that the main sanitation decisions are on investment, emptying, repair and cleaning. Landlords make investment, emptying and repair decisions, while tenants make cleaning decisions. Absentee landlords are less involved in most decision-making compared to live-in landlords, who rarely consult tenants in decision-making. Tenants make decisions after consultations with a third party and often collectively with other tenants. Sanitation interventions in informal settlements should thus, target landlords and tenants, with investment efforts being directed at landlords and maintenance efforts at tenants.

New FEDS Software Helps You Design for Maximum Energy Efficiency, Minimum Cost

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

Gilbride, Theresa L.

2003-01-30

This article was written for the Partner Update a newsletter put out by Potomac Communications for DOE's Rebuild America program. The article describes the FEDS (Federal Energy Decision System) software, the official analytical tool of the Rebuild America program. This software, developed by PNNL with support from DOE, FEMP and Rebuild, helps government entities and contractors make informed decisions about which energy efficiency improvements are the most cost effective for their facilities. FEDS churns thru literally thousands of calculations accounting for energy uses, costs, and interactions from different types of HVAC systems, lighting types, insulation levels, building types, occupancy levelsmore » and times. FEDS crunchs the numbers so decision makers can get fast reliable answers on which alternatives are the best for their particular building. In this article, we're touting the improvements in the latest upgrade of FEDS, which is available free to Rebuild America partners. We tell partners what FEDS does, how to order it, and even where to get tech support and training.« less

A supplier selection and order allocation problem with stochastic demands

NASA Astrophysics Data System (ADS)

Zhou, Yun; Zhao, Lei; Zhao, Xiaobo; Jiang, Jianhua

2011-08-01

We consider a system comprising a retailer and a set of candidate suppliers that operates within a finite planning horizon of multiple periods. The retailer replenishes its inventory from the suppliers and satisfies stochastic customer demands. At the beginning of each period, the retailer makes decisions on the replenishment quantity, supplier selection and order allocation among the selected suppliers. An optimisation problem is formulated to minimise the total expected system cost, which includes an outer level stochastic dynamic program for the optimal replenishment quantity and an inner level integer program for supplier selection and order allocation with a given replenishment quantity. For the inner level subproblem, we develop a polynomial algorithm to obtain optimal decisions. For the outer level subproblem, we propose an efficient heuristic for the system with integer-valued inventory, based on the structural properties of the system with real-valued inventory. We investigate the efficiency of the proposed solution approach, as well as the impact of parameters on the optimal replenishment decision with numerical experiments.

Ontology-Based Gap Analysis for Technology Selection: A Knowledge Management Framework for the Support of Equipment Purchasing Processes

NASA Astrophysics Data System (ADS)

Macris, Aristomenis M.; Georgakellos, Dimitrios A.

Technology selection decisions such as equipment purchasing and supplier selection are decisions of strategic importance to companies. The nature of these decisions usually is complex, unstructured and thus, difficult to be captured in a way that will be efficiently reusable. Knowledge reusability is of paramount importance since it enables users participate actively in process design/redesign activities stimulated by the changing technology selection environment. This paper addresses the technology selection problem through an ontology-based approach that captures and makes reusable the equipment purchasing process and assists in identifying (a) the specifications requested by the users' organization, (b) those offered by various candidate vendors' organizations and (c) in performing specifications gap analysis as a prerequisite for effective and efficient technology selection. This approach has practical appeal, operational simplicity, and the potential for both immediate and long-term strategic impact. An example from the iron and steel industry is also presented to illustrate the approach.

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

PubMed

Gillespie, Mary

2010-11-01

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

[Decision Making and Electrodermal Activity].

PubMed

Kobayakawa, Mutsutaka

2016-08-01

Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process.

[Big data analysis and evidence-based medicine: controversy or cooperation].

PubMed

Chen, Xinzu; Hu, Jiankun

2016-01-01

The development of evidence-based medicince should be an important milestone from the empirical medicine to the evidence-driving modern medicine. With the outbreak in biomedical data, the rising big data analysis can efficiently solve exploratory questions or decision-making issues in biomedicine and healthcare activities. The current problem in China is that big data analysis is still not well conducted and applied to deal with problems such as clinical decision-making, public health policy, and should not be a debate whether big data analysis can replace evidence-based medicine or not. Therefore, we should clearly understand, no matter whether evidence-based medicine or big data analysis, the most critical infrastructure must be the substantial work in the design, constructure and collection of original database in China.

Episodic future thinking reduces temporal discounting in healthy adolescents.

PubMed

Bromberg, Uli; Lobatcheva, Maria; Peters, Jan

2017-01-01

Episodic Future Thinking has proven efficient in reducing impulsive behavior in several adult populations. Whether it also has a beneficial impact on decision making in adolescents is not known. Here the impact of episodic future thinking on discounting behavior was investigated in a sample of healthy adolescents (n = 44, age range 13-16 years). Discounting behavior in trials including episodic future thinking was significantly less impulsive than in control trials (t = 2.74, p = .009, dz = .44). In a subsample we controlled for executive function, alcohol use and developmental measures. Neither executive function nor alcohol use but developmental measures explained variability in the effect of episodic future thinking. These findings reveal that episodic future thinking can improve adolescent decision making while the effect is to some degree modulated by developmental measures.

Applying Behavioral Economics to Public Health Policy: Illustrative Examples and Promising Directions.

PubMed

Matjasko, Jennifer L; Cawley, John H; Baker-Goering, Madeleine M; Yokum, David V

2016-05-01

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Research on computer aided testing of pilot response to critical in-flight events

NASA Technical Reports Server (NTRS)

Giffin, W. C.; Rockwell, T. H.; Smith, P. J.

1984-01-01

Experiments on pilot decision making are described. The development of models of pilot decision making in critical in flight events (CIFE) are emphasized. The following tests are reported on the development of: (1) a frame system representation describing how pilots use their knowledge in a fault diagnosis task; (2) assessment of script norms, distance measures, and Markov models developed from computer aided testing (CAT) data; and (3) performance ranking of subject data. It is demonstrated that interactive computer aided testing either by touch CRT's or personal computers is a useful research and training device for measuring pilot information management in diagnosing system failures in simulated flight situations. Performance is dictated by knowledge of aircraft sybsystems, initial pilot structuring of the failure symptoms and efficient testing of plausible causal hypotheses.

Clinical overview: a framework for analysis.

PubMed

Bossen, Claus; Jensen, Lotte G

2013-01-01

In this presentation, we investigate concepts and theories for analysing how healthcare professionals achieve overview of patient cases. By 'overview' we mean the situation in which a healthcare professional with sufficient certainty and in concrete situations knows how to proceed based on available information upon a patient. Achieving overview is central for the efficient and safe use of healthcare IT systems, and for the realization of the potential improvements of healthcare that are behind investments in such systems. We focus on the theories of decision-making, sensemaking, narratives, ethnomethodology and distributed cognition. Whereas decision-making theory tend to be sequential and normative, we find the concept of 'functional deployment' in sensemaking theory, 'emplotment' in narrative theory, the focus on 'members' methods' in ethnomethodology and the inclusion of 'computational artifacts' in distributed cognition helpful.

Supply chain optimization for pediatric perioperative departments.

PubMed

Davis, Janice L; Doyle, Robert

2011-09-01

Economic challenges compel pediatric perioperative departments to reduce nonlabor supply costs while maintaining the quality of patient care. Optimization of the supply chain introduces a framework for decision making that drives fiscally responsible decisions. The cost-effective supply chain is driven by implementing a value analysis process for product selection, being mindful of product sourcing decisions to reduce supply expense, creating logistical efficiency that will eliminate redundant processes, and managing inventory to ensure product availability. The value analysis approach is an analytical methodology for product selection that involves product evaluation and recommendation based on consideration of clinical benefit, overall financial impact, and revenue implications. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

PubMed Central

Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

2016-01-01

Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

What Is a "Good" Treatment Decision? Decisional Control, Knowledge, Treatment Decision Making, and Quality of Life in Men with Clinically Localized Prostate Cancer.

PubMed

Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J; Homish, D Lynn

2016-08-01

We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision-making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision making is an advantageous model for studying patient treatment decision-making dynamics because there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Men with newly diagnosed clinically localized prostate cancer (N = 1529) completed measures of decisional control, prostate cancer knowledge, and decision-making experiences (decisional conflict and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed at 6 months after treatment. More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control, predicted better QOL 6 months after treatment. Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time that they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. © The Author(s) 2016.

Involving the public in spatial decision making using Internet GIS

NASA Astrophysics Data System (ADS)

Liu, Zhengrong; Sheng, Grant; Wang, Lei

2006-10-01

Public participation is an integral part of legislation or decision making processes. Traditionally, public participation took place through face-to-face encounters such as public meetings and other fora. However, some important factors limiting the efficiency and effectiveness of this mode of public participation include: geographic separation of participants, scheduling and financial constraints in attending meetings, and limited duration of meetings. These led to the awareness that public participation requires new methods in order to achieve a better democratic decision making. On the other hand, GIS has in the past been accused of being an elitist technology, giving more power to those people already possessing it and depriving those, namely the general public, who more often lack such direct forms of information access. Public participation GIS (PPGIS) is emerging as a distinct subset of two previously separate activities: technology-based spatial analysis and participatory democracy. The paper considers both traditional methods and Internet-based technologies of public participation and argues that new Internet-based technologies have the potential to widen participation by using online spatial decision support systems. GIS and the Internet can be used together to provide the general public with a powerful mechanism for becoming more involved in decision problems. Provision of full access to spatial and non-spatial data, along with the appropriate tools with which to use it, may greatly empower the general public. PPGIS focuses on engaging the public to participate and become involved in a particular subject of interest. It empowers GIS users from all walks of life and enabling them to use the technology purposefully to capture their local knowledge and advance their goals. In the project of public participatory Ontario nuclear waste siting, we focused on developing an Internet based PPGIS prototype to help the public to participate online from inception to the final phase of site decision-making. It shows that in certain siting problems and policy formulation processes, participatory online systems are a useful means of implementing public participation through informing and engaging the public to participate in spatial decision making. Web based PPGIS can involve more participants and higher degree of participation among experts, officials and the pblic than traditional means.

Tuning the speed-accuracy trade-off to maximize reward rate in multisensory decision-making.

PubMed

Drugowitsch, Jan; DeAngelis, Gregory C; Angelaki, Dora E; Pouget, Alexandre

2015-06-19

For decisions made under time pressure, effective decision making based on uncertain or ambiguous evidence requires efficient accumulation of evidence over time, as well as appropriately balancing speed and accuracy, known as the speed/accuracy trade-off. For simple unimodal stimuli, previous studies have shown that human subjects set their speed/accuracy trade-off to maximize reward rate. We extend this analysis to situations in which information is provided by multiple sensory modalities. Analyzing previously collected data (Drugowitsch et al., 2014), we show that human subjects adjust their speed/accuracy trade-off to produce near-optimal reward rates. This trade-off can change rapidly across trials according to the sensory modalities involved, suggesting that it is represented by neural population codes rather than implemented by slow neuronal mechanisms such as gradual changes in synaptic weights. Furthermore, we show that deviations from the optimal speed/accuracy trade-off can be explained by assuming an incomplete gradient-based learning of these trade-offs.

Linguistic hesitant fuzzy multi-criteria decision-making method based on evidential reasoning

NASA Astrophysics Data System (ADS)

Zhou, Huan; Wang, Jian-qiang; Zhang, Hong-yu; Chen, Xiao-hong

2016-01-01

Linguistic hesitant fuzzy sets (LHFSs), which can be used to represent decision-makers' qualitative preferences as well as reflect their hesitancy and inconsistency, have attracted a great deal of attention due to their flexibility and efficiency. This paper focuses on a multi-criteria decision-making approach that combines LHFSs with the evidential reasoning (ER) method. After reviewing existing studies of LHFSs, a new order relationship and Hamming distance between LHFSs are introduced and some linguistic scale functions are applied. Then, the ER algorithm is used to aggregate the distributed assessment of each alternative. Subsequently, the set of aggregated alternatives on criteria are further aggregated to get the overall value of each alternative. Furthermore, a nonlinear programming model is developed and genetic algorithms are used to obtain the optimal weights of the criteria. Finally, two illustrative examples are provided to show the feasibility and usability of the method, and comparison analysis with the existing method is made.

Selecting a provider: what factors influence patients' decision making?

PubMed

Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

2011-01-01

Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

Bridging groundwater models and decision support with a Bayesian network

USGS Publications Warehouse

Fienen, Michael N.; Masterson, John P.; Plant, Nathaniel G.; Gutierrez, Benjamin T.; Thieler, E. Robert

2013-01-01

Resource managers need to make decisions to plan for future environmental conditions, particularly sea level rise, in the face of substantial uncertainty. Many interacting processes factor in to the decisions they face. Advances in process models and the quantification of uncertainty have made models a valuable tool for this purpose. Long-simulation runtimes and, often, numerical instability make linking process models impractical in many cases. A method for emulating the important connections between model input and forecasts, while propagating uncertainty, has the potential to provide a bridge between complicated numerical process models and the efficiency and stability needed for decision making. We explore this using a Bayesian network (BN) to emulate a groundwater flow model. We expand on previous approaches to validating a BN by calculating forecasting skill using cross validation of a groundwater model of Assateague Island in Virginia and Maryland, USA. This BN emulation was shown to capture the important groundwater-flow characteristics and uncertainty of the groundwater system because of its connection to island morphology and sea level. Forecast power metrics associated with the validation of multiple alternative BN designs guided the selection of an optimal level of BN complexity. Assateague island is an ideal test case for exploring a forecasting tool based on current conditions because the unique hydrogeomorphological variability of the island includes a range of settings indicative of past, current, and future conditions. The resulting BN is a valuable tool for exploring the response of groundwater conditions to sea level rise in decision support.

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

One Way of Thinking About Decision Making.

ERIC Educational Resources Information Center

Dalis, Gus T.; Strasser, Ben B.

The authors present the DALSTRA model of decision making, a descriptive statement of ways individuals or groups respond to different kinds of decision-making problems they encounter. Decision making is viewed in two phases: the decision-making antecedents (whether to decide, how to decide) and the modes of decision making (Chance/Impulse,…

Strategic Decision Making Paradigms: A Primer for Senior Leaders

DTIC Science & Technology

2009-07-01

decision making . STRATEGIC DECISION MAKING Strategic Change: There are several strategic...influenced by stakeholders outside of the organization. The Ontology of Strategic Decision Making . Strategic decisions are non-routine and involve...Coates USAWC, July 2009 5 The Complexity of Strategic Decision Making Strategic decisions entail “ill-structured,”6 “messy” or

Operational Characteristics Identification and Simulation Model Verification for Incheon International Airport

NASA Technical Reports Server (NTRS)

Eun, Yeonju; Jeon, Daekeun; Lee, Hanbong; Zhu, Zhifan; Jung, Yoon C.; Jeong, Myeongsook; Kim, Hyounkyong; Oh, Eunmi; Hong, Sungkwon; Lee, Junwon

2016-01-01

Incheon International Airport (ICN) is one of the hub airports in East Asia. Airport operations at ICN have been growing more than 5% per year in the past five years. According to the current airport expansion plan, a new passenger terminal will be added and the current cargo ramp will be expanded in 2018. This expansion project will bring 77 new stands without adding a new runway to the airport. Due to such continuous growth in airport operations and future expansion of the ramps, it will be highly likely that airport surface traffic will experience more congestion, and therefore, suffer from efficiency degradation. There is a growing awareness in aviation research community of need for strategic and tactical surface scheduling capabilities for efficient airport surface operations. Specific to ICN airport operations, a need for A-CDM (Airport - Collaborative Decision Making) or S-CDM(Surface - Collaborative Decision Making), and controller decision support tools for efficient air traffic management has arisen since several years ago. In the United States, there has been independent research efforts made by academia, industry, and government research organizations to enhance efficiency and predictability of surface operations at busy airports. Among these research activities, the Spot and Runway Departure Advisor (SARDA) developed and tested by National Aeronautics and Space Administration (NASA) is a decision support tool to provide tactical advisories to the controllers for efficient surface operations. The effectiveness of SARDA concept, was successfully verified through the human-in-the-loop (HITL) simulations for both spot release and runway operations advisories for ATC Tower controllers of Dallas/Fort Worth International Airport (DFW) in 2010 and 2012, and gate pushback advisories for the ramp controller of Charlotte/Douglas International Airport (CLT) in 2014. The SARDA concept for tactical surface scheduling is further enhanced and is being integrated into NASA's Airspace Technology Demonstration - 2 (ATD-2) project for technology demonstration of Integrated Arrival/Departure/Surface (ADS) operations at CLT. This study is a part of the international research collaboration between KAIA (Korea Agency for Infrastructure Technology Advancement)/KARI (Korea Aerospace Research Institute) and NASA, which is being conducted to validate the effectiveness of SARDA concept as a controller decision support tool for departure and surface management of ICN. This paper presents the preliminary results of the collaboration effort. It includes investigation of the operational environment of ICN, data analysis for identification of the operational characteristics of the airport, construction and verification of airport simulation model using Surface Operations Simulator and Scheduler (SOSS), NASA's fast-time simulation tool.

Operational Characteristics Identification and Simulation Model Verification for Incheon International Airport

NASA Technical Reports Server (NTRS)

Eun, Yeonju; Jeon, Daekeun; Lee, Hanbong; Zhu, Zhifan; Jung, Yoon C.; Jeong, Myeongsook; Kim, Hyounkyong; Oh, Eunmi; Hong, Sungkwon; Lee, Junwon

2016-01-01

Incheon International Airport (ICN) is one of the hub airports in East Asia. Airport operations at ICN have been growing more than 5 percent per year in the past five years. According to the current airport expansion plan, a new passenger terminal will be added and the current cargo ramp will be expanded in 2018. This expansion project will bring 77 new stands without adding a new runway to the airport. Due to such continuous growth in airport operations and future expansion of the ramps, it will be highly likely that airport surface traffic will experience more congestion, and therefore, suffer from efficiency degradation. There is a growing awareness in aviation research community of need for strategic and tactical surface scheduling capabilities for efficient airport surface operations. Specific to ICN airport operations, a need for A-CDM (Airport - Collaborative Decision Making) or S-CDM (Surface - Collaborative Decision Making), and controller decision support tools for efficient air traffic management has arisen since several years ago. In the United States, there has been independent research efforts made by academia, industry, and government research organizations to enhance efficiency and predictability of surface operations at busy airports. Among these research activities, the Spot and Runway Departure Advisor (SARDA) developed and tested by National Aeronautics and Space Administration (NASA) is a decision support tool to provide tactical advisories to the controllers for efficient surface operations. The effectiveness of SARDA concept, was successfully verified through the human-in-the-loop (HITL) simulations for both spot release and runway operations advisories for ATC Tower controllers of Dallas-Fort Worth International Airport (DFW) in 2010 and 2012, and gate pushback advisories for the ramp controller of Charlotte-Douglas International Airport (CLT) in 2014. The SARDA concept for tactical surface scheduling is further enhanced and is being integrated into NASA's Airspace Technology Demonstration-2 (ATD-2) project for technology demonstration of Integrated Arrival-Departure-Surface (IADS) operations at CLT. This study is a part of the international research collaboration between KAIA (Korea Agency for Infrastructure Technology Advancement), KARI (Korea Aerospace Research Institute) and NASA, which is being conducted to validate the effectiveness of SARDA concept as a controller decision support tool for departure and surface management of ICN. This paper presents the preliminary results of the collaboration effort. It includes investigation of the operational environment of ICN, data analysis for identification of the operational characteristics of the airport, construction and verification of airport simulation model using Surface Operations Simulator and Scheduler (SOSS), NASA's fast-time simulation tool.

Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-10-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

Shared Decision Making in ICUs: An American College of Critical Care Medicine and American Thoracic Society Policy Statement.

PubMed

Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B

2016-01-01

Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Patient and surrogate preferences for decision-making roles regarding value-laden choices range from preferring to exercise significant authority to ceding such authority to providers. Clinicians should adapt the decision-making model to the needs and preferences of the patient or surrogate.

Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

PubMed

Dhukaram, Anandhi Vivekanandan; Baber, Chris

2015-06-01

Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Application of a web-based Decision Support System in risk management

NASA Astrophysics Data System (ADS)

Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2013-04-01

Increasingly, risk information is widely available with the help of advanced technologies such as earth observation satellites, global positioning technologies, coupled with hazard modeling and analysis, and geographical information systems (GIS). Even though it exists, no effort will be put into action if it is not properly presented to the decision makers. These information need to be communicated clearly and show its usefulness so that people can make better informed decision. Therefore, communicating available risk information has become an important challenge and decision support systems have been one of the significant approaches which can help not only in presenting risk information to the decision makers but also in making efficient decisions while reducing human resources and time needed. In this study, the conceptual framework of an internet-based decision support system is presented to highlight its importance role in risk management framework and how it can be applied in case study areas chosen. The main purpose of the proposed system is to facilitate the available risk information in risk reduction by taking into account of the changes in climate, land use and socio-economic along with the risk scenarios. It allows the users to formulate, compare and select risk reduction scenarios (mainly for floods and landslides) through an enhanced participatory platform with diverse stakeholders' involvement in the decision making process. It is based on the three-tier (client-server) architecture which integrates web-GIS plus DSS functionalities together with cost benefit analysis and other supporting tools. Embedding web-GIS provides its end users to make better planning and informed decisions referenced to a geographical location, which is the one of the essential factors in disaster risk reduction programs. Different risk reduction measures of a specific area (local scale) will be evaluated using this web-GIS tool, available risk scenarios obtained from Probabilistic Risk Assessment (PRA) model and the knowledge collected from experts. The visualization of the risk reduction scenarios can also be shared among the users on the web to support the on-line participatory process. In addition, cost-benefit ratios of the different risk reduction scenarios can be prepared in order to serve as inputs for high-level decision makers. The most appropriate risk reduction scenarios will be chosen using Multi-Criteria Evaluation (MCE) method by weighting different parameters according to the preferences and criteria defined by the users. The role of public participation has been changing from one-way communication between authorities, experts, stakeholders and citizens towards more intensive two-way interaction. Involving the affected public and interest groups can enhance the level of legitimacy, transparency, and confidence in the decision making process. Due to its important part in decision making, online participatory tool is included in the DSS in order to allow the involved stakeholders interactively in risk reduction and be aware of the existing vulnerability conditions of the community. Moreover, it aims to achieve a more transparent and better informed decision-making process. The system is under in progress and the first tools implemented will be presented showing the wide possibilities of new web technologies which can have a great impact on the decision making process. It will be applied in four pilot areas in Europe: French Alps, North Eastern Italy, Romania and Poland. Nevertheless, the framework will be designed and implemented in a way to be applicable in any other regions.

Intelligent Soft Computing on Forex: Exchange Rates Forecasting with Hybrid Radial Basis Neural Network

PubMed Central

Marcek, Dusan; Durisova, Maria

2016-01-01

This paper deals with application of quantitative soft computing prediction models into financial area as reliable and accurate prediction models can be very helpful in management decision-making process. The authors suggest a new hybrid neural network which is a combination of the standard RBF neural network, a genetic algorithm, and a moving average. The moving average is supposed to enhance the outputs of the network using the error part of the original neural network. Authors test the suggested model on high-frequency time series data of USD/CAD and examine the ability to forecast exchange rate values for the horizon of one day. To determine the forecasting efficiency, they perform a comparative statistical out-of-sample analysis of the tested model with autoregressive models and the standard neural network. They also incorporate genetic algorithm as an optimizing technique for adapting parameters of ANN which is then compared with standard backpropagation and backpropagation combined with K-means clustering algorithm. Finally, the authors find out that their suggested hybrid neural network is able to produce more accurate forecasts than the standard models and can be helpful in eliminating the risk of making the bad decision in decision-making process. PMID:26977450

Intelligent Soft Computing on Forex: Exchange Rates Forecasting with Hybrid Radial Basis Neural Network.

PubMed

Falat, Lukas; Marcek, Dusan; Durisova, Maria

2016-01-01

This paper deals with application of quantitative soft computing prediction models into financial area as reliable and accurate prediction models can be very helpful in management decision-making process. The authors suggest a new hybrid neural network which is a combination of the standard RBF neural network, a genetic algorithm, and a moving average. The moving average is supposed to enhance the outputs of the network using the error part of the original neural network. Authors test the suggested model on high-frequency time series data of USD/CAD and examine the ability to forecast exchange rate values for the horizon of one day. To determine the forecasting efficiency, they perform a comparative statistical out-of-sample analysis of the tested model with autoregressive models and the standard neural network. They also incorporate genetic algorithm as an optimizing technique for adapting parameters of ANN which is then compared with standard backpropagation and backpropagation combined with K-means clustering algorithm. Finally, the authors find out that their suggested hybrid neural network is able to produce more accurate forecasts than the standard models and can be helpful in eliminating the risk of making the bad decision in decision-making process.

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework

PubMed Central

Teeguarden, Justin. G.; Tan, Yu-Mei; Edwards, Stephen W.; Leonard, Jeremy A.; Anderson, Kim A.; Corley, Richard A.; Harding, Anna K; Kile, Molly L.; Simonich, Staci M; Stone, David; Tanguay, Robert L.; Waters, Katrina M.; Harper, Stacey L.; Williams, David E.

2016-01-01

Synopsis Driven by major scientific advances in analytical methods, biomonitoring, computational tools, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the “systems approaches” used in the biological sciences is a necessary step in this evolution. Here we propose the Aggregate Exposure Pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the Adverse Outcome Pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more efficient integration of exposure assessment and hazard identification. Together, the two pathways form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making. PMID:26759916

Robust Decision Making to Support Water Quality Climate Adaptation: a Case Study in the Chesapeake Bay Watershed

NASA Astrophysics Data System (ADS)

Fischbach, J. R.; Lempert, R. J.; Molina-Perez, E.

2017-12-01

The U.S. Environmental Protection Agency (USEPA), together with state and local partners, develops watershed implementation plans designed to meet water quality standards. Climate uncertainty, along with uncertainty about future land use changes or the performance of water quality best management practices (BMPs), may make it difficult for these implementation plans to meet water quality goals. In this effort, we explored how decision making under deep uncertainty (DMDU) methods such as Robust Decision Making (RDM) could help USEPA and its partners develop implementation plans that are more robust to future uncertainty. The study focuses on one part of the Chesapeake Bay watershed, the Patuxent River, which is 2,479 sq km in area, highly urbanized, and has a rapidly growing population. We simulated the contribution of stormwater contaminants from the Patuxent to the overall Total Maximum Daily Load (TMDL) for the Chesapeake Bay under multiple scenarios reflecting climate and other uncertainties. Contaminants considered included nitrogen, phosphorus, and sediment loads. The assessment included a large set of scenario simulations using the USEPA Chesapeake Bay Program's Phase V watershed model. Uncertainties represented in the analysis included 18 downscaled climate projections (based on 6 general circulation models and 3 emissions pathways), 12 land use scenarios with different population projections and development patterns, and alternative assumptions about BMP performance standards and efficiencies associated with different suites of stormwater BMPs. Finally, we developed cost estimates for each of the performance standards and compared cost to TMDL performance as a key tradeoff for future water quality management decisions. In this talk, we describe how this research can help inform climate-related decision support at USEPA's Chesapeake Bay Program, and more generally how RDM and other DMDU methods can support improved water quality management under climate uncertainty.

Physician efficiency and reimbursement: a case study.

PubMed

Cantrell, L E; Flick, J A

1986-01-01

Joint ventures between hospitals and doctors are being widely developed and reported as the most promising mechanism for building alliances, providing financial rewards, and accessing new markets. However, joint ventures cannot be structured to involve an entire medical staff directly. Likewise, they cannot motivate a medical staff to change medical practice patterns in order to improve a hospital's reimbursement efficiency. This article describes a system of physician economic efficiency criteria that is being used by one hospital in making medical staff reappointment decisions and has the effect of placing all physicians at risk individually for the hospital's reimbursement performance. Although somewhat controversial, this economic efficiency program has proven a remarkably effective tool for change.

Smart Manufacturing Technologies and Data Analytics for Improving Energy Efficiency in Industrial Energy Systems

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

Nimbalkar, Sachin U.; Guo, Wei; Wenning, Thomas J.

Smart manufacturing and advanced data analytics can help the manufacturing sector unlock energy efficiency from the equipment level to the entire manufacturing facility and the whole supply chain. These technologies can make manufacturing industries more competitive, with intelligent communication systems, real-time energy savings, and increased energy productivity. Smart manufacturing can give all employees in an organization the actionable information they need, when they need it, so that each person can contribute to the optimal operation of the corporation through informed, data-driven decision making. This paper examines smart technologies and data analytics approaches for improving energy efficiency and reducing energy costsmore » in process-supporting energy systems. It dives into energy-saving improvement opportunities through smart manufacturing technologies and sophisticated data collection and analysis. The energy systems covered in this paper include those with motors and drives, fans, pumps, air compressors, steam, and process heating.« less

Evaluating the decision accuracy and speed of clinical data visualizations.

PubMed

Pieczkiewicz, David S; Finkelstein, Stanley M

2010-01-01

Clinicians face an increasing volume of biomedical data. Assessing the efficacy of systems that enable accurate and timely clinical decision making merits corresponding attention. This paper discusses the multiple-reader multiple-case (MRMC) experimental design and linear mixed models as means of assessing and comparing decision accuracy and latency (time) for decision tasks in which clinician readers must interpret visual displays of data. These tools can assess and compare decision accuracy and latency (time). These experimental and statistical techniques, used extensively in radiology imaging studies, offer a number of practical and analytic advantages over more traditional quantitative methods such as percent-correct measurements and ANOVAs, and are recommended for their statistical efficiency and generalizability. An example analysis using readily available, free, and commercial statistical software is provided as an appendix. While these techniques are not appropriate for all evaluation questions, they can provide a valuable addition to the evaluative toolkit of medical informatics research.

Decision-making in Swiss home-like childbirth: A grounded theory study.

PubMed

Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

2017-12-01

Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Shared decision-making - Rhetoric and reality: Women's experiences and perceptions of adjuvant treatment decision-making for breast cancer.

PubMed

Mahmoodi, Neda; Sargeant, Sally

2017-01-01

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.

Energy and Man's Environment Activity Guide: An Interdisciplinary Teacher's Guide to Energy and Environmental Activities, Section Three - Conversion of Energy.

ERIC Educational Resources Information Center

Jones, John, Ed.

This publication presents the activities pertaining to the third goal of this activity guide series. The activities in this publication focus on understanding conservation processes, efficiencies, socioeconomic costs, and personal decision-making. These materials are appropriate for middle school and junior high school students. These activities,…

Analyzing the Cost Efficiency of Academic Departments and Instructional Personnel at State Universities.

ERIC Educational Resources Information Center

Norris, Robert G.

A cost-effectiveness model is presented for academic administrators to use in making evaluation and planning decisions related directly to the instructional activities of academic departments. The advantages seen in the model are that it is simple and flexible, concentrates on balancing income generated by the department to expenses incurred, and…

The Impact of Size and Specialisation on Universities' Department Performance: A DEA Analysis Applied to Austrian Universities

ERIC Educational Resources Information Center

Leitner, Karl-Heinz; Prikoszovits, Julia; Schaffhauser-Linzatti, Michaela; Stowasser, Rainer; Wagner, Karin

2007-01-01

This paper explores the performance efficiency of natural and technical science departments at Austrian universities using Data Envelopment Analysis (DEA). We present DEA as an alternative tool for benchmarking and ranking the assignment of decision-making units (organisations and organisational units). The method applies a multiple input and…

Improving Decision Making in Schools through Teacher Participation

ERIC Educational Resources Information Center

Mualuko, Ndiku J.; Mukasa, Simiyu A.; Achoka, Judy S. K.

2009-01-01

The hierarchical structure that places head teachers at the apex of a pyramid of staff is a common feature in secondary schools in Kenya. In this arrangement, school heads are poised to use their superior knowledge and experience to direct and control the working of the entire school. This negatively affects efficiency and productivity of the…

Enhancing Continuity of Care Using an Emergency Medical Card and a Continuity of Care Report

ERIC Educational Resources Information Center

Olola, Christopher Hillary Opiyo

2010-01-01

Discontinuity of care due to poor communication of patient health information among healthcare providers (HCPs) is a major efficiency and patient safety concern. Patients often see multiple HCPs and during each visit, the patient's core health information is required for appropriate decision making. Patients with access to their electronic medical…

Allocation of Public Resources for Psychological Therapy between Types of Mental Health Condition: Towards Structural Balance

ERIC Educational Resources Information Center

Tustin, Don

2009-01-01

This paper addresses issues of allocating public resources efficiently between mental health conditions that are associated with different levels of disability, and presents an adaptation of an established framework to help decision-making in this area. The adapted framework refers to psychological interventions that are universal, indicated,…

Innovative and Alternative Technologies. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.

ERIC Educational Resources Information Center

Cole, Charles A.

Innovative and alternative methods of wastewater treatment can improve the efficiency and lower the cost of waste treatment procedures. Described in this instructor's guide is a one-hour learning session for citizens interested in improving water quality planning and decision making. Among the topics covered are the need for alternative wastewater…

Relationship Between Forage Allowance and Grazing Efficiency in the Great Plains: Implications for Managing Rangelands for Both Livestock Production and Desired Ecosystem Goods and Services

USDA-ARS?s Scientific Manuscript database

Emergence of desired ecosystem goods and services from rangelands as a societal benefit and a potential income source for land managers has implications regarding the management of plant communities traditionally used primarily for livestock production. Contemporary decision-making on rangelands in ...

Testing the Efficiency of Markov Chain Monte Carlo with People Using Facial Affect Categories

ERIC Educational Resources Information Center

Martin, Jay B.; Griffiths, Thomas L.; Sanborn, Adam N.

2012-01-01

Exploring how people represent natural categories is a key step toward developing a better understanding of how people learn, form memories, and make decisions. Much research on categorization has focused on artificial categories that are created in the laboratory, since studying natural categories defined on high-dimensional stimuli such as…

Efficiency vs. Effectiveness: Can W. Edwards Deming's Principles of Quality Management Be Applied Successfully to American Education.

ERIC Educational Resources Information Center

Petry, John R.

The field of education has been slow to recognize the Total Quality Management (TQM) concept. This resistance may result from entrenched management styles characterized by hierarchical decision-making structures. TQM emphasizes management based on leadership instead of management by objective, command, and coercion. The TQM concept consists of…

Soil Disturbance Monitoring in the USDA Forest Service, Pacific Northwest Region

Treesearch

Steven W. Howes

2006-01-01

In order to make reasoned decisions, USDA Forest Service managers must understand how changes in specific indicators of soil quality resulting from project implementation affect long-term forest productivity and watershed health. They must also be able to efficiently and economically assess the degree and extent of such changes across specified areas and adjust...

Predicting yields from Appalachian red oak logs and lumber

Treesearch

Daniel E. Dunmire

1971-01-01

One utilization problem is in pinpointing how to efficiently and effectively recover usable parts from logs, bolts, and lumber. Yields, which are output divided by input, provide a key to managers who make processing decisions. Research results are applied to indicate yields of graded lumber and dimension stock from graded Appalachian red oak (group) logs. How to...

Junior Faculty of Color in the Corporate University: Implications of Neoliberalism and Neoconservatism on Research, Teaching and Service

ERIC Educational Resources Information Center

Osei-Kofi, Nana

2012-01-01

In higher education today, an overwhelming acceptance of neoliberal and neoconservative ideologies that advance corporate logics of efficiency, competition and profit maximization is commonplace. Market-driven logics and neoconservative ideals shape decision-making about what is taught, how material is taught, who teaches, who does research, who…

Screening Systems and Decision Making at the Preschool Level: Application of a Comprehensive Validity Framework

ERIC Educational Resources Information Center

Kettler, Ryan J.; Feeney-Kettler, Kelly A.

2011-01-01

Universal screening is designed to be an efficient method for identifying preschool students with mental health problems, but prior to use, screening systems must be evaluated to determine their appropriateness within a specific setting. In this article, an evidence-based validity framework is applied to four screening systems for identifying…

Sustainable Leadership and Future-Oriented Decision Making in the Educational Governance--A Finnish Case

ERIC Educational Resources Information Center

Metsamuuronen, Jari; Kuosa, Tuomo; Laukkanen, Reijo

2013-01-01

Purpose: During the new millennium the Finnish educational system has faced a new challenge: how to explain glorious PISA results produced with only a small variance between schools, average national costs and, as regards the average duration of studies, relatively efficiently. Explanations for this issue can be searched for in many different…

Measuring Shared Decision Making in Psychiatric Care

PubMed Central

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

2014-01-01

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

A predictive model of nuclear power plant crew decision-making and performance in a dynamic simulation environment

NASA Astrophysics Data System (ADS)

Coyne, Kevin Anthony

The safe operation of complex systems such as nuclear power plants requires close coordination between the human operators and plant systems. In order to maintain an adequate level of safety following an accident or other off-normal event, the operators often are called upon to perform complex tasks during dynamic situations with incomplete information. The safety of such complex systems can be greatly improved if the conditions that could lead operators to make poor decisions and commit erroneous actions during these situations can be predicted and mitigated. The primary goal of this research project was the development and validation of a cognitive model capable of simulating nuclear plant operator decision-making during accident conditions. Dynamic probabilistic risk assessment methods can improve the prediction of human error events by providing rich contextual information and an explicit consideration of feedback arising from man-machine interactions. The Accident Dynamics Simulator paired with the Information, Decision, and Action in a Crew context cognitive model (ADS-IDAC) shows promise for predicting situational contexts that might lead to human error events, particularly knowledge driven errors of commission. ADS-IDAC generates a discrete dynamic event tree (DDET) by applying simple branching rules that reflect variations in crew responses to plant events and system status changes. Branches can be generated to simulate slow or fast procedure execution speed, skipping of procedure steps, reliance on memorized information, activation of mental beliefs, variations in control inputs, and equipment failures. Complex operator mental models of plant behavior that guide crew actions can be represented within the ADS-IDAC mental belief framework and used to identify situational contexts that may lead to human error events. This research increased the capabilities of ADS-IDAC in several key areas. The ADS-IDAC computer code was improved to support additional branching events and provide a better representation of the IDAC cognitive model. An operator decision-making engine capable of responding to dynamic changes in situational context was implemented. The IDAC human performance model was fully integrated with a detailed nuclear plant model in order to realistically simulate plant accident scenarios. Finally, the improved ADS-IDAC model was calibrated, validated, and updated using actual nuclear plant crew performance data. This research led to the following general conclusions: (1) A relatively small number of branching rules are capable of efficiently capturing a wide spectrum of crew-to-crew variabilities. (2) Compared to traditional static risk assessment methods, ADS-IDAC can provide a more realistic and integrated assessment of human error events by directly determining the effect of operator behaviors on plant thermal hydraulic parameters. (3) The ADS-IDAC approach provides an efficient framework for capturing actual operator performance data such as timing of operator actions, mental models, and decision-making activities.

Interpretable Decision Sets: A Joint Framework for Description and Prediction

PubMed Central

Lakkaraju, Himabindu; Bach, Stephen H.; Jure, Leskovec

2016-01-01

One of the most important obstacles to deploying predictive models is the fact that humans do not understand and trust them. Knowing which variables are important in a model’s prediction and how they are combined can be very powerful in helping people understand and trust automatic decision making systems. Here we propose interpretable decision sets, a framework for building predictive models that are highly accurate, yet also highly interpretable. Decision sets are sets of independent if-then rules. Because each rule can be applied independently, decision sets are simple, concise, and easily interpretable. We formalize decision set learning through an objective function that simultaneously optimizes accuracy and interpretability of the rules. In particular, our approach learns short, accurate, and non-overlapping rules that cover the whole feature space and pay attention to small but important classes. Moreover, we prove that our objective is a non-monotone submodular function, which we efficiently optimize to find a near-optimal set of rules. Experiments show that interpretable decision sets are as accurate at classification as state-of-the-art machine learning techniques. They are also three times smaller on average than rule-based models learned by other methods. Finally, results of a user study show that people are able to answer multiple-choice questions about the decision boundaries of interpretable decision sets and write descriptions of classes based on them faster and more accurately than with other rule-based models that were designed for interpretability. Overall, our framework provides a new approach to interpretable machine learning that balances accuracy, interpretability, and computational efficiency. PMID:27853627

Decision Making In A High-Tech World: Automation Bias and Countermeasures

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.; Skitka, Linda J.; Burdick, Mark R.; Heers, Susan T.; Rosekind, Mark R. (Technical Monitor)

1996-01-01

Automated decision aids and decision support systems have become essential tools in many high-tech environments. In aviation, for example, flight management systems computers not only fly the aircraft, but also calculate fuel efficient paths, detect and diagnose system malfunctions and abnormalities, and recommend or carry out decisions. Air Traffic Controllers will soon be utilizing decision support tools to help them predict and detect potential conflicts and to generate clearances. Other fields as disparate as nuclear power plants and medical diagnostics are similarly becoming more and more automated. Ideally, the combination of human decision maker and automated decision aid should result in a high-performing team, maximizing the advantages of additional cognitive and observational power in the decision-making process. In reality, however, the presence of these aids often short-circuits the way that even very experienced decision makers have traditionally handled tasks and made decisions, and introduces opportunities for new decision heuristics and biases. Results of recent research investigating the use of automated aids have indicated the presence of automation bias, that is, errors made when decision makers rely on automated cues as a heuristic replacement for vigilant information seeking and processing. Automation commission errors, i.e., errors made when decision makers inappropriately follow an automated directive, or automation omission errors, i.e., errors made when humans fail to take action or notice a problem because an automated aid fails to inform them, can result from this tendency. Evidence of the tendency to make automation-related omission and commission errors has been found in pilot self reports, in studies using pilots in flight simulations, and in non-flight decision making contexts with student samples. Considerable research has found that increasing social accountability can successfully ameliorate a broad array of cognitive biases and resultant errors. To what extent these effects generalize to performance situations is not yet empirically established. The two studies to be presented represent concurrent efforts, with student and professional pilot samples, to determine the effects of accountability pressures on automation bias and on the verification of the accurate functioning of automated aids. Students (Experiment 1) and commercial pilots (Experiment 2) performed simulated flight tasks using automated aids. In both studies, participants who perceived themselves as accountable for their strategies of interaction with the automation were significantly more likely to verify its correctness, and committed significantly fewer automation-related errors than those who did not report this perception.

Energy Saving Melting and Revert Reduction Technology: Melting Efficiency in Die Casting Operations

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

David Schwam

2012-12-15

This project addressed multiple aspects of the aluminum melting and handling in die casting operations, with the objective of increasing the energy efficiency while improving the quality of the molten metal. The efficiency of melting has always played an important role in the profitability of aluminum die casting operations. Consequently, die casters need to make careful choices in selecting and operating melting equipment and procedures. The capital cost of new melting equipment with higher efficiency can sometimes be recovered relatively fast when it replaces old melting equipment with lower efficiency. Upgrades designed to improve energy efficiency of existing equipment maymore » be well justified. Energy efficiency is however not the only factor in optimizing melting operations. Melt losses and metal quality are also very important. Selection of melting equipment has to take into consideration the specific conditions at the die casting shop such as availability of floor space, average quantity of metal used as well as the ability to supply more metal during peaks in demand. In all these cases, it is essential to make informed decisions based on the best available data.« less

Linking decision-making research and cancer prevention and control: important themes.

PubMed

McCaul, Kevin D; Peters, Ellen; Nelson, Wendy; Stefanek, Michael

2005-07-01

This article describes 6 themes underlying the multiple presentations from the Basic and Applied Decision Making in Cancer Control meeting, held February 19-20, 2004. The following themes have important implications for research and practice linking basic decision-making research to cancer prevention and control: (a) Traditional decision-making theories fail to capture real-world decision making, (b) decision makers are often unable to predict future preferences, (c) preferences are often constructed on the spot and thus are influenced by situational cues, (d) decision makers often rely on feelings rather than beliefs when making a decision, (e) the perspective of the decision maker is critical in determining preferences, and (f) informed decision making may--or may not--yield the best decisions.

Should dentistry be part of the National Health Information Infrastructure?

PubMed

Schleyer, Titus K L

2004-12-01

The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely. The author reviews the NHII and its goals and structure through published reports and background literature. The author evaluates the advantages and disadvantages of the NHII regarding their implications for the dental care system. The NHII proposes to implement computer-based patient records, or CPRs, for most Americans by 2014, connect personal health information with other clinical and public health information, and enable different types of care providers to access CPRs. Advantages of the NHII include transparency of health information across health care providers, potentially increased involvement of patients in their care, better clinical decision making through connecting patient-specific information with the best clinical evidence, increased efficiency, enhanced bioterrorism defense and potential cost savings. Challenges in the implementation of the NHII in dentistry include limited use of CPRs, required investments in information technology, limited availability and adoption of standards, and perceived threats to privacy and confidentiality. The implementation of the NHII is making rapid strides. Dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met. Practice Implications. The NHII has far-reaching implications on dental practice by making it easier to access relevant patient information and by helping to improve clinical decision making.

Volume sharing of reservoir water

NASA Astrophysics Data System (ADS)

Dudley, Norman J.

1988-05-01

Previous models optimize short-, intermediate-, and long-run irrigation decision making in a simplified river valley system characterized by highly variable water supplies and demands for a single decision maker controlling both reservoir releases and farm water use. A major problem in relaxing the assumption of one decision maker is communicating the stochastic nature of supplies and demands between reservoir and farm managers. In this paper, an optimizing model is used to develop release rules for reservoir management when all users share equally in releases, and computer simulation is used to generate an historical time sequence of announced releases. These announced releases become a state variable in a farm management model which optimizes farm area-to-irrigate decisions through time. Such modeling envisages the use of growing area climatic data by the reservoir authority to gauge water demand and the transfer of water supply data from reservoir to farm managers via computer data files. Alternative model forms, including allocating water on a priority basis, are discussed briefly. Results show lower mean aggregate farm income and lower variance of aggregate farm income than in the single decision-maker case. This short-run economic efficiency loss coupled with likely long-run economic efficiency losses due to the attenuated nature of property rights indicates the need for quite different ways of integrating reservoir and farm management.

Couples’ reports of household decision-making and the utilization of maternal health services in Bangladesh

PubMed Central

Story, William T.; Burgard, Sarah A.

2012-01-01

This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service use focus on women’s reports; however, men are often involved in these decisions as well. Recently, studies have started to explore the association between health outcomes and reports of household decision-making from both husbands and wives as matched pairs. Many studies of household decision-making emphasize the importance of the wife alone making decisions; however, some have argued that joint decision-making between husbands and wives may yield better reproductive health outcomes than women making decisions without input or agreement from their partners. Husbands’ involvement in decision-making is particularly important in Bangladesh because men often dominate household decisions related to large, health-related purchases. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and skilled delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives give concordant responses about who makes household decisions since discordant reports about who makes these decisions are negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and skilled delivery care. Finally, associations between household decision-making arrangements and health service utilization vary depending on whose report is used and the type of health service utilized. PMID:23068556

Couples' reports of household decision-making and the utilization of maternal health services in Bangladesh.

PubMed

Story, William T; Burgard, Sarah A

2012-12-01

This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service utilization focus on women's reports; however, men are often involved in these decisions as well. Recently, studies have started to explore the association between health outcomes and reports of household decision-making from both husbands and wives as matched pairs. Many studies of household decision-making emphasize the importance of the wife alone making decisions; however, some have argued that joint decision-making between husbands and wives may yield better reproductive health outcomes than women making decisions without input or agreement from their partners. Husbands' involvement in decision-making is particularly important in Bangladesh because men often dominate household decisions related to large, health-related purchases. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and skilled delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives give concordant responses about who makes household decisions since discordant reports about who makes these decisions are negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and skilled delivery care. Finally, associations between household decision-making arrangements and health service utilization vary depending on whose report is used and the type of health service utilized. Copyright © 2012 Elsevier Ltd. All rights reserved.

Shared decision-making in epilepsy management.

PubMed

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

2015-06-01

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

[Shared decision-making in medical practice--patient-centred communication skills].

PubMed

van Staveren, Remke

2011-01-01

Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

School Mapping and Geospatial Analysis of the Schools in Jasra Development Block of India

NASA Astrophysics Data System (ADS)

Agrawal, S.; Gupta, R. D.

2016-06-01

GIS is a collection of tools and techniques that works on the geospatial data and is used in the analysis and decision making. Education is an inherent part of any civil society. Proper educational facilities generate the high quality human resource for any nation. Therefore, government needs an efficient system that can help in analysing the current state of education and its progress. Government also needs a system that can support in decision making and policy framing. GIS can serve the mentioned requirements not only for government but also for the general public. In order to meet the standards of human development, it is necessary for the government and decision makers to have a close watch on the existing education policy and its implementation condition. School mapping plays an important role in this aspect. School mapping consists of building the geospatial database of schools that supports in the infrastructure development, policy analysis and decision making. The present research work is an attempt for supporting Right to Education (RTE) and Sarv Sikha Abhiyaan (SSA) programmes run by Government of India through the use of GIS. School mapping of the study area is performed which is followed by the geospatial analysis. This research work will help in assessing the present status of educational infrastructure in Jasra block of Allahabad district, India.

Site Suitability Analysis for Beekeeping via Analythical Hyrearchy Process, Konya Example

NASA Astrophysics Data System (ADS)

Sarı, F.; Ceylan, D. A.

2017-11-01

Over the past decade, the importance of the beekeeping activities has been emphasized in the field of biodiversity, ecosystems, agriculture and human health. Thus, efficient management and deciding correct beekeeping activities seems essential to maintain and improve productivity and efficiency. Due to this importance, considering the economic contributions to the rural area, the need for suitability analysis concept has been revealed. At this point, Multi Criteria Decision Analysis (MCDA) and Geographical Information Systems (GIS) integration provides efficient solutions to the complex structure of decision- making process for beekeeping activities. In this study, site suitability analysis via Analytical Hierarchy Process (AHP) was carried out for Konya city in Turkey. Slope, elevation, aspect, distance to water resources, roads and settlements, precipitation and flora criteria are included to determine suitability. The requirements, expectations and limitations of beekeeping activities are specified with the participation of experts and stakeholders. The final suitability map were validated with existing 117 beekeeping locations and Turkish Statistical Institute 2016 beekeeping statistics for Konya province.

Advancing in the Career Decision-Making Process: The Role of Coping Strategies and Career Decision-Making Profiles

ERIC Educational Resources Information Center

Perez, Maya; Gati, Itamar

2017-01-01

We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…

Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision

PubMed Central

Edwards, Adrian; Elwyn, Glyn

2006-01-01

Abstract Background  Shared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice. Aims  We undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely. Method  The study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi‐structured telephone interviews were conducted and analysed using the constant comparative method of content analysis. Results  All patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as ‘patient‐led’. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions. Conclusions  Practitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non‐alignment of patient preferences with the actual model of decision making if this occurs. PMID:17083558